BRIAN YAMADA
Dependent on policy B04M000262
Claims
1
Attributed to this person
Charged
478.00
Total submitted
Denied
478.00
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 | BRIAN YAMADA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000262 |
| Date of birth | 28 Sep 1989 |
| Plan | PLATINUM PPO |
| Covered from | 23 Sep 2024 |
| Covered to | 29 Jun 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 |
|---|---|---|---|---|---|
| CLM0001131 | 10 Sep 2024 | 478.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 478.00 |