OMAR OKAFOR
Dependent on policy B10M000735
Claims
2
Attributed to this person
Charged
1,414.00
Total submitted
Denied
160.70
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 | OMAR OKAFOR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B10M000735 |
| Date of birth | 12 Jan 1970 |
| Plan | BRONZE EPO |
| Covered from | 6 Jan 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003089 | 2 Dec 2024 | 579.00 | MERIDIAN HEALTH PLAN | CARC 18 · DUPLICATE | 160.70 |
| CLM0003090 | 22 Oct 2024 | 835.00 | MERIDIAN HEALTH PLAN | Not denied | — |