HENRY YAMADA
Dependent on policy B02M000417
Claims
1
Attributed to this person
Charged
574.00
Total submitted
Denied
254.48
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 | HENRY YAMADA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000417 |
| Date of birth | 21 May 1979 |
| Plan | BRONZE EPO |
| Covered from | 6 Jan 2024 |
| Covered to | 14 Mar 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001782 | 8 Mar 2024 | 574.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 254.48 |