JULIA TANAKA
Subscriber on policy B05M000026
Claims
3
Attributed to this person
Charged
1,500.00
Total submitted
Denied
715.00
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 | JULIA TANAKA |
| Role on the policy | Subscriber |
| Policy | B05M000026 |
| Date of birth | 18 Nov 1982 |
| Plan | SILVER HMO |
| Covered from | 21 Jun 2024 |
| Covered to | 18 Oct 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000118 | 4 Oct 2024 | 710.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000117 | 26 Sep 2024 | 715.00 | NORTHSTAR MUTUAL | CARC 109 · COB | 715.00 |
| CLM0000116 | 22 Jul 2024 | 75.00 | NORTHSTAR MUTUAL | Not denied | — |