DenialIntel

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B07M000130›CARLA TANAKA

CARLA TANAKA

Dependent on policy B07M000130

Claims
1
Attributed to this person
Charged
443.00
Total submitted
Denied
194.47
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

FieldValue
NameCARLA TANAKA
Role on the policyDependent · relationship 19
PolicyB07M000130
Date of birth14 Aug 2009
PlanSILVER HMO
Covered from2 Apr 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00005453 Jan 2026443.00CASCADE CARECARC 27 · ELIGIBILITY194.47