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 B03M000163›VICTOR BAKER

VICTOR BAKER

Subscriber on policy B03M000163

Claims
2
Attributed to this person
Charged
942.00
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
NameVICTOR BAKER
Role on the policySubscriber
PolicyB03M000163
Date of birth12 Feb 2002
PlanGOLD PPO
Covered from2 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000066819 Apr 2026813.00MERIDIAN HEALTH PLANNot denied—
CLM000066918 Oct 2025129.00MERIDIAN HEALTH PLANNot denied—