OMAR OKAFOR
Dependent on policy B03M000557
Claims
1
Attributed to this person
Charged
177.00
Total submitted
Denied
177.00
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 | OMAR OKAFOR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000557 |
| Date of birth | 2 Sep 1965 |
| Plan | BRONZE EPO |
| Covered from | 8 Sep 2024 |
| Covered to | 10 Mar 2025 |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0002277 | 20 Nov 2024 | 177.00 | MERIDIAN HEALTH PLAN | CARC 50 · MEDICAL_NECESSITY | 177.00 |