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.

ZARA CHEN

Dependent on policy B08M000425

Claims
3
Attributed to this person
Charged
1,929.00
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
NameZARA CHEN
Role on the policyDependent · relationship 19
PolicyB08M000425
Date of birth13 Sep 2009
PlanPLATINUM PPO
Covered from28 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000195627 Jul 2026771.00MERIDIAN HEALTH PLANNot denied—
CLM000195813 Jul 2025611.00MERIDIAN HEALTH PLANNot denied—
CLM000195725 Aug 2024547.00MERIDIAN HEALTH PLANNot denied—