UMA TANAKA
Subscriber on policy B03M000744
Claims
3
Attributed to this person
Charged
1,528.00
Total submitted
Denied
727.02
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 | B03M000744 |
| Date of birth | 11 Dec 1958 |
| Plan | GOLD PPO |
| Covered from | 26 Nov 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 |
|---|---|---|---|---|---|
| CLM0003122 | 19 Mar 2026 | 451.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003123 | 26 Aug 2025 | 537.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 187.02 |
| CLM0003124 | 4 Jun 2025 | 540.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 540.00 |