TOMAS YAMADA
Subscriber on policy B01M000080
Claims
3
Attributed to this person
Charged
1,707.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
73.95
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 | TOMAS YAMADA |
| Role on the policy | Subscriber |
| Policy | B01M000080 |
| Date of birth | 4 Dec 2003 |
| Plan | GOLD PPO |
| Covered from | 18 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 73.95 |
| Total | 73.95 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000324 | 21 Feb 2026 | 388.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000325 | 15 Mar 2025 | 826.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000326 | 5 Nov 2024 | 493.00 | NORTHSTAR MUTUAL | Not denied | — |