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 B06M000134›DAVID REYES

DAVID REYES

Subscriber on policy B06M000134

Claims
1
Attributed to this person
Charged
865.00
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
NameDAVID REYES
Role on the policySubscriber
PolicyB06M000134
Date of birth25 Nov 1962
PlanPLATINUM PPO
Covered from10 Jul 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00006542 Oct 2025865.00MERIDIAN HEALTH PLANNot denied—