CARLA TANAKA
Subscriber on policy B07M000316
Claims
1
Attributed to this person
Charged
632.00
Total submitted
Denied
632.00
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 | CARLA TANAKA |
| Role on the policy | Subscriber |
| Policy | B07M000316 |
| Date of birth | 15 Aug 2001 |
| Plan | GOLD PPO |
| Covered from | 9 May 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 |
|---|---|---|---|---|---|
| CLM0001360 | 27 Jan 2025 | 632.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 632.00 |