KEVIN TANAKA
Subscriber on policy B09M000713
Claims
3
Attributed to this person
Charged
1,528.00
Total submitted
Denied
1,272.00
2 denied claims
Patient responsibility
50.00
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 | KEVIN TANAKA |
| Role on the policy | Subscriber |
| Policy | B09M000713 |
| Date of birth | 20 Sep 1955 |
| Plan | BRONZE EPO |
| Covered from | 24 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 50.00 |
| Total | 50.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003021 | 25 Jun 2026 | 817.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 817.00 |
| CLM0003022 | 9 Apr 2026 | 256.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003020 | 1 Nov 2025 | 455.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 455.00 |