CARLA OKAFOR
Subscriber on policy B10M000572
Claims
1
Attributed to this person
Charged
581.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
116.20
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 | CARLA OKAFOR |
| Role on the policy | Subscriber |
| Policy | B10M000572 |
| Date of birth | 3 Sep 1990 |
| Plan | SILVER HMO |
| Covered from | 16 Sep 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 116.20 |
| Total | 116.20 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002366 | 11 Jun 2026 | 581.00 | NORTHSTAR MUTUAL | Not denied | — |