PRIYA TANAKA
Dependent on policy B02M000259
Claims
2
Attributed to this person
Charged
747.00
Total submitted
Denied
575.00
1 denied claims
Patient responsibility
25.80
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 | B02M000259 |
| Date of birth | 19 Oct 2018 |
| Plan | GOLD PPO |
| Covered from | 27 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 25.80 |
| Total | 25.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001132 | 13 Jun 2026 | 575.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 575.00 |
| CLM0001133 | 10 Dec 2025 | 172.00 | CASCADE CARE | Not denied | — |