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 B07M000463›IVAN FOSTER

IVAN FOSTER

Subscriber on policy B07M000463

Claims
3
Attributed to this person
Charged
861.00
Total submitted
Denied
484.00
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
NameIVAN FOSTER
Role on the policySubscriber
PolicyB07M000463
Date of birth26 Jan 1990
PlanSILVER HMO
Covered from5 Feb 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00019543 Dec 2025174.00MERIDIAN HEALTH PLANNot denied—
CLM00019567 Apr 2025203.00MERIDIAN HEALTH PLANNot denied—
CLM000195526 Jan 2024484.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY484.00