AMARA OKAFOR
Subscriber on policy B03M000000
Claims
3
Attributed to this person
Charged
2,143.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
195.60
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 | AMARA OKAFOR |
| Role on the policy | Subscriber |
| Policy | B03M000000 |
| Date of birth | 4 Apr 1986 |
| Plan | PLATINUM PPO |
| Covered from | 3 Jan 2025 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 1 · Deductible | 2 | 195.60 |
| Total | 195.60 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000002 | 3 Aug 2026 | 474.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000001 | 1 Feb 2026 | 839.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000003 | 19 Jan 2025 | 830.00 | NORTHSTAR MUTUAL | Not denied | — |