IVAN TANAKA
Subscriber on policy B10M000402
Claims
1
Attributed to this person
Charged
853.00
Total submitted
Denied
853.00
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 | IVAN TANAKA |
| Role on the policy | Subscriber |
| Policy | B10M000402 |
| Date of birth | 17 Nov 1984 |
| Plan | BRONZE EPO |
| Covered from | 24 Jul 2024 |
| Covered to | 13 Jan 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 |
|---|---|---|---|---|---|
| CLM0001663 | 28 Sep 2024 | 853.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 853.00 |