NADIA TANAKA
Subscriber on policy B08M000327
Claims
2
Attributed to this person
Charged
1,110.00
Total submitted
Denied
87.78
2 denied claims
Patient responsibility
577.85
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 | NADIA TANAKA |
| Role on the policy | Subscriber |
| Policy | B08M000327 |
| Date of birth | 11 Oct 1963 |
| Plan | GOLD PPO |
| Covered from | 16 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 577.85 |
| Total | 577.85 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001503 | 28 Jan 2026 | 221.00 | CASCADE CARE | CARC 96 · NON_COVERED | 87.78 |
| CLM0001502 | 3 May 2024 | 889.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |