ZARA TANAKA
Dependent on policy B05M000365
Claims
2
Attributed to this person
Charged
967.00
Total submitted
Denied
806.00
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 | ZARA TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000365 |
| Date of birth | 14 Jun 1998 |
| Plan | GOLD PPO |
| Covered from | 19 Feb 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 |
|---|---|---|---|---|---|
| CLM0001555 | 12 Feb 2026 | 161.00 | CASCADE CARE | Not denied | — |
| CLM0001554 | 1 Dec 2024 | 806.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 806.00 |