KEVIN OKAFOR
Subscriber on policy B07M000570
Claims
2
Attributed to this person
Charged
762.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
44.20
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 | KEVIN OKAFOR |
| Role on the policy | Subscriber |
| Policy | B07M000570 |
| Date of birth | 14 Oct 1996 |
| Plan | BRONZE EPO |
| Covered from | 2 Feb 2024 |
| Covered to | 20 Sep 2024 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 44.20 |
| Total | 44.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002411 | 18 Jun 2024 | 68.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |
| CLM0002412 | 25 Apr 2024 | 694.00 | CASCADE CARE | Not denied | — |