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 B07M000407›UMA JOHNSON

UMA JOHNSON

Subscriber on policy B07M000407

Claims
1
Attributed to this person
Charged
338.00
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
NameUMA JOHNSON
Role on the policySubscriber
PolicyB07M000407
Date of birth13 Nov 1987
PlanGOLD PPO
Covered from21 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00017249 Apr 2025338.00MERIDIAN HEALTH PLANNot denied—