TOMAS YAMADA
Dependent on policy B09M000207
Claims
3
Attributed to this person
Charged
1,625.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
51.45
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 | Dependent · relationship 01 |
| Policy | B09M000207 |
| Date of birth | 3 Oct 1949 |
| Plan | BRONZE EPO |
| Covered from | 14 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 51.45 |
| Total | 51.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000871 | 1 Jan 2026 | 343.00 | CASCADE CARE | Not denied | — |
| CLM0000870 | 17 May 2025 | 623.00 | CASCADE CARE | Not denied | — |
| CLM0000872 | 29 Apr 2025 | 659.00 | CASCADE CARE | Not denied | — |