SOFIA TANAKA
Dependent on policy B03M000888
Claims
2
Attributed to this person
Charged
1,281.00
Total submitted
Denied
582.00
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 | SOFIA TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000888 |
| Date of birth | 31 Mar 1946 |
| Plan | BRONZE EPO |
| Covered from | 11 May 2025 |
| Covered to | 2 Feb 2026 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003847 | 5 Nov 2025 | 582.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 582.00 |
| CLM0003846 | 4 Jun 2025 | 699.00 | MERIDIAN HEALTH PLAN | Not denied | — |