RAVI TANAKA
Dependent on policy B02M000228
Claims
2
Attributed to this person
Charged
1,363.00
Total submitted
Denied
810.00
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 | RAVI TANAKA |
| Role on the policy | Dependent · relationship 19 |
| Policy | B02M000228 |
| Date of birth | 23 Dec 2016 |
| 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 |
|---|---|---|---|---|---|
| CLM0000993 | 1 Jun 2026 | 553.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000994 | 3 Apr 2025 | 810.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 810.00 |