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 B02M000292›HENRY OKAFOR

HENRY OKAFOR

Dependent on policy B02M000292

Claims
3
Attributed to this person
Charged
860.00
Total submitted
Denied
542.00
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
NameHENRY OKAFOR
Role on the policyDependent · relationship 01
PolicyB02M000292
Date of birth29 Oct 1966
PlanBRONZE EPO
Covered from18 Jun 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00012602 Aug 2026318.00MERIDIAN HEALTH PLANNot denied—
CLM000126113 May 2026405.00MERIDIAN HEALTH PLANCARC 16 · BILLING_ERROR405.00
CLM000126220 Dec 2025137.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING137.00