WENDY YAMADA
Dependent on policy B03M000289
Claims
2
Attributed to this person
Charged
661.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
96.40
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 | WENDY YAMADA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000289 |
| Date of birth | 6 Jul 1983 |
| Plan | PLATINUM PPO |
| Covered from | 1 Oct 2024 |
| Covered to | 22 Mar 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 96.40 |
| Total | 96.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001140 | 29 Sep 2024 | 482.00 | CASCADE CARE | Not denied | — |
| CLM0001139 | 3 Sep 2024 | 179.00 | CASCADE CARE | Not denied | — |