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 B05M000342›NADIA OKAFOR

NADIA OKAFOR

Dependent on policy B05M000342

Claims
3
Attributed to this person
Charged
1,697.00
Total submitted
Denied
828.00
2 denied claims
Patient responsibility
130.35
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
NameNADIA OKAFOR
Role on the policyDependent · relationship 19
PolicyB05M000342
Date of birth3 Sep 2009
PlanSILVER HMO
Covered from7 Mar 2025
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 1 · Deductible1130.35
Total130.35

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000146123 Nov 2025561.00MERIDIAN HEALTH PLANCARC 29 · TIMELY_FILING561.00
CLM000146218 Apr 2025869.00MERIDIAN HEALTH PLANNot denied—
CLM000146025 Feb 2025267.00MERIDIAN HEALTH PLANCARC 26 · ELIGIBILITY267.00