HENRY YAMADA
Subscriber on policy B02M000748
Claims
1
Attributed to this person
Charged
825.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
123.75
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 | HENRY YAMADA |
| Role on the policy | Subscriber |
| Policy | B02M000748 |
| Date of birth | 25 Dec 1994 |
| Plan | SILVER HMO |
| Covered from | 8 Dec 2024 |
| Covered to | 21 Aug 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 123.75 |
| Total | 123.75 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003136 | 27 Jul 2025 | 825.00 | CASCADE CARE | Not denied | — |