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 B10M000420›NADIA OKAFOR

NADIA OKAFOR

Subscriber on policy B10M000420

Claims
1
Attributed to this person
Charged
584.00
Total submitted
Denied
273.11
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 OKAFOR
Role on the policySubscriber
PolicyB10M000420
Date of birth15 Jan 1958
PlanBRONZE EPO
Covered from30 Apr 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00017472 Sep 2025584.00MERIDIAN HEALTH PLANCARC 109 ยท COB273.11