NADIA TANAKA
Dependent on policy B10M000014
Claims
3
Attributed to this person
Charged
1,645.00
Total submitted
Denied
426.00
1 denied claims
Patient responsibility
243.80
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 | NADIA TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B10M000014 |
| Date of birth | 21 Nov 2016 |
| Plan | SILVER HMO |
| Covered from | 10 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 2 | 243.80 |
| Total | 243.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000056 | 15 Jun 2026 | 524.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000055 | 18 Jan 2026 | 426.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 426.00 |
| CLM0000054 | 19 Mar 2025 | 695.00 | NORTHSTAR MUTUAL | Not denied | — |