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 B02M000254›PRIYA QUINN

PRIYA QUINN

Subscriber on policy B02M000254

Claims
1
Attributed to this person
Charged
332.00
Total submitted
Denied
332.00
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
NamePRIYA QUINN
Role on the policySubscriber
PolicyB02M000254
Date of birth3 May 1967
PlanPLATINUM PPO
Covered from23 Apr 2025
Covered to10 Jan 2026

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000110913 Jan 2026332.00MERIDIAN HEALTH PLANCARC 27 ยท ELIGIBILITY332.00