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 B04M000293›FIONA NGUYEN

FIONA NGUYEN

Subscriber on policy B04M000293

Claims
2
Attributed to this person
Charged
1,321.00
Total submitted
Denied
752.00
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
NameFIONA NGUYEN
Role on the policySubscriber
PolicyB04M000293
Date of birth16 Jun 1984
PlanGOLD PPO
Covered from8 Apr 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000127027 Apr 2026569.00MERIDIAN HEALTH PLANNot denied—
CLM000127127 May 2025752.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY752.00