PRIYA TANAKA
Dependent on policy B09M000876
Claims
3
Attributed to this person
Charged
751.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
47.10
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 | PRIYA TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000876 |
| Date of birth | 19 Aug 2016 |
| Plan | BRONZE EPO |
| Covered from | 26 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 47.10 |
| Total | 47.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003719 | 23 May 2026 | 355.00 | CASCADE CARE | Not denied | — |
| CLM0003718 | 19 Aug 2025 | 82.00 | CASCADE CARE | Not denied | — |
| CLM0003720 | 28 May 2024 | 314.00 | CASCADE CARE | Not denied | — |