X12 Ingest & Denial Analytics

Demo Environment โ€” Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B06M000363›BRIAN USMAN

BRIAN USMAN

Subscriber on policy B06M000363

Claims
1
Attributed to this person
Charged
411.00
Total submitted
Denied
411.00
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 โ€” 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
NameBRIAN USMAN
Role on the policySubscriber
PolicyB06M000363
Date of birth8 Nov 1953
PlanPLATINUM PPO
Covered from21 Nov 2024
Covered to23 Jul 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000165122 Dec 2024411.00MERIDIAN HEALTH PLANCARC 96 ยท NON_COVERED411.00