LEILA TANAKA
Dependent on policy B05M000844
Claims
1
Attributed to this person
Charged
335.00
Total submitted
Denied
88.59
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 | LEILA TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000844 |
| Date of birth | 21 Aug 1989 |
| Plan | SILVER HMO |
| Covered from | 8 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 |
|---|---|---|---|---|---|
| CLM0003585 | 7 Nov 2024 | 335.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 88.59 |