OMAR OKAFOR
Subscriber on policy B06M000141
Claims
3
Attributed to this person
Charged
958.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
17.40
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 | OMAR OKAFOR |
| Role on the policy | Subscriber |
| Policy | B06M000141 |
| Date of birth | 14 Apr 1992 |
| Plan | BRONZE EPO |
| Covered from | 3 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 17.40 |
| Total | 17.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000692 | 4 Mar 2025 | 87.00 | CASCADE CARE | Not denied | — |
| CLM0000691 | 26 Nov 2024 | 571.00 | CASCADE CARE | Not denied | — |
| CLM0000690 | 9 Sep 2024 | 300.00 | CASCADE CARE | Not denied | — |