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 B04M000004›JULIA ANDERSON

JULIA ANDERSON

Dependent on policy B04M000004

Claims
2
Attributed to this person
Charged
1,011.00
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
NameJULIA ANDERSON
Role on the policyDependent · relationship 01
PolicyB04M000004
Date of birth13 Feb 1991
PlanSILVER HMO
Covered from28 Apr 2025
Covered to6 Aug 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000001517 Jul 2025563.00MERIDIAN HEALTH PLANNot denied—
CLM00000145 Jul 2025448.00MERIDIAN HEALTH PLANNot denied—