AMARA TANAKA
Dependent on policy B02M000212
Claims
1
Attributed to this person
Charged
680.00
Total submitted
Denied
186.59
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 | AMARA TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000212 |
| Date of birth | 2 Dec 2015 |
| Plan | BRONZE EPO |
| Covered from | 20 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 |
|---|---|---|---|---|---|
| CLM0000931 | 3 Mar 2025 | 680.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 186.59 |