DenialIntel

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 B02M000363›AMARA ANDERSON

AMARA ANDERSON

Subscriber on policy B02M000363

Claims
2
Attributed to this person
Charged
1,275.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
106.05
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
NameAMARA ANDERSON
Role on the policySubscriber
PolicyB02M000363
Date of birth26 Feb 1990
PlanGOLD PPO
Covered from2 May 2025
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 1 · Deductible1106.05
Total106.05

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000155825 Dec 2025707.00MERIDIAN HEALTH PLANNot denied—
CLM000155726 May 2025568.00MERIDIAN HEALTH PLANNot denied—