HENRY YAMADA
Dependent on policy B03M000848
Claims
1
Attributed to this person
Charged
519.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
77.85
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 | Dependent · relationship 01 |
| Policy | B03M000848 |
| Date of birth | 1 Mar 1992 |
| Plan | SILVER HMO |
| Covered from | 16 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 77.85 |
| Total | 77.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003676 | 26 Jul 2025 | 519.00 | CASCADE CARE | Not denied | — |