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 IQBAL

Dependent on policy B05M000078

Claims
2
Attributed to this person
Charged
659.00
Total submitted
Denied
483.00
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
NameUMA IQBAL
Role on the policyDependent · relationship 01
PolicyB05M000078
Date of birth31 Mar 1967
PlanPLATINUM PPO
Covered from29 Feb 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00003632 Feb 2025483.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY483.00
CLM000036411 Dec 2024176.00MERIDIAN HEALTH PLANNot denied—