HENRY OKAFOR
Dependent on policy B01M000030
Claims
3
Attributed to this person
Charged
1,403.00
Total submitted
Denied
579.00
2 denied claims
Patient responsibility
164.80
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 | Dependent · relationship 19 |
| Policy | B01M000030 |
| Date of birth | 29 Jul 2016 |
| Plan | PLATINUM PPO |
| Covered from | 24 Mar 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 164.80 |
| Total | 164.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000123 | 29 Jun 2026 | 824.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000121 | 19 Mar 2025 | 157.00 | MERIDIAN HEALTH PLAN | CARC 26 · ELIGIBILITY | 157.00 |
| CLM0000122 | 4 Mar 2025 | 422.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 422.00 |