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 B06M000325›HENRY DIAZ

HENRY DIAZ

Subscriber on policy B06M000325

Claims
3
Attributed to this person
Charged
1,311.00
Total submitted
Denied
347.00
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 DIAZ
Role on the policySubscriber
PolicyB06M000325
Date of birth22 Feb 1976
PlanGOLD PPO
Covered from15 Apr 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000148716 Feb 2026182.00MERIDIAN HEALTH PLANNot denied—
CLM000148623 Jan 2026347.00MERIDIAN HEALTH PLANCARC 50 · MEDICAL_NECESSITY347.00
CLM000148818 Nov 2025782.00MERIDIAN HEALTH PLANNot denied—