X12 Ingest & Denial Analytics

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Members›policy B07M000171›BRIAN OKAFOR

BRIAN OKAFOR

Dependent on policy B07M000171

Claims
3
Attributed to this person
Charged
1,075.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
30.00
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

FieldValue
NameBRIAN OKAFOR
Role on the policyDependent · relationship 01
PolicyB07M000171
Date of birth18 May 1994
PlanBRONZE EPO
Covered from19 Dec 2024
Covered toopen

Patient responsibility reported on the 835

ReasonAdjustmentsAmount reported
CARC 3 · Copay130.00
Total30.00

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM00006923 May 2026251.00MERIDIAN HEALTH PLANNot denied—
CLM00006933 Feb 2025689.00MERIDIAN HEALTH PLANNot denied—
CLM000069427 Jan 2025135.00MERIDIAN HEALTH PLANNot denied—