TOMAS YAMADA
Dependent on policy B10M000864
Claims
1
Attributed to this person
Charged
576.00
Total submitted
Denied
576.00
1 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 | Dependent · relationship 01 |
| Policy | B10M000864 |
| Date of birth | 26 Apr 1973 |
| Plan | SILVER HMO |
| Covered from | 18 Mar 2024 |
| Covered to | 4 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 |
|---|---|---|---|---|---|
| CLM0003663 | 10 Jul 2024 | 576.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 576.00 |