YUSUF YAMADA
Dependent on policy B08M000254
Claims
3
Attributed to this person
Charged
2,037.00
Total submitted
Denied
750.00
1 denied claims
Patient responsibility
131.55
Reported on the 835
Patient responsibility is the amount reported on the 835 as assigned to the patient — deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.
Who this is
| Field | Value |
|---|---|
| Name | YUSUF YAMADA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000254 |
| Date of birth | 23 Aug 1993 |
| Plan | BRONZE EPO |
| Covered from | 6 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 131.55 |
| Total | 131.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001151 | 28 Feb 2025 | 877.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001152 | 27 May 2024 | 410.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001150 | 3 Apr 2024 | 750.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 750.00 |