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 B06M000004›BRIAN CHEN

BRIAN CHEN

Subscriber on policy B06M000004

Claims
3
Attributed to this person
Charged
1,288.00
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 CHEN
Role on the policySubscriber
PolicyB06M000004
Date of birth15 Feb 1995
PlanGOLD PPO
Covered from12 May 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000001719 Jul 2026513.00MERIDIAN HEALTH PLANNot denied—
CLM000001828 Feb 2026115.00MERIDIAN HEALTH PLANNot denied—
CLM000001624 Aug 2025660.00MERIDIAN HEALTH PLANNot denied—