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 B08M000387›GRACE CHEN

GRACE CHEN

Dependent on policy B08M000387

Claims
1
Attributed to this person
Charged
384.00
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
NameGRACE CHEN
Role on the policyDependent · relationship 01
PolicyB08M000387
Date of birth17 Feb 1984
PlanSILVER HMO
Covered from31 May 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00017673 Jun 2026384.00MERIDIAN HEALTH PLANNot denied—