VICTOR YAMADA
Dependent on policy B05M000065
Claims
1
Attributed to this person
Charged
270.00
Total submitted
Denied
270.00
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 | VICTOR YAMADA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000065 |
| Date of birth | 1 Dec 1992 |
| Plan | SILVER HMO |
| Covered from | 9 Jan 2025 |
| Covered to | 31 Oct 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000311 | 24 Jan 2025 | 270.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 270.00 |