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 B10M000256›IVAN USMAN

IVAN USMAN

Subscriber on policy B10M000256

Claims
1
Attributed to this person
Charged
382.00
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
NameIVAN USMAN
Role on the policySubscriber
PolicyB10M000256
Date of birth18 Nov 1997
PlanPLATINUM PPO
Covered from12 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00010435 Nov 2025382.00MERIDIAN HEALTH PLANNot denied—