FIONA TANAKA
Dependent on policy B02M000253
Claims
3
Attributed to this person
Charged
549.00
Total submitted
Denied
198.96
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 | FIONA TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000253 |
| Date of birth | 5 Oct 1971 |
| Plan | SILVER HMO |
| Covered from | 4 Jan 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 |
|---|---|---|---|---|---|
| CLM0001107 | 27 Nov 2024 | 88.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 27.96 |
| CLM0001106 | 30 Sep 2024 | 290.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001108 | 18 Jul 2024 | 171.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 171.00 |