RAVI TANAKA
Dependent on policy B03M000156
Claims
2
Attributed to this person
Charged
843.00
Total submitted
Denied
284.00
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 | B03M000156 |
| Date of birth | 7 Jan 2022 |
| Plan | PLATINUM PPO |
| Covered from | 7 Jun 2025 |
| 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 |
|---|---|---|---|---|---|
| CLM0000637 | 23 Dec 2025 | 559.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000639 | 20 Sep 2025 | 284.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 284.00 |