JULIA YAMADA
Subscriber on policy B04M000861
Claims
2
Attributed to this person
Charged
778.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
100.35
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 | JULIA YAMADA |
| Role on the policy | Subscriber |
| Policy | B04M000861 |
| Date of birth | 10 Apr 1952 |
| Plan | GOLD PPO |
| Covered from | 4 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 100.35 |
| Total | 100.35 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003722 | 25 Feb 2025 | 669.00 | CASCADE CARE | Not denied | — |
| CLM0003723 | 13 Jan 2025 | 109.00 | CASCADE CARE | Not denied | — |