ELENA TANAKA
Dependent on policy B04M000440
Claims
2
Attributed to this person
Charged
936.00
Total submitted
Denied
507.00
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 | ELENA TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000440 |
| Date of birth | 24 Dec 2016 |
| Plan | PLATINUM PPO |
| Covered from | 16 Feb 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 |
|---|---|---|---|---|---|
| CLM0001892 | 24 Mar 2025 | 507.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 507.00 |
| CLM0001891 | 15 Dec 2024 | 429.00 | MERIDIAN HEALTH PLAN | Not denied | — |