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 B10M000724›YUSUF NGUYEN

YUSUF NGUYEN

Subscriber on policy B10M000724

Claims
2
Attributed to this person
Charged
1,182.00
Total submitted
Denied
649.00
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 — 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
NameYUSUF NGUYEN
Role on the policySubscriber
PolicyB10M000724
Date of birth4 Sep 1955
PlanBRONZE EPO
Covered from28 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000303718 Mar 2025533.00MERIDIAN HEALTH PLANNot denied—
CLM000303625 Mar 2024649.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY649.00