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 B10M000307›NADIA OKAFOR

NADIA OKAFOR

Dependent on policy B10M000307

Claims
2
Attributed to this person
Charged
973.00
Total submitted
Denied
973.00
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
NameNADIA OKAFOR
Role on the policyDependent · relationship 19
PolicyB10M000307
Date of birth10 Jan 2010
PlanGOLD PPO
Covered from10 Jan 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00012955 Jul 2025886.00CASCADE CARECARC 27 · ELIGIBILITY886.00
CLM00012945 Apr 202587.00CASCADE CARECARC 27 · ELIGIBILITY87.00