MARCUS OKAFOR
Subscriber on policy B07M000306
Claims
2
Attributed to this person
Charged
610.00
Total submitted
Denied
160.00
2 denied claims
Patient responsibility
292.50
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 | MARCUS OKAFOR |
| Role on the policy | Subscriber |
| Policy | B07M000306 |
| Date of birth | 28 Jan 1990 |
| Plan | GOLD PPO |
| Covered from | 8 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 292.50 |
| Total | 292.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001313 | 26 Jul 2025 | 450.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0001312 | 3 Apr 2025 | 160.00 | NORTHSTAR MUTUAL | CARC 16 · BILLING_ERROR | 160.00 |