CARLA TANAKA
Dependent on policy B01M000176
Claims
3
Attributed to this person
Charged
1,579.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
60.80
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 | CARLA TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B01M000176 |
| Date of birth | 11 Aug 2021 |
| Plan | PLATINUM PPO |
| Covered from | 31 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 60.80 |
| Total | 60.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000755 | 20 Apr 2026 | 424.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000756 | 9 Apr 2026 | 304.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000757 | 25 Jan 2026 | 851.00 | MERIDIAN HEALTH PLAN | Not denied | — |