FIONA OKAFOR
Subscriber on policy B09M000464
Claims
2
Attributed to this person
Charged
527.00
Total submitted
Denied
193.00
1 denied claims
Patient responsibility
50.10
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 | FIONA OKAFOR |
| Role on the policy | Subscriber |
| Policy | B09M000464 |
| Date of birth | 29 Mar 1998 |
| Plan | PLATINUM PPO |
| Covered from | 29 Apr 2025 |
| Covered to | 27 Sep 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 50.10 |
| Total | 50.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001957 | 21 Oct 2025 | 193.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 193.00 |
| CLM0001956 | 13 Oct 2025 | 334.00 | CASCADE CARE | Not denied | — |