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 B10M000219›IVAN USMAN

IVAN USMAN

Dependent on policy B10M000219

Claims
2
Attributed to this person
Charged
1,721.00
Total submitted
Denied
847.00
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 — 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
NameIVAN USMAN
Role on the policyDependent · relationship 19
PolicyB10M000219
Date of birth12 Apr 2012
PlanBRONZE EPO
Covered from16 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00008991 Aug 2026847.00MERIDIAN HEALTH PLANCARC 50 · MEDICAL_NECESSITY847.00
CLM000089823 Oct 2025874.00MERIDIAN HEALTH PLANNot denied—