TOMAS TANAKA
Dependent on policy B05M000754
Claims
3
Attributed to this person
Charged
1,008.00
Total submitted
Denied
601.00
1 denied claims
Patient responsibility
51.00
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 | TOMAS TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000754 |
| Date of birth | 5 Jul 2016 |
| 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 | 51.00 |
| Total | 51.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003224 | 4 Mar 2026 | 67.00 | CASCADE CARE | Not denied | — |
| CLM0003225 | 10 Jan 2026 | 601.00 | CASCADE CARE | CARC 11 · CODING | 601.00 |
| CLM0003223 | 1 Jul 2025 | 340.00 | CASCADE CARE | Not denied | — |