KEVIN YAMADA
Subscriber on policy B09M000207
Claims
3
Attributed to this person
Charged
804.00
Total submitted
Denied
190.14
3 denied claims
Patient responsibility
284.70
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 | Subscriber |
| Policy | B09M000207 |
| Date of birth | 28 Nov 1956 |
| Plan | BRONZE EPO |
| Covered from | 14 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 284.70 |
| Total | 284.70 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000868 | 3 Mar 2025 | 79.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 79.00 |
| CLM0000867 | 27 Dec 2024 | 438.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0000869 | 18 Jun 2024 | 287.00 | CASCADE CARE | CARC 11 · CODING | 111.14 |