YUSUF TANAKA
Dependent on policy B07M000271
Claims
2
Attributed to this person
Charged
1,243.00
Total submitted
Denied
744.00
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 | YUSUF TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000271 |
| Date of birth | 11 Mar 2003 |
| Plan | GOLD PPO |
| Covered from | 26 Jan 2024 |
| Covered to | 17 Sep 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 |
|---|---|---|---|---|---|
| CLM0001172 | 17 Oct 2024 | 744.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 744.00 |
| CLM0001171 | 7 Aug 2024 | 499.00 | MERIDIAN HEALTH PLAN | Not denied | — |