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 B03M000097›HENRY TANAKA

HENRY TANAKA

Subscriber on policy B03M000097

Claims
3
Attributed to this person
Charged
1,385.00
Total submitted
Denied
0.00
0 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
NameHENRY TANAKA
Role on the policySubscriber
PolicyB03M000097
Date of birth23 Feb 1952
PlanBRONZE EPO
Covered from13 Apr 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000039620 Dec 2025886.00NORTHSTAR MUTUALNot denied—
CLM000039718 Jun 2025201.00NORTHSTAR MUTUALNot denied—
CLM00003981 Mar 2025298.00NORTHSTAR MUTUALNot denied—