MARCUS TANAKA
Dependent on policy B04M000420
Claims
3
Attributed to this person
Charged
1,030.00
Total submitted
Denied
314.00
2 denied claims
Patient responsibility
143.20
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 | MARCUS TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B04M000420 |
| Date of birth | 23 Mar 1946 |
| Plan | PLATINUM PPO |
| Covered from | 17 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 143.20 |
| Total | 143.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001810 | 6 Apr 2026 | 218.00 | CASCADE CARE | CARC 18 · DUPLICATE | 218.00 |
| CLM0001812 | 10 Jan 2026 | 96.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 96.00 |
| CLM0001811 | 26 Oct 2025 | 716.00 | CASCADE CARE | Not denied | — |