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 B05M000074›IVAN USMAN

IVAN USMAN

Subscriber on policy B05M000074

Claims
2
Attributed to this person
Charged
390.00
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
NameIVAN USMAN
Role on the policySubscriber
PolicyB05M000074
Date of birth8 Feb 1987
PlanBRONZE EPO
Covered from26 Jan 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000034116 Apr 2025126.00MERIDIAN HEALTH PLANNot denied—
CLM000034224 Aug 2024264.00MERIDIAN HEALTH PLANNot denied—