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 B09M000750›VICTOR TANAKA

VICTOR TANAKA

Dependent on policy B09M000750

Claims
1
Attributed to this person
Charged
627.00
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
NameVICTOR TANAKA
Role on the policyDependent · relationship 01
PolicyB09M000750
Date of birth18 Jun 1992
PlanGOLD PPO
Covered from24 Jun 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00031841 Oct 2025627.00MERIDIAN HEALTH PLANNot denied—