X12 Ingest & Denial Analytics

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Members›policy B03M000265›SOFIA TANAKA

SOFIA TANAKA

Dependent on policy B03M000265

Claims
3
Attributed to this person
Charged
1,521.00
Total submitted
Denied
1,375.00
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

FieldValue
NameSOFIA TANAKA
Role on the policyDependent · relationship 01
PolicyB03M000265
Date of birth26 Mar 1967
PlanPLATINUM PPO
Covered from30 Apr 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000107115 Jul 2026146.00CASCADE CARENot denied—
CLM000106929 Oct 2025815.00CASCADE CARECARC 27 · ELIGIBILITY815.00
CLM00010705 Oct 2025560.00CASCADE CARECARC 16 · BILLING_ERROR560.00