LEILA YAMADA
Dependent on policy B05M000166
Claims
2
Attributed to this person
Charged
1,408.00
Total submitted
Denied
228.87
1 denied claims
Patient responsibility
133.95
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 | LEILA YAMADA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000166 |
| Date of birth | 24 Apr 1972 |
| Plan | PLATINUM PPO |
| Covered from | 8 Aug 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 133.95 |
| Total | 133.95 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000701 | 28 Mar 2025 | 515.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 228.87 |
| CLM0000702 | 30 Sep 2024 | 893.00 | CASCADE CARE | Not denied | — |