TOMAS YAMADA
Dependent on policy B01M000657
Claims
3
Attributed to this person
Charged
1,104.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
60.45
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 19 |
| Policy | B01M000657 |
| Date of birth | 12 Jul 2013 |
| Plan | BRONZE EPO |
| Covered from | 8 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 60.45 |
| Total | 60.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002941 | 29 Dec 2025 | 370.00 | CASCADE CARE | Not denied | — |
| CLM0002942 | 6 Aug 2025 | 331.00 | CASCADE CARE | Not denied | — |
| CLM0002940 | 17 Jul 2025 | 403.00 | CASCADE CARE | Not denied | — |