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 B05M000085›OMAR USMAN

OMAR USMAN

Subscriber on policy B05M000085

Claims
2
Attributed to this person
Charged
1,008.00
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
NameOMAR USMAN
Role on the policySubscriber
PolicyB05M000085
Date of birth22 Jul 1953
PlanSILVER HMO
Covered from8 May 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000038621 Apr 2026353.00MERIDIAN HEALTH PLANNot denied—
CLM000038713 May 2025655.00MERIDIAN HEALTH PLANNot denied—