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 B02M000046›CARLA CHEN

CARLA CHEN

Subscriber on policy B02M000046

Claims
2
Attributed to this person
Charged
1,088.00
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
NameCARLA CHEN
Role on the policySubscriber
PolicyB02M000046
Date of birth20 Jul 1970
PlanGOLD PPO
Covered from9 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000022121 Dec 2025646.00MERIDIAN HEALTH PLANNot denied—
CLM00002205 Dec 2025442.00MERIDIAN HEALTH PLANNot denied—