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 B06M000089›OMAR KUMAR

OMAR KUMAR

Subscriber on policy B06M000089

Claims
3
Attributed to this person
Charged
1,337.00
Total submitted
Denied
84.32
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
NameOMAR KUMAR
Role on the policySubscriber
PolicyB06M000089
Date of birth9 Jun 1985
PlanPLATINUM PPO
Covered from26 Dec 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00004648 Feb 2026374.00MERIDIAN HEALTH PLANNot denied—
CLM000046628 Jul 2025634.00MERIDIAN HEALTH PLANNot denied—
CLM000046525 Apr 2025329.00MERIDIAN HEALTH PLANCARC 197 · AUTHORIZATION84.32