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 B02M000226›ZARA PATEL

ZARA PATEL

Dependent on policy B02M000226

Claims
3
Attributed to this person
Charged
1,606.00
Total submitted
Denied
1,212.00
2 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
NameZARA PATEL
Role on the policyDependent · relationship 01
PolicyB02M000226
Date of birth4 Jul 2000
PlanBRONZE EPO
Covered from26 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000098420 Mar 2026783.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE783.00
CLM000098317 Oct 2025394.00MERIDIAN HEALTH PLANNot denied—
CLM000098511 Sep 2024429.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY429.00