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 B10M000121›DAVID NGUYEN

DAVID NGUYEN

Subscriber on policy B10M000121

Claims
3
Attributed to this person
Charged
1,257.00
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
NameDAVID NGUYEN
Role on the policySubscriber
PolicyB10M000121
Date of birth26 Mar 1950
PlanPLATINUM PPO
Covered from15 Apr 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000050626 Mar 202685.00MERIDIAN HEALTH PLANNot denied—
CLM000050827 Jun 2025443.00MERIDIAN HEALTH PLANNot denied—
CLM000050714 Jun 2025729.00MERIDIAN HEALTH PLANNot denied—