GRACE TANAKA
Dependent on policy B10M000835
Claims
2
Attributed to this person
Charged
850.00
Total submitted
Denied
17.68
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 | GRACE TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000835 |
| Date of birth | 28 Jan 1978 |
| Plan | SILVER HMO |
| Covered from | 2 Jan 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0003553 | 25 Dec 2025 | 125.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003555 | 11 May 2025 | 725.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 17.68 |