VICTOR YAMADA
Dependent on policy B09M000150
Claims
3
Attributed to this person
Charged
1,526.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
289.25
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 | VICTOR YAMADA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000150 |
| Date of birth | 23 Feb 1973 |
| Plan | SILVER HMO |
| Covered from | 28 May 2025 |
| Covered to | 17 Mar 2026 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 289.25 |
| Total | 289.25 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000638 | 20 Dec 2025 | 445.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0000636 | 3 Nov 2025 | 241.00 | CASCADE CARE | Not denied | — |
| CLM0000637 | 24 Jul 2025 | 840.00 | CASCADE CARE | Not denied | — |