CARLA YAMADA
Subscriber on policy B03M000221
Claims
2
Attributed to this person
Charged
1,118.00
Total submitted
Denied
113.10
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 | CARLA YAMADA |
| Role on the policy | Subscriber |
| Policy | B03M000221 |
| Date of birth | 14 Dec 1993 |
| Plan | BRONZE EPO |
| Covered from | 8 Feb 2025 |
| Covered to | 14 Apr 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000899 | 28 Feb 2025 | 433.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 113.10 |
| CLM0000898 | 16 Feb 2025 | 685.00 | CASCADE CARE | Not denied | — |