AMARA YAMADA
Dependent on policy B07M000090
Claims
3
Attributed to this person
Charged
2,072.00
Total submitted
Denied
162.90
1 denied claims
Patient responsibility
15.00
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 | AMARA YAMADA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000090 |
| Date of birth | 1 Aug 1999 |
| Plan | GOLD PPO |
| Covered from | 17 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 15.00 |
| Total | 15.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000378 | 5 Aug 2026 | 881.00 | CASCADE CARE | Not denied | — |
| CLM0000379 | 26 Oct 2025 | 521.00 | CASCADE CARE | Not denied | — |
| CLM0000377 | 3 Aug 2025 | 670.00 | CASCADE CARE | CARC 109 · COB | 162.90 |