X12 Ingest & Denial Analytics

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B07M000031›OMAR USMAN

OMAR USMAN

Dependent on policy B07M000031

Claims
2
Attributed to this person
Charged
574.00
Total submitted
Denied
362.52
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

FieldValue
NameOMAR USMAN
Role on the policyDependent · relationship 01
PolicyB07M000031
Date of birth29 Jun 2008
PlanBRONZE EPO
Covered from4 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00001431 Apr 2026251.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY251.00
CLM000014413 Jan 2026323.00MERIDIAN HEALTH PLANCARC 11 · CODING111.52