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 B01M000397›MARCUS REYES

MARCUS REYES

Subscriber on policy B01M000397

Claims
3
Attributed to this person
Charged
1,802.00
Total submitted
Denied
144.39
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
NameMARCUS REYES
Role on the policySubscriber
PolicyB01M000397
Date of birth7 Mar 1996
PlanBRONZE EPO
Covered from17 Apr 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000176316 Jul 2026755.00MERIDIAN HEALTH PLANNot denied—
CLM000176514 Jun 2026743.00MERIDIAN HEALTH PLANNot denied—
CLM00017641 Sep 2024304.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING144.39