WENDY OKAFOR
Subscriber on policy B08M000204
Claims
1
Attributed to this person
Charged
511.00
Total submitted
Denied
511.00
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 | WENDY OKAFOR |
| Role on the policy | Subscriber |
| Policy | B08M000204 |
| Date of birth | 4 Feb 1983 |
| Plan | GOLD PPO |
| Covered from | 26 Apr 2024 |
| Covered to | 14 Aug 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 |
|---|---|---|---|---|---|
| CLM0000907 | 24 Sep 2024 | 511.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 511.00 |