HENRY TANAKA
Subscriber on policy B07M000503
Claims
3
Attributed to this person
Charged
1,106.00
Total submitted
Denied
603.60
2 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 | HENRY TANAKA |
| Role on the policy | Subscriber |
| Policy | B07M000503 |
| Date of birth | 24 Oct 1993 |
| Plan | SILVER HMO |
| Covered from | 29 Jun 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 |
|---|---|---|---|---|---|
| CLM0002148 | 23 Feb 2026 | 651.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 313.60 |
| CLM0002149 | 14 Aug 2025 | 165.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002150 | 14 Sep 2024 | 290.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 290.00 |