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 B03M000369›AMARA OKAFOR

AMARA OKAFOR

Dependent on policy B03M000369

Claims
1
Attributed to this person
Charged
515.00
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
NameAMARA OKAFOR
Role on the policyDependent · relationship 01
PolicyB03M000369
Date of birth24 Apr 1980
PlanSILVER HMO
Covered from3 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000150414 Aug 2025515.00MERIDIAN HEALTH PLANNot denied—