SOFIA OKAFOR
Dependent on policy B09M000857
Claims
3
Attributed to this person
Charged
1,370.00
Total submitted
Denied
893.00
1 denied claims
Patient responsibility
18.00
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 | SOFIA OKAFOR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B09M000857 |
| Date of birth | 31 Aug 1969 |
| Plan | PLATINUM PPO |
| Covered from | 20 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 18.00 |
| Total | 18.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003636 | 13 Jul 2026 | 893.00 | NORTHSTAR MUTUAL | CARC 29 · TIMELY_FILING | 893.00 |
| CLM0003635 | 14 Jun 2025 | 357.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0003634 | 13 Apr 2025 | 120.00 | NORTHSTAR MUTUAL | Not denied | — |