GRACE YAMADA
Subscriber on policy B10M000792
Claims
3
Attributed to this person
Charged
1,730.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
125.60
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 | GRACE YAMADA |
| Role on the policy | Subscriber |
| Policy | B10M000792 |
| Date of birth | 2 Feb 1977 |
| Plan | BRONZE EPO |
| Covered from | 30 Sep 2024 |
| Covered to | 6 Jul 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 125.60 |
| Total | 125.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003346 | 19 May 2025 | 388.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003345 | 3 Apr 2025 | 714.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003347 | 10 Feb 2025 | 628.00 | MERIDIAN HEALTH PLAN | Not denied | — |