DenialIntel

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 B10M000636›IVAN TANAKA

IVAN TANAKA

Subscriber on policy B10M000636

Claims
2
Attributed to this person
Charged
542.00
Total submitted
Denied
542.00
2 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 TANAKA
Role on the policySubscriber
PolicyB10M000636
Date of birth29 Jan 1954
PlanBRONZE EPO
Covered from24 Aug 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000263717 Dec 2025135.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING135.00
CLM00026365 Aug 2024407.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY407.00