SOFIA YAMADA
Subscriber on policy B10M000289
Claims
2
Attributed to this person
Charged
1,152.00
Total submitted
Denied
900.00
1 denied claims
Patient responsibility
37.80
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 | SOFIA YAMADA |
| Role on the policy | Subscriber |
| Policy | B10M000289 |
| Date of birth | 30 Nov 2000 |
| Plan | BRONZE EPO |
| Covered from | 30 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 37.80 |
| Total | 37.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001213 | 13 May 2025 | 252.00 | CASCADE CARE | Not denied | — |
| CLM0001212 | 2 Sep 2024 | 900.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 900.00 |