AMARA YAMADA
Subscriber on policy B10M000196
Claims
2
Attributed to this person
Charged
1,169.00
Total submitted
Denied
252.37
1 denied claims
Patient responsibility
78.90
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 | AMARA YAMADA |
| Role on the policy | Subscriber |
| Policy | B10M000196 |
| Date of birth | 4 Jul 1961 |
| Plan | BRONZE EPO |
| Covered from | 30 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 78.90 |
| Total | 78.90 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000808 | 5 Apr 2026 | 526.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000809 | 24 Oct 2025 | 643.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 252.37 |