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 B05M000258›BRIAN QUINN

BRIAN QUINN

Dependent on policy B05M000258

Claims
1
Attributed to this person
Charged
433.00
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 QUINN
Role on the policyDependent · relationship 19
PolicyB05M000258
Date of birth17 Mar 1997
PlanPLATINUM PPO
Covered from25 Mar 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000106626 Mar 2026433.00MERIDIAN HEALTH PLANNot denied—