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 B01M000295›ZARA ANDERSON

ZARA ANDERSON

Dependent on policy B01M000295

Claims
3
Attributed to this person
Charged
828.00
Total submitted
Denied
415.00
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 — 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
NameZARA ANDERSON
Role on the policyDependent · relationship 01
PolicyB01M000295
Date of birth4 Nov 1944
PlanPLATINUM PPO
Covered from8 Mar 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000129630 Dec 2025177.00MERIDIAN HEALTH PLANNot denied—
CLM00012975 Dec 2025236.00MERIDIAN HEALTH PLANNot denied—
CLM00012956 Mar 2025415.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY415.00