AMARA OKAFOR
Subscriber on policy B09M000489
Claims
2
Attributed to this person
Charged
1,025.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
153.75
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 | B09M000489 |
| Date of birth | 6 Apr 1975 |
| Plan | BRONZE EPO |
| Covered from | 8 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 2 | 153.75 |
| Total | 153.75 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002054 | 12 Oct 2025 | 428.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0002055 | 29 Mar 2024 | 597.00 | NORTHSTAR MUTUAL | Not denied | — |