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 B02M000195›YUSUF JOHNSON

YUSUF JOHNSON

Dependent on policy B02M000195

Claims
1
Attributed to this person
Charged
898.00
Total submitted
Denied
313.74
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
NameYUSUF JOHNSON
Role on the policyDependent · relationship 19
PolicyB02M000195
Date of birth6 Mar 1995
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
CLM00008548 Apr 2025898.00MERIDIAN HEALTH PLANCARC 16 · BILLING_ERROR313.74