UMA TANAKA
Subscriber on policy B02M000440
Claims
2
Attributed to this person
Charged
407.00
Total submitted
Denied
161.92
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 | UMA TANAKA |
| Role on the policy | Subscriber |
| Policy | B02M000440 |
| Date of birth | 9 Apr 1979 |
| Plan | BRONZE EPO |
| Covered from | 19 Aug 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 |
|---|---|---|---|---|---|
| CLM0001877 | 5 Dec 2025 | 144.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 45.24 |
| CLM0001878 | 18 Feb 2025 | 263.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 116.68 |