RAVI TANAKA
Subscriber on policy B04M000238
Claims
2
Attributed to this person
Charged
724.00
Total submitted
Denied
328.00
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 | Subscriber |
| Policy | B04M000238 |
| Date of birth | 15 Aug 1961 |
| Plan | GOLD PPO |
| Covered from | 5 Jan 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 |
|---|---|---|---|---|---|
| CLM0001033 | 8 Aug 2026 | 396.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0001034 | 10 Dec 2024 | 328.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 328.00 |