HENRY OKAFOR
Subscriber on policy B01M000846
Claims
2
Attributed to this person
Charged
489.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
169.65
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 | HENRY OKAFOR |
| Role on the policy | Subscriber |
| Policy | B01M000846 |
| Date of birth | 1 Jun 1973 |
| Plan | PLATINUM PPO |
| Covered from | 22 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 169.65 |
| Total | 169.65 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003750 | 16 Apr 2026 | 261.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |
| CLM0003749 | 18 Dec 2025 | 228.00 | CASCADE CARE | Not denied | — |