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 B02M000323›MARCUS GARCIA

MARCUS GARCIA

Subscriber on policy B02M000323

Claims
2
Attributed to this person
Charged
733.00
Total submitted
Denied
733.00
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
NameMARCUS GARCIA
Role on the policySubscriber
PolicyB02M000323
Date of birth10 Jun 1997
PlanPLATINUM PPO
Covered from24 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000137730 Jul 2026570.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY570.00
CLM000137628 Feb 2025163.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING163.00