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 B10M000327›KEVIN EVANS

KEVIN EVANS

Subscriber on policy B10M000327

Claims
2
Attributed to this person
Charged
1,014.00
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
NameKEVIN EVANS
Role on the policySubscriber
PolicyB10M000327
Date of birth20 Aug 1963
PlanGOLD PPO
Covered from4 May 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00013716 Jul 2026866.00MERIDIAN HEALTH PLANNot denied—
CLM000137230 Dec 2025148.00MERIDIAN HEALTH PLANNot denied—