IVAN TANAKA
Dependent on policy B10M000857
Claims
3
Attributed to this person
Charged
961.00
Total submitted
Denied
391.00
1 denied claims
Patient responsibility
66.15
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 | IVAN TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000857 |
| Date of birth | 29 Jun 1966 |
| Plan | BRONZE EPO |
| Covered from | 27 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 66.15 |
| Total | 66.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003627 | 15 Apr 2026 | 129.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003626 | 29 Jan 2026 | 441.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0003625 | 8 Dec 2025 | 391.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 391.00 |