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 B09M000421›ELENA NGUYEN

ELENA NGUYEN

Dependent on policy B09M000421

Claims
3
Attributed to this person
Charged
1,151.00
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
NameELENA NGUYEN
Role on the policyDependent · relationship 19
PolicyB09M000421
Date of birth20 May 2022
PlanGOLD PPO
Covered from25 Feb 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000175615 Feb 2026180.00MERIDIAN HEALTH PLANNot denied—
CLM00017571 Nov 2024504.00MERIDIAN HEALTH PLANNot denied—
CLM000175830 Apr 2024467.00MERIDIAN HEALTH PLANNot denied—