AMARA YAMADA
Subscriber on policy B09M000057
Claims
3
Attributed to this person
Charged
2,176.00
Total submitted
Denied
1,563.00
2 denied claims
Patient responsibility
122.60
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 | AMARA YAMADA |
| Role on the policy | Subscriber |
| Policy | B09M000057 |
| Date of birth | 8 Jun 1951 |
| Plan | PLATINUM PPO |
| Covered from | 6 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 122.60 |
| Total | 122.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000261 | 20 Mar 2026 | 781.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 781.00 |
| CLM0000260 | 12 Sep 2024 | 613.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000259 | 30 Apr 2024 | 782.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 782.00 |