DenialIntel

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B02M000468›AMARA TANAKA

AMARA TANAKA

Subscriber on policy B02M000468

Claims
2
Attributed to this person
Charged
773.00
Total submitted
Denied
489.00
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

FieldValue
NameAMARA TANAKA
Role on the policySubscriber
PolicyB02M000468
Date of birth6 Jul 1955
PlanSILVER HMO
Covered from31 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000199613 Mar 2026284.00NORTHSTAR MUTUALNot denied—
CLM00019978 Sep 2025489.00NORTHSTAR MUTUALCARC 27 · ELIGIBILITY489.00