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 B03M000320›AMARA NGUYEN

AMARA NGUYEN

Subscriber on policy B03M000320

Claims
2
Attributed to this person
Charged
1,754.00
Total submitted
Denied
860.00
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
NameAMARA NGUYEN
Role on the policySubscriber
PolicyB03M000320
Date of birth25 Apr 1973
PlanBRONZE EPO
Covered from22 Mar 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000127817 Apr 2025860.00MERIDIAN HEALTH PLANCARC 50 · MEDICAL_NECESSITY860.00
CLM000127926 Oct 2024894.00MERIDIAN HEALTH PLANNot denied—