BRIAN YAMADA
Subscriber on policy B05M000421
Claims
3
Attributed to this person
Charged
1,330.00
Total submitted
Denied
613.97
2 denied claims
Patient responsibility
50.00
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 | Subscriber |
| Policy | B05M000421 |
| Date of birth | 23 Feb 1992 |
| Plan | PLATINUM PPO |
| Covered from | 23 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 50.00 |
| Total | 50.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001771 | 30 Jan 2026 | 450.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 450.00 |
| CLM0001770 | 20 Mar 2025 | 171.00 | CASCADE CARE | Not denied | — |
| CLM0001772 | 23 Jun 2024 | 709.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 163.97 |