TOMAS YAMADA
Subscriber on policy B08M000898
Claims
3
Attributed to this person
Charged
1,083.00
Total submitted
Denied
533.00
2 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 | TOMAS YAMADA |
| Role on the policy | Subscriber |
| Policy | B08M000898 |
| Date of birth | 1 Jan 1978 |
| Plan | BRONZE EPO |
| Covered from | 23 Mar 2024 |
| Covered to | 12 Jul 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0004013 | 21 Jul 2024 | 327.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 327.00 |
| CLM0004014 | 13 Jul 2024 | 550.00 | CASCADE CARE | Not denied | — |
| CLM0004012 | 1 Jul 2024 | 206.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 206.00 |