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 B09M000024›ZARA VARGAS

ZARA VARGAS

Dependent on policy B09M000024

Claims
2
Attributed to this person
Charged
429.00
Total submitted
Denied
83.17
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
NameZARA VARGAS
Role on the policyDependent · relationship 19
PolicyB09M000024
Date of birth15 May 2000
PlanSILVER HMO
Covered from10 May 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000010524 Mar 2026239.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE83.17
CLM00001043 Mar 2026190.00MERIDIAN HEALTH PLANNot denied—