MARCUS YAMADA
Dependent on policy B10M000094
Claims
3
Attributed to this person
Charged
1,695.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
378.95
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 | MARCUS YAMADA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000094 |
| Date of birth | 5 Feb 1973 |
| Plan | BRONZE EPO |
| Covered from | 20 Apr 2024 |
| Covered to | 30 Sep 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 378.95 |
| Total | 378.95 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000393 | 15 Sep 2024 | 595.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000392 | 24 May 2024 | 517.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000394 | 23 May 2024 | 583.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |