AMARA OKAFOR
Subscriber on policy B09M000449
Claims
3
Attributed to this person
Charged
1,648.00
Total submitted
Denied
1,047.00
2 denied claims
Patient responsibility
120.20
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 | AMARA OKAFOR |
| Role on the policy | Subscriber |
| Policy | B09M000449 |
| Date of birth | 24 May 1961 |
| Plan | PLATINUM PPO |
| Covered from | 7 Apr 2025 |
| Covered to | 30 Sep 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 120.20 |
| Total | 120.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001879 | 12 Nov 2025 | 643.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 643.00 |
| CLM0001881 | 2 Nov 2025 | 601.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001880 | 17 Aug 2025 | 404.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 404.00 |