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 B05M000181›JULIA TANAKA

JULIA TANAKA

Dependent on policy B05M000181

Claims
1
Attributed to this person
Charged
627.00
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
NameJULIA TANAKA
Role on the policyDependent · relationship 19
PolicyB05M000181
Date of birth19 Mar 2010
PlanPLATINUM PPO
Covered from14 Mar 2025
Covered to23 Dec 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000076515 May 2025627.00MERIDIAN HEALTH PLANNot denied—