HENRY TANAKA
Dependent on policy B03M000776
Claims
3
Attributed to this person
Charged
1,215.00
Total submitted
Denied
575.00
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 | HENRY TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000776 |
| Date of birth | 23 Oct 1989 |
| Plan | GOLD PPO |
| Covered from | 30 Apr 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 |
|---|---|---|---|---|---|
| CLM0003293 | 1 Jun 2026 | 503.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 503.00 |
| CLM0003292 | 23 Jul 2025 | 72.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 72.00 |
| CLM0003291 | 21 Jan 2025 | 640.00 | MERIDIAN HEALTH PLAN | Not denied | — |