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 B01M000436›CARLA HUGHES

CARLA HUGHES

Subscriber on policy B01M000436

Claims
3
Attributed to this person
Charged
836.00
Total submitted
Denied
108.00
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
NameCARLA HUGHES
Role on the policySubscriber
PolicyB01M000436
Date of birth23 Feb 1982
PlanGOLD PPO
Covered from19 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000191929 Mar 2026202.00MERIDIAN HEALTH PLANNot denied—
CLM000192014 Apr 2025526.00MERIDIAN HEALTH PLANNot denied—
CLM000192130 Jan 2025108.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY108.00