HENRY YAMADA
Subscriber on policy B04M000262
Claims
1
Attributed to this person
Charged
281.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
42.15
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 | B04M000262 |
| Date of birth | 8 Feb 1980 |
| Plan | PLATINUM PPO |
| Covered from | 23 Sep 2024 |
| Covered to | 29 Jun 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 42.15 |
| Total | 42.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001130 | 20 Feb 2025 | 281.00 | CASCADE CARE | Not denied | — |