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 B02M000025›VICTOR PATEL

VICTOR PATEL

Subscriber on policy B02M000025

Claims
1
Attributed to this person
Charged
167.00
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
NameVICTOR PATEL
Role on the policySubscriber
PolicyB02M000025
Date of birth11 Jun 1994
PlanBRONZE EPO
Covered from7 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00001338 Feb 2026167.00MERIDIAN HEALTH PLANNot denied—