WENDY TANAKA
Dependent on policy B02M000120
Claims
1
Attributed to this person
Charged
391.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
78.20
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 | WENDY TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000120 |
| Date of birth | 11 Jun 2006 |
| Plan | PLATINUM PPO |
| Covered from | 29 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 78.20 |
| Total | 78.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000549 | 28 Feb 2026 | 391.00 | MERIDIAN HEALTH PLAN | Not denied | — |