SOFIA OKAFOR
Subscriber on policy B10M000820
Claims
1
Attributed to this person
Charged
361.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
54.15
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 | Subscriber |
| Policy | B10M000820 |
| Date of birth | 13 Jun 1961 |
| Plan | GOLD PPO |
| Covered from | 18 May 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 54.15 |
| Total | 54.15 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003464 | 1 Sep 2024 | 361.00 | MERIDIAN HEALTH PLAN | Not denied | — |