LEILA OKAFOR
Subscriber on policy B02M000735
Claims
1
Attributed to this person
Charged
560.00
Total submitted
Denied
560.00
1 denied claims
Patient responsibility
0.00
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 | B02M000735 |
| Date of birth | 24 Mar 1978 |
| Plan | BRONZE EPO |
| Covered from | 18 Jun 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003072 | 7 Dec 2024 | 560.00 | MERIDIAN HEALTH PLAN | CARC 197 · AUTHORIZATION | 560.00 |