HENRY TANAKA
Subscriber on policy B04M000750
Claims
3
Attributed to this person
Charged
1,625.00
Total submitted
Denied
731.00
1 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 | HENRY TANAKA |
| Role on the policy | Subscriber |
| Policy | B04M000750 |
| Date of birth | 21 Jul 1959 |
| Plan | PLATINUM PPO |
| Covered from | 29 Nov 2024 |
| Covered to | 5 Jun 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 |
|---|---|---|---|---|---|
| CLM0003273 | 22 Jun 2025 | 270.00 | CASCADE CARE | Not denied | — |
| CLM0003275 | 21 Mar 2025 | 624.00 | CASCADE CARE | Not denied | — |
| CLM0003274 | 23 Nov 2024 | 731.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 731.00 |