SOFIA TANAKA
Dependent on policy B06M000249
Claims
1
Attributed to this person
Charged
807.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
30.00
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 | B06M000249 |
| Date of birth | 9 May 1949 |
| Plan | BRONZE EPO |
| Covered from | 20 Jul 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 30.00 |
| Total | 30.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001182 | 22 Sep 2025 | 807.00 | MERIDIAN HEALTH PLAN | Not denied | — |