MARCUS OKAFOR
Dependent on policy B09M000489
Claims
1
Attributed to this person
Charged
504.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
20.00
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 | MARCUS OKAFOR |
| Role on the policy | Dependent · relationship 19 |
| Policy | B09M000489 |
| Date of birth | 8 May 2011 |
| Plan | BRONZE EPO |
| Covered from | 8 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 20.00 |
| Total | 20.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002057 | 18 Dec 2025 | 504.00 | NORTHSTAR MUTUAL | Not denied | — |