PRIYA YAMADA
Dependent on policy B01M000726
Claims
1
Attributed to this person
Charged
643.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
96.45
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 | PRIYA YAMADA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B01M000726 |
| Date of birth | 18 Oct 1987 |
| Plan | GOLD PPO |
| Covered from | 6 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 96.45 |
| Total | 96.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003230 | 1 Feb 2025 | 643.00 | MERIDIAN HEALTH PLAN | Not denied | — |