HENRY TANAKA
Subscriber on policy B03M000242
Claims
3
Attributed to this person
Charged
1,249.00
Total submitted
Denied
355.00
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 | HENRY TANAKA |
| Role on the policy | Subscriber |
| Policy | B03M000242 |
| Date of birth | 30 Dec 1970 |
| Plan | SILVER HMO |
| Covered from | 3 Apr 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 |
|---|---|---|---|---|---|
| CLM0000985 | 18 Jun 2025 | 522.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000983 | 17 Apr 2025 | 355.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 355.00 |
| CLM0000984 | 22 Oct 2024 | 372.00 | NORTHSTAR MUTUAL | Not denied | — |