CARLA TANAKA
Subscriber on policy B07M000258
Claims
2
Attributed to this person
Charged
489.00
Total submitted
Denied
173.00
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 | Subscriber |
| Policy | B07M000258 |
| Date of birth | 23 Nov 1983 |
| Plan | GOLD PPO |
| Covered from | 16 Feb 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0001104 | 3 Apr 2026 | 173.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 173.00 |
| CLM0001103 | 7 Jan 2026 | 316.00 | NORTHSTAR MUTUAL | Not denied | — |