CARLA OKAFOR
Dependent on policy B05M000048
Claims
3
Attributed to this person
Charged
1,913.00
Total submitted
Denied
666.00
1 denied claims
Patient responsibility
130.80
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 | CARLA OKAFOR |
| Role on the policy | Dependent · relationship 01 |
| Policy | B05M000048 |
| Date of birth | 16 May 1983 |
| Plan | GOLD PPO |
| Covered from | 8 Jul 2024 |
| Covered to | 1 May 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 2 · Coinsurance | 1 | 130.80 |
| Total | 130.80 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000222 | 16 May 2025 | 666.00 | MERIDIAN HEALTH PLAN | CARC 27 · ELIGIBILITY | 666.00 |
| CLM0000221 | 30 Apr 2025 | 593.00 | MERIDIAN HEALTH PLAN | Not denied | — |
| CLM0000220 | 19 Aug 2024 | 654.00 | MERIDIAN HEALTH PLAN | Not denied | — |