HENRY TANAKA
Subscriber on policy B10M000045
Claims
2
Attributed to this person
Charged
298.00
Total submitted
Denied
298.00
2 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 | HENRY TANAKA |
| Role on the policy | Subscriber |
| Policy | B10M000045 |
| Date of birth | 7 Apr 1973 |
| Plan | PLATINUM PPO |
| Covered from | 29 Aug 2024 |
| Covered to | 2 Nov 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000168 | 22 Dec 2024 | 116.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 116.00 |
| CLM0000169 | 7 Nov 2024 | 182.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 182.00 |