DenialIntel

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B03M000190›UMA YAMADA

UMA YAMADA

Subscriber on policy B03M000190

Claims
3
Attributed to this person
Charged
1,607.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
118.20
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

FieldValue
NameUMA YAMADA
Role on the policySubscriber
PolicyB03M000190
Date of birth23 May 1991
PlanBRONZE EPO
Covered from3 Apr 2025
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 2 · Coinsurance1118.20
Total118.20

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000077423 Jul 2026774.00CASCADE CARENot denied—
CLM000077310 May 2026242.00CASCADE CARENot denied—
CLM000077211 Nov 2025591.00CASCADE CARENot denied—