CARLA OKAFOR
Dependent on policy B07M000843
Claims
1
Attributed to this person
Charged
283.00
Total submitted
Denied
283.00
1 denied claims
Patient responsibility
0.00
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
| Field | Value |
|---|---|
| Name | CARLA OKAFOR |
| Role on the policy | Dependent · relationship 19 |
| Policy | B07M000843 |
| Date of birth | 4 Feb 2000 |
| Plan | PLATINUM PPO |
| Covered from | 3 May 2024 |
| Covered to | 27 Oct 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003465 | 13 Apr 2024 | 283.00 | NORTHSTAR MUTUAL | CARC 26 · ELIGIBILITY | 283.00 |