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 B01M000200›VICTOR YAMADA

VICTOR YAMADA

Subscriber on policy B01M000200

Claims
3
Attributed to this person
Charged
2,187.00
Total submitted
Denied
349.90
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
NameVICTOR YAMADA
Role on the policySubscriber
PolicyB01M000200
Date of birth24 Jan 1976
PlanPLATINUM PPO
Covered from10 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000085615 Oct 2025718.00MERIDIAN HEALTH PLANCARC 16 · BILLING_ERROR349.90
CLM000085527 Apr 2025603.00MERIDIAN HEALTH PLANNot denied—
CLM000085423 Nov 2024866.00MERIDIAN HEALTH PLANNot denied—