PRIYA TANAKA
Dependent on policy B08M000824
Claims
1
Attributed to this person
Charged
873.00
Total submitted
Denied
873.00
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 | PRIYA TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000824 |
| Date of birth | 24 Jul 1971 |
| Plan | SILVER HMO |
| Covered from | 3 Apr 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 |
|---|---|---|---|---|---|
| CLM0003679 | 18 Apr 2024 | 873.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 873.00 |