FIONA TANAKA
Dependent on policy B09M000655
Claims
2
Attributed to this person
Charged
641.00
Total submitted
Denied
350.00
1 denied claims
Patient responsibility
0.00
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 | Dependent · relationship 01 |
| Policy | B09M000655 |
| Date of birth | 12 Oct 2000 |
| Plan | GOLD PPO |
| Covered from | 17 Oct 2024 |
| Covered to | 27 Mar 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002780 | 5 Oct 2024 | 291.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002779 | 22 Sep 2024 | 350.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 350.00 |