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 B09M000101›ZARA NGUYEN

ZARA NGUYEN

Dependent on policy B09M000101

Claims
3
Attributed to this person
Charged
2,250.00
Total submitted
Denied
790.00
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
NameZARA NGUYEN
Role on the policyDependent · relationship 01
PolicyB09M000101
Date of birth9 Jan 1998
PlanGOLD PPO
Covered from16 Nov 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00004225 Nov 2025759.00MERIDIAN HEALTH PLANNot denied—
CLM000042111 Oct 2025790.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING790.00
CLM00004233 Oct 2025701.00MERIDIAN HEALTH PLANNot denied—