OMAR TANAKA
Subscriber on policy B08M000434
Claims
2
Attributed to this person
Charged
1,104.00
Total submitted
Denied
622.00
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 | OMAR TANAKA |
| Role on the policy | Subscriber |
| Policy | B08M000434 |
| Date of birth | 13 May 2004 |
| Plan | GOLD PPO |
| Covered from | 9 Mar 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 |
|---|---|---|---|---|---|
| CLM0001990 | 30 May 2026 | 482.00 | CASCADE CARE | Not denied | — |
| CLM0001991 | 31 Mar 2026 | 622.00 | CASCADE CARE | CARC 96 · NON_COVERED | 622.00 |