NADIA YAMADA
Subscriber on policy B03M000559
Claims
1
Attributed to this person
Charged
587.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
381.55
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 | NADIA YAMADA |
| Role on the policy | Subscriber |
| Policy | B03M000559 |
| Date of birth | 18 Oct 1977 |
| Plan | BRONZE EPO |
| Covered from | 22 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 381.55 |
| Total | 381.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002282 | 2 Jun 2025 | 587.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 0.00 |