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 B09M000004›HENRY KUMAR

HENRY KUMAR

Subscriber on policy B09M000004

Claims
3
Attributed to this person
Charged
1,820.00
Total submitted
Denied
39.96
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 — 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
NameHENRY KUMAR
Role on the policySubscriber
PolicyB09M000004
Date of birth3 Dec 1950
PlanGOLD PPO
Covered from12 May 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000001631 Aug 2025855.00MERIDIAN HEALTH PLANNot denied—
CLM00000173 Jan 2025142.00MERIDIAN HEALTH PLANCARC 197 · AUTHORIZATION39.96
CLM000001518 Aug 2024823.00MERIDIAN HEALTH PLANNot denied—