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 B07M000200›DAVID OKAFOR

DAVID OKAFOR

Subscriber on policy B07M000200

Claims
3
Attributed to this person
Charged
826.00
Total submitted
Denied
235.00
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

FieldValue
NameDAVID OKAFOR
Role on the policySubscriber
PolicyB07M000200
Date of birth30 Dec 1998
PlanSILVER HMO
Covered from17 Feb 2025
Covered to29 Jul 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000083226 Jun 2025314.00MERIDIAN HEALTH PLANNot denied—
CLM000083415 Apr 2025235.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE235.00
CLM000083329 Mar 2025277.00MERIDIAN HEALTH PLANNot denied—