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 B03M000876›ZARA KUMAR

ZARA KUMAR

Subscriber on policy B03M000876

Claims
2
Attributed to this person
Charged
981.00
Total submitted
Denied
651.00
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 KUMAR
Role on the policySubscriber
PolicyB03M000876
Date of birth10 May 2000
PlanSILVER HMO
Covered from19 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00038034 Dec 2025330.00NORTHSTAR MUTUALNot denied—
CLM000380427 Jan 2024651.00NORTHSTAR MUTUALCARC 27 · ELIGIBILITY651.00