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 B03M000294›ZARA ANDERSON

ZARA ANDERSON

Dependent on policy B03M000294

Claims
3
Attributed to this person
Charged
1,674.00
Total submitted
Denied
328.00
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
NameZARA ANDERSON
Role on the policyDependent · relationship 01
PolicyB03M000294
Date of birth15 Sep 1988
PlanSILVER HMO
Covered from28 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000116624 Nov 2025328.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY328.00
CLM000116718 Oct 2025660.00MERIDIAN HEALTH PLANNot denied—
CLM000116818 Dec 2024686.00MERIDIAN HEALTH PLANNot denied—