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 B04M000009›RAVI YAMADA

RAVI YAMADA

Subscriber on policy B04M000009

Claims
3
Attributed to this person
Charged
720.00
Total submitted
Denied
321.00
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
NameRAVI YAMADA
Role on the policySubscriber
PolicyB04M000009
Date of birth6 Apr 1980
PlanSILVER HMO
Covered from20 Sep 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000004423 Mar 2026323.00MERIDIAN HEALTH PLANNot denied—
CLM000004521 Sep 202576.00MERIDIAN HEALTH PLANNot denied—
CLM000004623 Aug 2024321.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY321.00