GRACE OKAFOR
Subscriber on policy B06M000730
Claims
2
Attributed to this person
Charged
1,314.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
439.40
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 | GRACE OKAFOR |
| Role on the policy | Subscriber |
| Policy | B06M000730 |
| Date of birth | 31 Dec 1996 |
| Plan | PLATINUM PPO |
| Covered from | 5 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 439.40 |
| Total | 439.40 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003256 | 14 Jun 2026 | 676.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0003255 | 12 Mar 2026 | 638.00 | CASCADE CARE | Not denied | — |