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 B08M000206›BRIAN FOSTER

BRIAN FOSTER

Dependent on policy B08M000206

Claims
3
Attributed to this person
Charged
1,058.00
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
NameBRIAN FOSTER
Role on the policyDependent · relationship 01
PolicyB08M000206
Date of birth9 Feb 1992
PlanSILVER HMO
Covered from30 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000091310 Mar 2026404.00MERIDIAN HEALTH PLANNot denied—
CLM00009125 Jan 2026147.00MERIDIAN HEALTH PLANNot denied—
CLM00009147 Mar 2025507.00MERIDIAN HEALTH PLANNot denied—