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 B02M000365›BRIAN GARCIA

BRIAN GARCIA

Subscriber on policy B02M000365

Claims
3
Attributed to this person
Charged
680.00
Total submitted
Denied
0.00
0 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
NameBRIAN GARCIA
Role on the policySubscriber
PolicyB02M000365
Date of birth2 Apr 1960
PlanPLATINUM PPO
Covered from23 Jun 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00015644 Apr 2026135.00MERIDIAN HEALTH PLANNot denied—
CLM000156229 Apr 2025253.00MERIDIAN HEALTH PLANNot denied—
CLM000156314 Oct 2024292.00MERIDIAN HEALTH PLANNot denied—