ELENA YAMADA
Dependent on policy B03M000569
Claims
2
Attributed to this person
Charged
573.00
Total submitted
Denied
340.00
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 | ELENA YAMADA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B03M000569 |
| Date of birth | 14 Apr 1986 |
| Plan | SILVER HMO |
| Covered from | 28 May 2025 |
| Covered to | 28 Aug 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 |
|---|---|---|---|---|---|
| CLM0002328 | 15 Jul 2025 | 233.00 | CASCADE CARE | Not denied | — |
| CLM0002329 | 17 May 2025 | 340.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 340.00 |