PRIYA OKAFOR
Dependent on policy B06M000375
Claims
3
Attributed to this person
Charged
960.00
Total submitted
Denied
158.00
2 denied claims
Patient responsibility
202.15
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 | PRIYA OKAFOR |
| Role on the policy | Dependent · relationship 19 |
| Policy | B06M000375 |
| Date of birth | 30 Sep 2007 |
| Plan | PLATINUM PPO |
| Covered from | 28 Nov 2024 |
| Covered to | 9 Aug 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 202.15 |
| Total | 202.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001714 | 30 Sep 2025 | 311.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0001716 | 16 Jun 2025 | 491.00 | CASCADE CARE | Not denied | — |
| CLM0001715 | 27 Nov 2024 | 158.00 | CASCADE CARE | CARC 18 · DUPLICATE | 158.00 |