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 B06M000065›HENRY PATEL

HENRY PATEL

Subscriber on policy B06M000065

Claims
2
Attributed to this person
Charged
428.00
Total submitted
Denied
277.00
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
NameHENRY PATEL
Role on the policySubscriber
PolicyB06M000065
Date of birth25 Oct 1953
PlanPLATINUM PPO
Covered from29 Mar 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000034928 Nov 2025151.00MERIDIAN HEALTH PLANNot denied—
CLM00003507 Nov 2025277.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE277.00