VICTOR YAMADA
Subscriber on policy B01M000793
Claims
2
Attributed to this person
Charged
880.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
37.95
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 | VICTOR YAMADA |
| Role on the policy | Subscriber |
| Policy | B01M000793 |
| Date of birth | 9 Apr 1998 |
| Plan | PLATINUM PPO |
| Covered from | 14 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 37.95 |
| Total | 37.95 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003520 | 4 Apr 2025 | 253.00 | CASCADE CARE | Not denied | — |
| CLM0003521 | 24 Feb 2025 | 627.00 | CASCADE CARE | Not denied | — |