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 B09M000471›NADIA BAKER

NADIA BAKER

Subscriber on policy B09M000471

Claims
1
Attributed to this person
Charged
533.00
Total submitted
Denied
533.00
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
NameNADIA BAKER
Role on the policySubscriber
PolicyB09M000471
Date of birth2 Jan 1951
PlanSILVER HMO
Covered from18 Apr 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000199525 Aug 2025533.00MERIDIAN HEALTH PLANCARC 27 ยท ELIGIBILITY533.00