KEVIN YAMADA
Dependent on policy B07M000351
Claims
3
Attributed to this person
Charged
1,233.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
40.00
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 | KEVIN YAMADA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000351 |
| Date of birth | 31 May 2002 |
| Plan | SILVER HMO |
| Covered from | 3 Jun 2024 |
| Covered to | 17 Feb 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 40.00 |
| Total | 40.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001492 | 26 Aug 2024 | 295.00 | CASCADE CARE | Not denied | — |
| CLM0001493 | 3 Aug 2024 | 170.00 | CASCADE CARE | Not denied | — |
| CLM0001491 | 6 Jun 2024 | 768.00 | CASCADE CARE | Not denied | — |