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 B08M000405›SOFIA CHEN

SOFIA CHEN

Subscriber on policy B08M000405

Claims
1
Attributed to this person
Charged
197.00
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
NameSOFIA CHEN
Role on the policySubscriber
PolicyB08M000405
Date of birth10 Mar 1991
PlanBRONZE EPO
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
CLM000185812 Nov 2025197.00MERIDIAN HEALTH PLANNot denied—