DenialIntel

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 B05M000513›LEILA YAMADA

LEILA YAMADA

Subscriber on policy B05M000513

Claims
2
Attributed to this person
Charged
1,187.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
159.00
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
NameLEILA YAMADA
Role on the policySubscriber
PolicyB05M000513
Date of birth2 May 1973
PlanSILVER HMO
Covered from20 Jul 2024
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 2 · Coinsurance1159.00
Total159.00

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000220527 May 2026392.00MERIDIAN HEALTH PLANNot denied—
CLM000220413 Oct 2025795.00MERIDIAN HEALTH PLANNot denied—