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 B10M000002›BRIAN USMAN

BRIAN USMAN

Subscriber on policy B10M000002

Claims
2
Attributed to this person
Charged
1,045.00
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
NameBRIAN USMAN
Role on the policySubscriber
PolicyB10M000002
Date of birth26 Jul 1998
PlanGOLD PPO
Covered from18 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000001722 Jul 2025774.00MERIDIAN HEALTH PLANNot denied—
CLM000001627 Jan 2024271.00MERIDIAN HEALTH PLANNot denied—