YUSUF TANAKA
Subscriber on policy B05M000754
Claims
3
Attributed to this person
Charged
1,787.00
Total submitted
Denied
771.31
2 denied claims
Patient responsibility
81.15
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 | YUSUF TANAKA |
| Role on the policy | Subscriber |
| Policy | B05M000754 |
| Date of birth | 12 Dec 1982 |
| Plan | GOLD PPO |
| Covered from | 12 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 81.15 |
| Total | 81.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003218 | 14 Feb 2026 | 675.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 200.31 |
| CLM0003217 | 3 Jul 2025 | 541.00 | CASCADE CARE | Not denied | — |
| CLM0003219 | 26 Feb 2025 | 571.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 571.00 |