CARLA OKAFOR
Subscriber on policy B06M000127
Claims
3
Attributed to this person
Charged
1,744.00
Total submitted
Denied
525.00
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
| Field | Value |
|---|---|
| Name | CARLA OKAFOR |
| Role on the policy | Subscriber |
| Policy | B06M000127 |
| Date of birth | 24 May 1959 |
| Plan | SILVER HMO |
| Covered from | 4 May 2024 |
| Covered to | 11 Aug 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000626 | 12 Sep 2024 | 525.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 525.00 |
| CLM0000625 | 2 Aug 2024 | 392.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000624 | 17 Jun 2024 | 827.00 | NORTHSTAR MUTUAL | Not denied | — |