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 B01M000421›KEVIN VARGAS

KEVIN VARGAS

Subscriber on policy B01M000421

Claims
1
Attributed to this person
Charged
394.00
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
NameKEVIN VARGAS
Role on the policySubscriber
PolicyB01M000421
Date of birth21 Jan 1984
PlanPLATINUM PPO
Covered from11 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000186320 Feb 2026394.00MERIDIAN HEALTH PLANNot denied—