GRACE OKAFOR
Subscriber on policy B06M000572
Claims
1
Attributed to this person
Charged
472.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
70.80
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
| Field | Value |
|---|---|
| Name | GRACE OKAFOR |
| Role on the policy | Subscriber |
| Policy | B06M000572 |
| Date of birth | 3 Sep 1973 |
| Plan | BRONZE EPO |
| Covered from | 7 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 70.80 |
| Total | 70.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002560 | 11 Nov 2025 | 472.00 | MERIDIAN HEALTH PLAN | Not denied | — |