IVAN YAMADA
Dependent on policy B04M000683
Claims
2
Attributed to this person
Charged
1,379.00
Total submitted
Denied
147.22
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 | IVAN YAMADA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000683 |
| Date of birth | 5 May 2023 |
| Plan | SILVER HMO |
| Covered from | 28 Mar 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 |
|---|---|---|---|---|---|
| CLM0002984 | 19 Nov 2024 | 487.00 | CASCADE CARE | CARC 96 · NON_COVERED | 147.22 |
| CLM0002985 | 22 Jun 2024 | 892.00 | CASCADE CARE | Not denied | — |