SOFIA OKAFOR
Subscriber on policy B03M000403
Claims
2
Attributed to this person
Charged
589.00
Total submitted
Denied
19.34
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 | SOFIA OKAFOR |
| Role on the policy | Subscriber |
| Policy | B03M000403 |
| Date of birth | 3 Oct 1964 |
| Plan | PLATINUM PPO |
| Covered from | 10 Apr 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 |
|---|---|---|---|---|---|
| CLM0001641 | 6 Jul 2024 | 75.00 | MERIDIAN HEALTH PLAN | CARC 29 · TIMELY_FILING | 19.34 |
| CLM0001640 | 4 Jul 2024 | 514.00 | MERIDIAN HEALTH PLAN | Not denied | — |