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 B01M000210›YUSUF DIAZ

YUSUF DIAZ

Subscriber on policy B01M000210

Claims
3
Attributed to this person
Charged
1,032.00
Total submitted
Denied
190.85
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
NameYUSUF DIAZ
Role on the policySubscriber
PolicyB01M000210
Date of birth19 Dec 1972
PlanBRONZE EPO
Covered from23 May 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000088513 Feb 2026320.00MERIDIAN HEALTH PLANNot denied—
CLM00008869 Dec 2025587.00MERIDIAN HEALTH PLANCARC 11 · CODING190.85
CLM000088412 Nov 2025125.00MERIDIAN HEALTH PLANNot denied—