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.

UMA QUINN

Subscriber on policy B01M000017

Claims
2
Attributed to this person
Charged
918.00
Total submitted
Denied
918.00
2 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
NameUMA QUINN
Role on the policySubscriber
PolicyB01M000017
Date of birth22 Mar 1968
PlanBRONZE EPO
Covered from17 Apr 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000006121 Apr 2026445.00MERIDIAN HEALTH PLANCARC 27 · ELIGIBILITY445.00
CLM00000624 May 2025473.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING473.00