DenialIntel

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 B09M000514›LEILA EVANS

LEILA EVANS

Dependent on policy B09M000514

Claims
2
Attributed to this person
Charged
330.00
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
NameLEILA EVANS
Role on the policyDependent · relationship 01
PolicyB09M000514
Date of birth8 Nov 1987
PlanGOLD PPO
Covered from28 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00021753 Mar 2026242.00MERIDIAN HEALTH PLANNot denied—
CLM000217414 Jan 202688.00MERIDIAN HEALTH PLANNot denied—