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 B02M000190›NADIA SMITH

NADIA SMITH

Subscriber on policy B02M000190

Claims
2
Attributed to this person
Charged
964.00
Total submitted
Denied
0.00
0 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 SMITH
Role on the policySubscriber
PolicyB02M000190
Date of birth4 Jun 1965
PlanSILVER HMO
Covered from16 Feb 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000083714 May 2026705.00MERIDIAN HEALTH PLANNot denied—
CLM000083823 Apr 2024259.00MERIDIAN HEALTH PLANNot denied—