SOFIA TANAKA
Subscriber on policy B08M000828
Claims
2
Attributed to this person
Charged
1,040.00
Total submitted
Denied
378.00
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 | SOFIA TANAKA |
| Role on the policy | Subscriber |
| Policy | B08M000828 |
| Date of birth | 18 Apr 1981 |
| Plan | SILVER HMO |
| Covered from | 28 Aug 2024 |
| Covered to | 6 Apr 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003693 | 10 Apr 2025 | 378.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 378.00 |
| CLM0003694 | 14 Feb 2025 | 662.00 | CASCADE CARE | Not denied | — |