LEILA OKAFOR
Dependent on policy B10M000420
Claims
2
Attributed to this person
Charged
1,081.00
Total submitted
Denied
275.19
1 denied claims
Patient responsibility
41.55
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 | LEILA OKAFOR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000420 |
| Date of birth | 3 Aug 1960 |
| Plan | BRONZE EPO |
| Covered from | 30 Apr 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 41.55 |
| Total | 41.55 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001749 | 18 Nov 2025 | 277.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0001748 | 14 Jul 2025 | 804.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 275.19 |