X12 Ingest & Denial Analytics

Demo Environment โ€” Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B01M000124›VICTOR IQBAL

VICTOR IQBAL

Subscriber on policy B01M000124

Claims
1
Attributed to this person
Charged
531.00
Total submitted
Denied
531.00
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 โ€” 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
NameVICTOR IQBAL
Role on the policySubscriber
PolicyB01M000124
Date of birth20 Aug 1965
PlanSILVER HMO
Covered from26 Apr 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000047922 Mar 2026531.00MERIDIAN HEALTH PLANCARC 96 ยท NON_COVERED531.00