OMAR TANAKA
Subscriber on policy B08M000093
Claims
3
Attributed to this person
Charged
1,441.00
Total submitted
Denied
635.00
1 denied claims
Patient responsibility
105.30
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 | OMAR TANAKA |
| Role on the policy | Subscriber |
| Policy | B08M000093 |
| Date of birth | 16 Aug 1982 |
| Plan | BRONZE EPO |
| Covered from | 17 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 105.30 |
| Total | 105.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000416 | 30 Jun 2026 | 104.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000417 | 21 May 2026 | 635.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 635.00 |
| CLM0000415 | 9 Feb 2024 | 702.00 | MERIDIAN HEALTH PLAN | Not denied | — |