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 B05M000811›SOFIA YAMADA

SOFIA YAMADA

Subscriber on policy B05M000811

Claims
2
Attributed to this person
Charged
1,525.00
Total submitted
Denied
1,525.00
2 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 YAMADA
Role on the policySubscriber
PolicyB05M000811
Date of birth21 Apr 1965
PlanGOLD PPO
Covered from4 Jun 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000344711 Jun 2025791.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING791.00
CLM00034461 Jun 2025734.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY734.00