FIONA TANAKA
Subscriber on policy B10M000841
Claims
2
Attributed to this person
Charged
591.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
9.45
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 | FIONA TANAKA |
| Role on the policy | Subscriber |
| Policy | B10M000841 |
| Date of birth | 15 Jul 1982 |
| Plan | SILVER HMO |
| Covered from | 15 Mar 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 9.45 |
| Total | 9.45 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003569 | 15 May 2026 | 63.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003568 | 28 Nov 2024 | 528.00 | NORTHSTAR MUTUAL | Not denied | — |