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 B04M000373›WENDY GARCIA

WENDY GARCIA

Dependent on policy B04M000373

Claims
1
Attributed to this person
Charged
271.00
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
NameWENDY GARCIA
Role on the policyDependent · relationship 01
PolicyB04M000373
Date of birth12 Sep 1977
PlanSILVER HMO
Covered from8 Apr 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000160017 Feb 2026271.00MERIDIAN HEALTH PLANNot denied—