VICTOR TANAKA
Subscriber on policy B10M000291
Claims
2
Attributed to this person
Charged
194.00
Total submitted
Denied
121.00
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 | VICTOR TANAKA |
| Role on the policy | Subscriber |
| Policy | B10M000291 |
| Date of birth | 19 Aug 1997 |
| Plan | GOLD PPO |
| Covered from | 5 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001219 | 23 Nov 2024 | 121.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 121.00 |
| CLM0001220 | 18 Aug 2024 | 73.00 | MERIDIAN HEALTH PLAN | Not denied | — |