WENDY YAMADA
Dependent on policy B01M000548
Claims
1
Attributed to this person
Charged
217.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
43.40
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 | WENDY YAMADA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000548 |
| Date of birth | 29 Jun 2020 |
| Plan | GOLD PPO |
| Covered from | 11 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 43.40 |
| Total | 43.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002465 | 25 Jan 2025 | 217.00 | CASCADE CARE | Not denied | — |