TOMAS OKAFOR
Dependent on policy B08M000398
Claims
3
Attributed to this person
Charged
1,187.00
Total submitted
Denied
612.06
2 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 | TOMAS OKAFOR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B08M000398 |
| Date of birth | 17 Apr 1995 |
| Plan | BRONZE EPO |
| Covered from | 5 Feb 2024 |
| Covered to | 30 Nov 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 |
|---|---|---|---|---|---|
| CLM0001824 | 3 Nov 2024 | 436.00 | CASCADE CARE | Not denied | — |
| CLM0001823 | 31 Aug 2024 | 517.00 | CASCADE CARE | CARC 96 · NON_COVERED | 517.00 |
| CLM0001825 | 30 Jun 2024 | 234.00 | CASCADE CARE | CARC 197 · AUTHORIZATION | 95.06 |