DAVID TANAKA
Subscriber on policy B09M000863
Claims
3
Attributed to this person
Charged
1,221.00
Total submitted
Denied
526.00
2 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 | DAVID TANAKA |
| Role on the policy | Subscriber |
| Policy | B09M000863 |
| Date of birth | 24 Jan 1990 |
| Plan | GOLD PPO |
| Covered from | 16 Nov 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 |
|---|---|---|---|---|---|
| CLM0003668 | 7 May 2026 | 695.00 | CASCADE CARE | Not denied | — |
| CLM0003669 | 30 Jan 2025 | 177.00 | CASCADE CARE | CARC 18 · DUPLICATE | 177.00 |
| CLM0003667 | 8 Jan 2025 | 349.00 | CASCADE CARE | CARC 16 · BILLING_ERROR | 349.00 |