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 B01M000212›AMARA JOHNSON

AMARA JOHNSON

Dependent on policy B01M000212

Claims
2
Attributed to this person
Charged
967.00
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
NameAMARA JOHNSON
Role on the policyDependent · relationship 19
PolicyB01M000212
Date of birth10 Oct 2003
PlanSILVER HMO
Covered from25 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00009047 Oct 2025241.00MERIDIAN HEALTH PLANNot denied—
CLM00009056 Jun 2025726.00MERIDIAN HEALTH PLANNot denied—