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 B02M000454›AMARA SMITH

AMARA SMITH

Subscriber on policy B02M000454

Claims
3
Attributed to this person
Charged
1,687.00
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
NameAMARA SMITH
Role on the policySubscriber
PolicyB02M000454
Date of birth10 Dec 1986
PlanBRONZE EPO
Covered from8 Jun 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000193623 Aug 2026147.00MERIDIAN HEALTH PLANNot denied—
CLM000193720 Jun 2026705.00MERIDIAN HEALTH PLANNot denied—
CLM000193525 Sep 2024835.00MERIDIAN HEALTH PLANNot denied—