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 B01M000361›NADIA USMAN

NADIA USMAN

Dependent on policy B01M000361

Claims
2
Attributed to this person
Charged
1,012.00
Total submitted
Denied
583.00
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
NameNADIA USMAN
Role on the policyDependent · relationship 19
PolicyB01M000361
Date of birth17 Nov 2004
PlanBRONZE EPO
Covered from6 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00016001 Apr 2025429.00MERIDIAN HEALTH PLANNot denied—
CLM000160113 Mar 2025583.00MERIDIAN HEALTH PLANCARC 18 · DUPLICATE583.00