WENDY OKAFOR
Subscriber on policy B01M000296
Claims
3
Attributed to this person
Charged
1,012.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
142.35
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 | B01M000296 |
| Date of birth | 30 May 2003 |
| Plan | GOLD PPO |
| Covered from | 10 Feb 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 50 · Other | 1 | 105.95 |
| CARC 2 · Coinsurance | 1 | 36.40 |
| Total | 142.35 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001302 | 29 May 2026 | 182.00 | CASCADE CARE | Not denied | — |
| CLM0001303 | 5 Apr 2026 | 667.00 | CASCADE CARE | Not denied | — |
| CLM0001301 | 3 Feb 2026 | 163.00 | CASCADE CARE | CARC 50 · MEDICAL_NECESSITY | 0.00 |