ZARA YAMADA
Dependent on policy B03M000590
Claims
3
Attributed to this person
Charged
456.00
Total submitted
Denied
372.00
3 denied claims
Patient responsibility
54.60
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 | ZARA YAMADA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000590 |
| Date of birth | 14 Mar 1969 |
| Plan | PLATINUM PPO |
| Covered from | 3 Jun 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 54.60 |
| Total | 54.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002410 | 19 Mar 2026 | 84.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0002412 | 24 May 2025 | 71.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 71.00 |
| CLM0002411 | 15 May 2025 | 301.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 301.00 |