GRACE TANAKA
Dependent on policy B10M000844
Claims
2
Attributed to this person
Charged
698.00
Total submitted
Denied
698.00
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 | GRACE TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000844 |
| Date of birth | 21 Apr 1959 |
| Plan | BRONZE EPO |
| Covered from | 11 Jun 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 |
|---|---|---|---|---|---|
| CLM0003580 | 3 Dec 2025 | 63.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 63.00 |
| CLM0003579 | 11 Dec 2024 | 635.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 635.00 |