LEILA TANAKA
Dependent on policy B05M000314
Claims
1
Attributed to this person
Charged
164.00
Total submitted
Denied
164.00
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 | LEILA TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000314 |
| Date of birth | 22 Sep 2017 |
| Plan | SILVER HMO |
| Covered from | 27 Jun 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 |
|---|---|---|---|---|---|
| CLM0001310 | 11 May 2026 | 164.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 164.00 |