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 B06M000115›PRIYA PATEL

PRIYA PATEL

Subscriber on policy B06M000115

Claims
1
Attributed to this person
Charged
71.00
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
NamePRIYA PATEL
Role on the policySubscriber
PolicyB06M000115
Date of birth6 Dec 1987
PlanGOLD PPO
Covered from16 Feb 2024
Covered to17 Oct 2024

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00005696 Oct 202471.00MERIDIAN HEALTH PLANNot denied—