HENRY YAMADA
Dependent on policy B02M000778
Claims
2
Attributed to this person
Charged
1,447.00
Total submitted
Denied
752.00
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 | HENRY YAMADA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000778 |
| Date of birth | 28 Mar 2003 |
| Plan | SILVER HMO |
| Covered from | 19 Apr 2024 |
| 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 |
|---|---|---|---|---|---|
| CLM0003247 | 20 Sep 2024 | 695.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003248 | 29 Jun 2024 | 752.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 752.00 |