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 B08M000110›ZARA GARCIA

ZARA GARCIA

Dependent on policy B08M000110

Claims
2
Attributed to this person
Charged
737.00
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
NameZARA GARCIA
Role on the policyDependent · relationship 01
PolicyB08M000110
Date of birth8 Jun 1948
PlanGOLD PPO
Covered from14 May 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000048119 Aug 2026331.00MERIDIAN HEALTH PLANNot denied—
CLM000048223 Jul 2025406.00MERIDIAN HEALTH PLANNot denied—