PRIYA TANAKA
Subscriber on policy B01M000176
Claims
3
Attributed to this person
Charged
1,520.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
175.50
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 | PRIYA TANAKA |
| Role on the policy | Subscriber |
| Policy | B01M000176 |
| Date of birth | 14 Jan 1983 |
| Plan | PLATINUM PPO |
| Covered from | 31 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 175.50 |
| Total | 175.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000746 | 4 Apr 2026 | 270.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0000745 | 2 Dec 2024 | 636.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000744 | 8 Nov 2024 | 614.00 | MERIDIAN HEALTH PLAN | Not denied | — |