CARLA YAMADA
Subscriber on policy B01M000060
Claims
3
Attributed to this person
Charged
1,588.00
Total submitted
Denied
501.00
1 denied claims
Patient responsibility
104.40
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 | CARLA YAMADA |
| Role on the policy | Subscriber |
| Policy | B01M000060 |
| Date of birth | 29 Oct 1968 |
| Plan | PLATINUM PPO |
| Covered from | 14 Feb 2025 |
| Covered to | 18 Jun 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 104.40 |
| Total | 104.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000258 | 5 Aug 2025 | 501.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 501.00 |
| CLM0000259 | 6 Mar 2025 | 565.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000260 | 31 Jan 2025 | 522.00 | MERIDIAN HEALTH PLAN | Not denied | — |