ZARA TANAKA
Dependent on policy B09M000655
Claims
2
Attributed to this person
Charged
1,221.00
Total submitted
Denied
870.00
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 | ZARA TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000655 |
| Date of birth | 2 Aug 2008 |
| 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 |
|---|---|---|---|---|---|
| CLM0002782 | 5 Apr 2025 | 351.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002781 | 13 Oct 2024 | 870.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 870.00 |