VICTOR TANAKA
Dependent on policy B10M000123
Claims
2
Attributed to this person
Charged
1,026.00
Total submitted
Denied
45.93
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 | VICTOR TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000123 |
| Date of birth | 16 Apr 2005 |
| Plan | BRONZE EPO |
| Covered from | 12 Oct 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 |
|---|---|---|---|---|---|
| CLM0000519 | 2 May 2025 | 883.00 | CASCADE CARE | Not denied | — |
| CLM0000520 | 12 Nov 2024 | 143.00 | CASCADE CARE | CARC 18 · DUPLICATE | 45.93 |