KEVIN OKAFOR
Subscriber on policy B09M000699
Claims
3
Attributed to this person
Charged
1,348.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
156.00
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 | KEVIN OKAFOR |
| Role on the policy | Subscriber |
| Policy | B09M000699 |
| Date of birth | 19 Jul 1954 |
| Plan | BRONZE EPO |
| Covered from | 7 Aug 2024 |
| Covered to | 15 Mar 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 118.80 |
| CARC 1 · Deductible | 1 | 37.20 |
| Total | 156.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002976 | 11 Sep 2024 | 248.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002977 | 21 Jul 2024 | 506.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0002978 | 17 Jul 2024 | 594.00 | MERIDIAN HEALTH PLAN | Not denied | — |