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 B05M000237›SOFIA TANAKA

SOFIA TANAKA

Subscriber on policy B05M000237

Claims
3
Attributed to this person
Charged
1,346.00
Total submitted
Denied
349.00
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
NameSOFIA TANAKA
Role on the policySubscriber
PolicyB05M000237
Date of birth22 Feb 1988
PlanPLATINUM PPO
Covered from27 Jun 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00009837 May 2026590.00MERIDIAN HEALTH PLANNot denied—
CLM000098127 Mar 2026407.00MERIDIAN HEALTH PLANNot denied—
CLM000098219 Jun 2024349.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY349.00