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 B06M000007›CARLA CHEN

CARLA CHEN

Subscriber on policy B06M000007

Claims
3
Attributed to this person
Charged
2,195.00
Total submitted
Denied
981.72
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
NameCARLA CHEN
Role on the policySubscriber
PolicyB06M000007
Date of birth3 Mar 1985
PlanSILVER HMO
Covered from6 Nov 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000003721 Apr 2025849.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY290.72
CLM000003622 Feb 2025691.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE691.00
CLM000003521 Feb 2025655.00MERIDIAN HEALTH PLANNot denied—