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 B01M000356›BRIAN YAMADA

BRIAN YAMADA

Dependent on policy B01M000356

Claims
1
Attributed to this person
Charged
274.00
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 YAMADA
Role on the policyDependent · relationship 19
PolicyB01M000356
Date of birth31 May 1997
PlanGOLD PPO
Covered from3 Dec 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000157513 Jun 2025274.00MERIDIAN HEALTH PLANNot denied—