X12 Ingest & Denial Analytics

Demo Environment โ€” Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B07M000231›DAVID PATEL

DAVID PATEL

Subscriber on policy B07M000231

Claims
1
Attributed to this person
Charged
838.00
Total submitted
Denied
20.84
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 โ€” 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 PATEL
Role on the policySubscriber
PolicyB07M000231
Date of birth12 Nov 1965
PlanPLATINUM PPO
Covered from5 Jun 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00009757 Jul 2025838.00MERIDIAN HEALTH PLANCARC 50 ยท MEDICAL_NECESSITY20.84