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 B09M000112›ZARA BAKER

ZARA BAKER

Subscriber on policy B09M000112

Claims
3
Attributed to this person
Charged
1,484.00
Total submitted
Denied
556.00
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 BAKER
Role on the policySubscriber
PolicyB09M000112
Date of birth28 May 1982
PlanPLATINUM PPO
Covered from12 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00004609 Nov 2025130.00MERIDIAN HEALTH PLANNot denied—
CLM000045911 Aug 2025556.00MERIDIAN HEALTH PLANCARC 11 · CODING556.00
CLM000046121 Apr 2025798.00MERIDIAN HEALTH PLANNot denied—