ELENA TANAKA
Dependent on policy B03M000527
Claims
2
Attributed to this person
Charged
1,110.00
Total submitted
Denied
243.58
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 | ELENA TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000527 |
| Date of birth | 3 Nov 2002 |
| Plan | BRONZE EPO |
| Covered from | 4 Nov 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 |
|---|---|---|---|---|---|
| CLM0002160 | 1 Feb 2026 | 850.00 | MERIDIAN HEALTH PLAN | CARC 16 · BILLING_ERROR | 243.58 |
| CLM0002161 | 29 Sep 2025 | 260.00 | MERIDIAN HEALTH PLAN | Not denied | — |