RAVI OKAFOR
Subscriber on policy B06M000038
Claims
2
Attributed to this person
Charged
789.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
25.00
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 | RAVI OKAFOR |
| Role on the policy | Subscriber |
| Policy | B06M000038 |
| Date of birth | 22 Dec 1985 |
| Plan | SILVER HMO |
| Covered from | 23 Feb 2025 |
| Covered to | 16 Nov 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 25.00 |
| Total | 25.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000215 | 17 Sep 2025 | 125.00 | CASCADE CARE | Not denied | — |
| CLM0000216 | 9 Apr 2025 | 664.00 | CASCADE CARE | Not denied | — |