TOMAS TANAKA
Dependent on policy B07M000752
Claims
3
Attributed to this person
Charged
1,443.00
Total submitted
Denied
904.77
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 | TOMAS TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B07M000752 |
| Date of birth | 17 Nov 1980 |
| Plan | BRONZE EPO |
| Covered from | 5 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 |
|---|---|---|---|---|---|
| CLM0003117 | 24 May 2026 | 838.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 838.00 |
| CLM0003119 | 28 Aug 2025 | 399.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003118 | 26 Sep 2024 | 206.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 66.77 |