CARLA OKAFOR
Dependent on policy B03M000085
Claims
3
Attributed to this person
Charged
1,268.00
Total submitted
Denied
338.28
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 | CARLA OKAFOR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B03M000085 |
| Date of birth | 11 Sep 1984 |
| Plan | SILVER HMO |
| Covered from | 22 Feb 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 |
|---|---|---|---|---|---|
| CLM0000362 | 19 Jun 2026 | 845.00 | NORTHSTAR MUTUAL | CARC 50 · MEDICAL_NECESSITY | 338.28 |
| CLM0000363 | 16 Mar 2025 | 120.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000361 | 3 Mar 2025 | 303.00 | NORTHSTAR MUTUAL | Not denied | — |