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 B09M000121›NADIA ANDERSON

NADIA ANDERSON

Subscriber on policy B09M000121

Claims
3
Attributed to this person
Charged
1,397.00
Total submitted
Denied
258.00
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
NameNADIA ANDERSON
Role on the policySubscriber
PolicyB09M000121
Date of birth9 Mar 1980
PlanGOLD PPO
Covered from22 Apr 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000049915 Jun 2025433.00MERIDIAN HEALTH PLANNot denied—
CLM000049711 Apr 2025258.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY258.00
CLM00004983 Nov 2024706.00MERIDIAN HEALTH PLANNot denied—