RAVI TANAKA
Subscriber on policy B02M000288
Claims
3
Attributed to this person
Charged
1,035.00
Total submitted
Denied
274.05
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 | B02M000288 |
| Date of birth | 26 May 2000 |
| Plan | SILVER HMO |
| Covered from | 3 Jun 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 |
|---|---|---|---|---|---|
| CLM0001232 | 16 Jun 2025 | 69.00 | NORTHSTAR MUTUAL | CARC 197 · AUTHORIZATION | 30.05 |
| CLM0001233 | 2 Sep 2024 | 722.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001234 | 11 Aug 2024 | 244.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 244.00 |