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 B02M000158›AMARA PATEL

AMARA PATEL

Dependent on policy B02M000158

Claims
1
Attributed to this person
Charged
781.00
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
NameAMARA PATEL
Role on the policyDependent · relationship 01
PolicyB02M000158
Date of birth7 Dec 1997
PlanSILVER HMO
Covered from8 May 2025
Covered to29 Sep 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00007132 Jul 2025781.00MERIDIAN HEALTH PLANNot denied—