TOMAS YAMADA
Dependent on policy B04M000033
Claims
2
Attributed to this person
Charged
830.00
Total submitted
Denied
830.00
2 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 19 |
| Policy | B04M000033 |
| Date of birth | 26 Nov 2004 |
| Plan | BRONZE EPO |
| Covered from | 12 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000150 | 14 Jan 2026 | 707.00 | CASCADE CARE | CARC 11 · CODING | 707.00 |
| CLM0000151 | 27 Sep 2025 | 123.00 | CASCADE CARE | CARC 18 · DUPLICATE | 123.00 |