IVAN YAMADA
Subscriber on policy B03M000717
Claims
3
Attributed to this person
Charged
1,526.00
Total submitted
Denied
474.00
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 | IVAN YAMADA |
| Role on the policy | Subscriber |
| Policy | B03M000717 |
| Date of birth | 21 Jun 1961 |
| Plan | SILVER HMO |
| Covered from | 19 Jan 2024 |
| Covered to | 15 Jun 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 |
|---|---|---|---|---|---|
| CLM0002990 | 29 Mar 2024 | 611.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002992 | 9 Feb 2024 | 441.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002991 | 9 Jan 2024 | 474.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 474.00 |