TOMAS TANAKA
Subscriber on policy B05M000218
Claims
2
Attributed to this person
Charged
1,162.00
Total submitted
Denied
905.68
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 | TOMAS TANAKA |
| Role on the policy | Subscriber |
| Policy | B05M000218 |
| Date of birth | 30 Jan 1983 |
| Plan | PLATINUM PPO |
| Covered from | 22 Jan 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0000900 | 28 Jan 2025 | 378.00 | MERIDIAN HEALTH PLAN | CARC 109 · COB | 121.68 |
| CLM0000899 | 14 Jan 2025 | 784.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 784.00 |