WENDY TANAKA
Subscriber on policy B08M000191
Claims
1
Attributed to this person
Charged
420.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
84.00
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 | WENDY TANAKA |
| Role on the policy | Subscriber |
| Policy | B08M000191 |
| Date of birth | 21 Oct 1967 |
| Plan | SILVER HMO |
| Covered from | 20 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 84.00 |
| Total | 84.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000849 | 8 Mar 2025 | 420.00 | MERIDIAN HEALTH PLAN | Not denied | — |