FIONA TANAKA
Subscriber on policy B08M000855
Claims
3
Attributed to this person
Charged
1,873.00
Total submitted
Denied
583.00
1 denied claims
Patient responsibility
122.55
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 | FIONA TANAKA |
| Role on the policy | Subscriber |
| Policy | B08M000855 |
| Date of birth | 29 Mar 1961 |
| Plan | BRONZE EPO |
| Covered from | 14 May 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 122.55 |
| Total | 122.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003827 | 26 Nov 2025 | 583.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 583.00 |
| CLM0003828 | 14 Sep 2025 | 817.00 | CASCADE CARE | Not denied | — |
| CLM0003826 | 16 Jun 2025 | 473.00 | CASCADE CARE | Not denied | — |