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 B04M000099›UMA HUGHES

UMA HUGHES

Dependent on policy B04M000099

Claims
1
Attributed to this person
Charged
105.00
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
NameUMA HUGHES
Role on the policyDependent · relationship 19
PolicyB04M000099
Date of birth18 Aug 2013
PlanBRONZE EPO
Covered from9 Jun 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00004526 Jul 2025105.00MERIDIAN HEALTH PLANNot denied—