JULIA YAMADA
Dependent on policy B04M000225
Claims
2
Attributed to this person
Charged
1,161.00
Total submitted
Denied
476.00
1 denied claims
Patient responsibility
137.00
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 | JULIA YAMADA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000225 |
| Date of birth | 5 Mar 2016 |
| Plan | BRONZE EPO |
| Covered from | 12 Nov 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 137.00 |
| Total | 137.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000989 | 1 Mar 2025 | 685.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000990 | 6 Dec 2024 | 476.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 476.00 |