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 B01M000361›AMARA USMAN

AMARA USMAN

Dependent on policy B01M000361

Claims
3
Attributed to this person
Charged
1,583.00
Total submitted
Denied
1,320.00
2 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 USMAN
Role on the policyDependent · relationship 19
PolicyB01M000361
Date of birth20 Feb 2009
PlanBRONZE EPO
Covered from6 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000159924 Nov 2025263.00MERIDIAN HEALTH PLANNot denied—
CLM000159722 Aug 2025800.00MERIDIAN HEALTH PLANCARC 197 · AUTHORIZATION800.00
CLM00015989 Jul 2025520.00MERIDIAN HEALTH PLANCARC 16 · BILLING_ERROR520.00