DenialIntel

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 B02M000195›BRIAN JOHNSON

BRIAN JOHNSON

Dependent on policy B02M000195

Claims
2
Attributed to this person
Charged
688.00
Total submitted
Denied
209.00
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 — 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
NameBRIAN JOHNSON
Role on the policyDependent · relationship 19
PolicyB02M000195
Date of birth27 Feb 1986
PlanSILVER HMO
Covered from11 Mar 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000085318 Oct 2025479.00MERIDIAN HEALTH PLANNot denied—
CLM000085210 Feb 2025209.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY209.00