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 B10M000649›VICTOR KUMAR

VICTOR KUMAR

Dependent on policy B10M000649

Claims
3
Attributed to this person
Charged
1,460.00
Total submitted
Denied
733.39
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
NameVICTOR KUMAR
Role on the policyDependent · relationship 01
PolicyB10M000649
Date of birth8 May 1998
PlanSILVER HMO
Covered from10 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00026835 Dec 2025666.00MERIDIAN HEALTH PLANNot denied—
CLM000268414 Oct 2025113.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE52.39
CLM00026854 Jul 2024681.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE681.00