RAVI TANAKA
Subscriber on policy B02M000136
Claims
3
Attributed to this person
Charged
1,480.00
Total submitted
Denied
841.78
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 | RAVI TANAKA |
| Role on the policy | Subscriber |
| Policy | B02M000136 |
| Date of birth | 1 Mar 1992 |
| Plan | SILVER HMO |
| Covered from | 24 Feb 2025 |
| Covered to | 5 Jun 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000617 | 16 May 2025 | 181.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000619 | 15 May 2025 | 584.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 584.00 |
| CLM0000618 | 27 Mar 2025 | 715.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 257.78 |