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 B02M000039›UMA HUGHES

UMA HUGHES

Subscriber on policy B02M000039

Claims
2
Attributed to this person
Charged
965.00
Total submitted
Denied
432.00
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
NameUMA HUGHES
Role on the policySubscriber
PolicyB02M000039
Date of birth23 Dec 1974
PlanGOLD PPO
Covered from7 Apr 2025
Covered to9 Nov 2025

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000019514 Nov 2025432.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY432.00
CLM00001946 Oct 2025533.00MERIDIAN HEALTH PLANNot denied—