IVAN OKAFOR
Subscriber on policy B02M000024
Claims
3
Attributed to this person
Charged
834.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
118.30
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 | IVAN OKAFOR |
| Role on the policy | Subscriber |
| Policy | B02M000024 |
| Date of birth | 9 Feb 1999 |
| Plan | BRONZE EPO |
| Covered from | 5 Feb 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 84.50 |
| CARC 2 · Coinsurance | 1 | 33.80 |
| Total | 118.30 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000132 | 26 Dec 2025 | 535.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000130 | 30 Mar 2025 | 130.00 | MERIDIAN HEALTH PLAN | CARC 96 · NON_COVERED | 0.00 |
| CLM0000131 | 26 Feb 2024 | 169.00 | MERIDIAN HEALTH PLAN | Not denied | — |