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 B01M000122›RAVI IQBAL

RAVI IQBAL

Subscriber on policy B01M000122

Claims
2
Attributed to this person
Charged
1,438.00
Total submitted
Denied
747.00
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
NameRAVI IQBAL
Role on the policySubscriber
PolicyB01M000122
Date of birth11 Jul 1999
PlanGOLD PPO
Covered from29 Oct 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000047322 Oct 2025747.00MERIDIAN HEALTH PLANCARC 197 · AUTHORIZATION747.00
CLM000047219 Aug 2025691.00MERIDIAN HEALTH PLANNot denied—