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 B06M000060›GRACE BAKER

GRACE BAKER

Subscriber on policy B06M000060

Claims
3
Attributed to this person
Charged
1,206.00
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
NameGRACE BAKER
Role on the policySubscriber
PolicyB06M000060
Date of birth21 Jul 1990
PlanBRONZE EPO
Covered from23 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00003281 Aug 2026260.00MERIDIAN HEALTH PLANNot denied—
CLM000032623 Jun 2026604.00MERIDIAN HEALTH PLANNot denied—
CLM000032716 Jul 2025342.00MERIDIAN HEALTH PLANNot denied—