IVAN YAMADA
Subscriber on policy B02M000139
Claims
2
Attributed to this person
Charged
696.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
82.40
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 | IVAN YAMADA |
| Role on the policy | Subscriber |
| Policy | B02M000139 |
| Date of birth | 10 Jan 1960 |
| Plan | GOLD PPO |
| Covered from | 29 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 82.40 |
| Total | 82.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000633 | 4 Aug 2026 | 284.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000634 | 15 May 2025 | 412.00 | MERIDIAN HEALTH PLAN | Not denied | — |