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 B09M000100›RAVI QUINN

RAVI QUINN

Subscriber on policy B09M000100

Claims
2
Attributed to this person
Charged
1,527.00
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
NameRAVI QUINN
Role on the policySubscriber
PolicyB09M000100
Date of birth19 Jun 1967
PlanSILVER HMO
Covered from8 Nov 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00004164 Jun 2026794.00MERIDIAN HEALTH PLANNot denied—
CLM00004175 Nov 2025733.00MERIDIAN HEALTH PLANNot denied—