X12 Ingest & Denial Analytics

Demo Environment โ€” Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B02M000127›HENRY MURPHY

HENRY MURPHY

Subscriber on policy B02M000127

Claims
1
Attributed to this person
Charged
623.00
Total submitted
Denied
623.00
1 denied claims
Patient responsibility
0.00
Reported on the 835

Patient responsibility is the amount reported on the 835 as assigned to the patient โ€” 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
NameHENRY MURPHY
Role on the policySubscriber
PolicyB02M000127
Date of birth9 May 1981
PlanGOLD PPO
Covered from13 Apr 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00005898 Jun 2025623.00MERIDIAN HEALTH PLANCARC 18 ยท DUPLICATE623.00