FIONA TANAKA
Subscriber on policy B09M000374
Claims
3
Attributed to this person
Charged
1,638.00
Total submitted
Denied
79.00
1 denied claims
Patient responsibility
40.00
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 | FIONA TANAKA |
| Role on the policy | Subscriber |
| Policy | B09M000374 |
| Date of birth | 3 Apr 1952 |
| Plan | GOLD PPO |
| Covered from | 8 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 40.00 |
| Total | 40.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001543 | 23 Oct 2025 | 805.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001545 | 7 Apr 2025 | 754.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001544 | 1 May 2024 | 79.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 79.00 |