IVAN TANAKA
Dependent on policy B04M000674
Claims
2
Attributed to this person
Charged
966.00
Total submitted
Denied
966.00
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
| Field | Value |
|---|---|
| Name | IVAN TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B04M000674 |
| Date of birth | 6 Jun 1977 |
| Plan | PLATINUM PPO |
| Covered from | 27 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002941 | 19 Mar 2026 | 512.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 512.00 |
| CLM0002942 | 20 Apr 2025 | 454.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 454.00 |