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.

UMA KUMAR

Dependent on policy B04M000250

Claims
2
Attributed to this person
Charged
841.00
Total submitted
Denied
841.00
2 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
NameUMA KUMAR
Role on the policyDependent · relationship 01
PolicyB04M000250
Date of birth23 Mar 1948
PlanBRONZE EPO
Covered from29 May 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000109026 Jul 2026444.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY444.00
CLM000108814 Feb 2026397.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING397.00