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 B04M000383›CARLA HUGHES

CARLA HUGHES

Dependent on policy B04M000383

Claims
1
Attributed to this person
Charged
711.00
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
NameCARLA HUGHES
Role on the policyDependent · relationship 19
PolicyB04M000383
Date of birth12 Jun 1980
PlanSILVER HMO
Covered from4 Feb 2025
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000163722 Mar 2025711.00MERIDIAN HEALTH PLANNot denied—