GRACE YAMADA
Subscriber on policy B10M000058
Claims
3
Attributed to this person
Charged
2,123.00
Total submitted
Denied
616.00
1 denied claims
Patient responsibility
0.00
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 | GRACE YAMADA |
| Role on the policy | Subscriber |
| Policy | B10M000058 |
| Date of birth | 24 Dec 1991 |
| Plan | SILVER HMO |
| Covered from | 6 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000234 | 24 Oct 2025 | 729.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000232 | 20 Jun 2025 | 778.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000233 | 29 Jan 2025 | 616.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 616.00 |