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 B02M000162›WENDY QUINN

WENDY QUINN

Dependent on policy B02M000162

Claims
2
Attributed to this person
Charged
954.00
Total submitted
Denied
133.00
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
NameWENDY QUINN
Role on the policyDependent · relationship 19
PolicyB02M000162
Date of birth17 Apr 1983
PlanSILVER HMO
Covered from21 Jun 2025
Covered to12 Apr 2026

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000073619 Sep 2025133.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING133.00
CLM000073517 Jul 2025821.00MERIDIAN HEALTH PLANNot denied—