FIONA YAMADA
Subscriber on policy B07M000487
Claims
3
Attributed to this person
Charged
1,513.00
Total submitted
Denied
276.00
1 denied claims
Patient responsibility
120.15
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 | FIONA YAMADA |
| Role on the policy | Subscriber |
| Policy | B07M000487 |
| Date of birth | 21 Jul 1966 |
| Plan | GOLD PPO |
| Covered from | 22 May 2025 |
| Covered to | 2 Sep 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 120.15 |
| Total | 120.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002075 | 27 Sep 2025 | 276.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 276.00 |
| CLM0002077 | 20 Jul 2025 | 436.00 | CASCADE CARE | Not denied | — |
| CLM0002076 | 28 May 2025 | 801.00 | CASCADE CARE | Not denied | — |