CARLA TANAKA
Dependent on policy B06M000341
Claims
1
Attributed to this person
Charged
134.00
Total submitted
Denied
134.00
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 | CARLA TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000341 |
| Date of birth | 11 Mar 1980 |
| Plan | SILVER HMO |
| Covered from | 17 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 |
|---|---|---|---|---|---|
| CLM0001548 | 8 Mar 2024 | 134.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 134.00 |