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 B01M000218›PRIYA WILSON

PRIYA WILSON

Subscriber on policy B01M000218

Claims
1
Attributed to this person
Charged
425.00
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 WILSON
Role on the policySubscriber
PolicyB01M000218
Date of birth3 Aug 1958
PlanGOLD PPO
Covered from28 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000093024 Aug 2025425.00MERIDIAN HEALTH PLANNot denied—