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 B08M000292›JULIA YAMADA

JULIA YAMADA

Dependent on policy B08M000292

Claims
2
Attributed to this person
Charged
597.00
Total submitted
Denied
597.00
2 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
NameJULIA YAMADA
Role on the policyDependent · relationship 19
PolicyB08M000292
Date of birth9 Mar 2006
PlanSILVER HMO
Covered from7 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000133910 Apr 2025319.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY319.00
CLM00013408 Jan 2025278.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY278.00