UMA TANAKA
Subscriber on policy B08M000653
Claims
3
Attributed to this person
Charged
1,313.00
Total submitted
Denied
240.00
2 denied claims
Patient responsibility
542.10
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 | UMA TANAKA |
| Role on the policy | Subscriber |
| Policy | B08M000653 |
| Date of birth | 1 Oct 1978 |
| Plan | PLATINUM PPO |
| Covered from | 1 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 542.10 |
| Total | 542.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002956 | 12 Jan 2026 | 834.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0002955 | 25 Oct 2025 | 239.00 | CASCADE CARE | Not denied | — |
| CLM0002954 | 12 Feb 2025 | 240.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 240.00 |