VICTOR TANAKA
Dependent on policy B05M000300
Claims
3
Attributed to this person
Charged
1,688.00
Total submitted
Denied
1,264.00
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 | VICTOR TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000300 |
| Date of birth | 24 Jan 1992 |
| Plan | PLATINUM PPO |
| Covered from | 23 Mar 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 |
|---|---|---|---|---|---|
| CLM0001241 | 16 Dec 2025 | 454.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 454.00 |
| CLM0001242 | 15 Jun 2025 | 424.00 | CASCADE CARE | Not denied | — |
| CLM0001243 | 14 Jun 2025 | 810.00 | CASCADE CARE | CARC 18 · DUPLICATE | 810.00 |