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 B05M000099›BRIAN PATEL

BRIAN PATEL

Subscriber on policy B05M000099

Claims
1
Attributed to this person
Charged
464.00
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
NameBRIAN PATEL
Role on the policySubscriber
PolicyB05M000099
Date of birth15 Mar 1950
PlanSILVER HMO
Covered from27 Aug 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000043430 Jan 2026464.00MERIDIAN HEALTH PLANNot denied—