RAVI OKAFOR
Subscriber on policy B09M000580
Claims
1
Attributed to this person
Charged
505.00
Total submitted
Denied
505.00
1 denied claims
Patient responsibility
0.00
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 | RAVI OKAFOR |
| Role on the policy | Subscriber |
| Policy | B09M000580 |
| Date of birth | 2 May 1962 |
| Plan | BRONZE EPO |
| Covered from | 29 Jan 2024 |
| Covered to | 29 Aug 2024 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002451 | 15 Oct 2024 | 505.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 505.00 |