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 B01M000159›WENDY GARCIA

WENDY GARCIA

Dependent on policy B01M000159

Claims
1
Attributed to this person
Charged
437.00
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
NameWENDY GARCIA
Role on the policyDependent · relationship 01
PolicyB01M000159
Date of birth19 Aug 1968
PlanSILVER HMO
Covered from17 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000068217 Apr 2026437.00MERIDIAN HEALTH PLANNot denied—