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 B09M000503›PRIYA JOHNSON

PRIYA JOHNSON

Dependent on policy B09M000503

Claims
1
Attributed to this person
Charged
224.00
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
NamePRIYA JOHNSON
Role on the policyDependent · relationship 19
PolicyB09M000503
Date of birth19 Feb 2022
PlanGOLD PPO
Covered from11 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000212611 Apr 2026224.00NORTHSTAR MUTUALNot denied—