RAVI OKAFOR
Subscriber on policy B02M000211
Claims
3
Attributed to this person
Charged
1,565.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
124.50
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 | RAVI OKAFOR |
| Role on the policy | Subscriber |
| Policy | B02M000211 |
| Date of birth | 21 Jun 1952 |
| Plan | GOLD PPO |
| Covered from | 20 Mar 2025 |
| Covered to | 8 Nov 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 1 | 124.50 |
| Total | 124.50 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000925 | 29 Jul 2025 | 334.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000924 | 12 Jun 2025 | 401.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000926 | 12 Mar 2025 | 830.00 | NORTHSTAR MUTUAL | Not denied | — |