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 B08M000060›PRIYA REYES

PRIYA REYES

Subscriber on policy B08M000060

Claims
2
Attributed to this person
Charged
1,306.00
Total submitted
Denied
713.00
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
NamePRIYA REYES
Role on the policySubscriber
PolicyB08M000060
Date of birth8 Feb 1970
PlanPLATINUM PPO
Covered from23 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000027811 Nov 2025713.00MERIDIAN HEALTH PLANCARC 16 · BILLING_ERROR713.00
CLM00002775 Aug 2025593.00MERIDIAN HEALTH PLANNot denied—