IVAN TANAKA
Subscriber on policy B02M000401
Claims
3
Attributed to this person
Charged
1,102.00
Total submitted
Denied
200.88
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 | IVAN TANAKA |
| Role on the policy | Subscriber |
| Policy | B02M000401 |
| Date of birth | 16 Aug 1982 |
| Plan | BRONZE EPO |
| Covered from | 31 Aug 2024 |
| Covered to | 23 Mar 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 |
|---|---|---|---|---|---|
| CLM0001721 | 28 Feb 2025 | 276.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 124.46 |
| CLM0001722 | 7 Dec 2024 | 286.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 76.42 |
| CLM0001720 | 24 Oct 2024 | 540.00 | CASCADE CARE | Not denied | — |