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 B10M000132›FIONA CHEN

FIONA CHEN

Subscriber on policy B10M000132

Claims
1
Attributed to this person
Charged
651.00
Total submitted
Denied
651.00
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
NameFIONA CHEN
Role on the policySubscriber
PolicyB10M000132
Date of birth13 May 1998
PlanSILVER HMO
Covered from12 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000054521 Sep 2025651.00MERIDIAN HEALTH PLANCARC 27 ยท ELIGIBILITY651.00