AMARA YAMADA
Dependent on policy B05M000564
Claims
1
Attributed to this person
Charged
755.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
151.00
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 | AMARA YAMADA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000564 |
| Date of birth | 28 Feb 2011 |
| Plan | PLATINUM PPO |
| Covered from | 11 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 151.00 |
| Total | 151.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002419 | 11 Apr 2024 | 755.00 | CASCADE CARE | Not denied | — |