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 B02M000378›CARLA WILSON

CARLA WILSON

Subscriber on policy B02M000378

Claims
3
Attributed to this person
Charged
1,158.00
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
NameCARLA WILSON
Role on the policySubscriber
PolicyB02M000378
Date of birth5 Jul 2000
PlanGOLD PPO
Covered from11 Mar 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00016176 Feb 2026294.00MERIDIAN HEALTH PLANNot denied—
CLM000161629 Jun 2025225.00MERIDIAN HEALTH PLANNot denied—
CLM000161510 Feb 2025639.00MERIDIAN HEALTH PLANNot denied—