LEILA OKAFOR
Subscriber on policy B10M000333
Claims
3
Attributed to this person
Charged
1,290.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
230.10
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 | LEILA OKAFOR |
| Role on the policy | Subscriber |
| Policy | B10M000333 |
| Date of birth | 2 Nov 1981 |
| Plan | GOLD PPO |
| Covered from | 15 Oct 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 230.10 |
| Total | 230.10 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001389 | 11 Dec 2025 | 208.00 | CASCADE CARE | Not denied | — |
| CLM0001388 | 22 Jul 2025 | 354.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0001390 | 5 Jun 2025 | 728.00 | CASCADE CARE | Not denied | — |