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 B07M000382›CARLA CHEN

CARLA CHEN

Subscriber on policy B07M000382

Claims
1
Attributed to this person
Charged
190.00
Total submitted
Denied
0.00
0 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
NameCARLA CHEN
Role on the policySubscriber
PolicyB07M000382
Date of birth22 Jan 1981
PlanSILVER HMO
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
CLM000162111 Jan 2026190.00MERIDIAN HEALTH PLANNot denied—