X12 Ingest & Denial Analytics

Demo Environment โ€” Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B08M000360›KEVIN MURPHY

KEVIN MURPHY

Subscriber on policy B08M000360

Claims
1
Attributed to this person
Charged
119.00
Total submitted
Denied
119.00
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 โ€” 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
NameKEVIN MURPHY
Role on the policySubscriber
PolicyB08M000360
Date of birth17 May 1984
PlanGOLD PPO
Covered from23 Jun 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00016492 Jan 2025119.00MERIDIAN HEALTH PLANCARC 50 ยท MEDICAL_NECESSITY119.00