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 B02M000381›YUSUF FOSTER

YUSUF FOSTER

Dependent on policy B02M000381

Claims
3
Attributed to this person
Charged
1,035.00
Total submitted
Denied
75.00
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
NameYUSUF FOSTER
Role on the policyDependent · relationship 01
PolicyB02M000381
Date of birth14 Aug 1962
PlanGOLD PPO
Covered from19 Apr 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00016253 Mar 202675.00MERIDIAN HEALTH PLANCARC 16 · BILLING_ERROR75.00
CLM00016268 Jan 2026563.00MERIDIAN HEALTH PLANNot denied—
CLM000162730 Dec 2025397.00MERIDIAN HEALTH PLANNot denied—