X12 Ingest & Denial Analytics

Demo Environment โ€” Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B10M000007›AMARA USMAN

AMARA USMAN

Subscriber on policy B10M000007

Claims
1
Attributed to this person
Charged
588.00
Total submitted
Denied
588.00
1 denied claims
Patient responsibility
0.00
Reported on the 835

Patient responsibility is the amount reported on the 835 as assigned to the patient โ€” 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 USMAN
Role on the policySubscriber
PolicyB10M000007
Date of birth2 Apr 1971
PlanPLATINUM PPO
Covered from21 Jun 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00000255 Oct 2025588.00MERIDIAN HEALTH PLANCARC 197 ยท AUTHORIZATION588.00