UMA TANAKA
Dependent on policy B10M000709
Claims
2
Attributed to this person
Charged
1,465.00
Total submitted
Denied
693.00
2 denied claims
Patient responsibility
501.80
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 | UMA TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000709 |
| Date of birth | 17 Jun 1968 |
| Plan | SILVER HMO |
| Covered from | 30 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 501.80 |
| Total | 501.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002974 | 29 Dec 2025 | 693.00 | MERIDIAN HEALTH PLAN | CARC 11 · CODING | 693.00 |
| CLM0002975 | 6 Nov 2024 | 772.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 0.00 |