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 B06M000177›VICTOR TANAKA

VICTOR TANAKA

Dependent on policy B06M000177

Claims
3
Attributed to this person
Charged
1,272.00
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
NameVICTOR TANAKA
Role on the policyDependent · relationship 01
PolicyB06M000177
Date of birth19 May 1957
PlanPLATINUM PPO
Covered from3 May 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000086616 May 2026218.00MERIDIAN HEALTH PLANNot denied—
CLM000086410 Feb 2026500.00MERIDIAN HEALTH PLANNot denied—
CLM000086525 Jun 2025554.00MERIDIAN HEALTH PLANNot denied—