DAVID YAMADA
Subscriber on policy B04M000748
Claims
1
Attributed to this person
Charged
895.00
Total submitted
Denied
388.12
1 denied claims
Patient responsibility
0.00
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 | DAVID YAMADA |
| Role on the policy | Subscriber |
| Policy | B04M000748 |
| Date of birth | 3 Apr 1990 |
| Plan | SILVER HMO |
| Covered from | 22 Mar 2024 |
| Covered to | 4 Aug 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003266 | 17 Jun 2024 | 895.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 388.12 |