OMAR TANAKA
Dependent on policy B02M000228
Claims
2
Attributed to this person
Charged
896.00
Total submitted
Denied
233.69
1 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 | OMAR TANAKA |
| Role on the policy | Dependent · relationship 01 |
| Policy | B02M000228 |
| Date of birth | 4 Jun 1987 |
| Plan | BRONZE EPO |
| Covered from | 20 Nov 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 |
|---|---|---|---|---|---|
| CLM0000988 | 27 Jun 2026 | 584.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 233.69 |
| CLM0000989 | 22 Nov 2025 | 312.00 | NORTHSTAR MUTUAL | Not denied | — |