GRACE YAMADA
Dependent on policy B05M000795
Claims
1
Attributed to this person
Charged
664.00
Total submitted
Denied
664.00
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 | GRACE YAMADA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000795 |
| Date of birth | 23 Oct 1995 |
| Plan | BRONZE EPO |
| Covered from | 10 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003376 | 31 Jul 2024 | 664.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 664.00 |