DenialIntel

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 B07M000490›CARLA MURPHY

CARLA MURPHY

Dependent on policy B07M000490

Claims
1
Attributed to this person
Charged
232.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
34.80
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 MURPHY
Role on the policyDependent · relationship 01
PolicyB07M000490
Date of birth13 Jun 1976
PlanBRONZE EPO
Covered from12 Mar 2025
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 1 · Deductible134.80
Total34.80

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000209626 Jul 2026232.00MERIDIAN HEALTH PLANNot denied—