GRACE OKAFOR
Subscriber on policy B05M000204
Claims
3
Attributed to this person
Charged
2,197.00
Total submitted
Denied
601.30
2 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 | GRACE OKAFOR |
| Role on the policy | Subscriber |
| Policy | B05M000204 |
| Date of birth | 14 Apr 1997 |
| Plan | PLATINUM PPO |
| Covered from | 22 Sep 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 |
|---|---|---|---|---|---|
| CLM0000854 | 25 Jun 2026 | 737.00 | NORTHSTAR MUTUAL | Not denied | — |
| CLM0000855 | 30 Jul 2025 | 794.00 | NORTHSTAR MUTUAL | CARC 96 · NON_COVERED | 344.86 |
| CLM0000853 | 17 Jan 2025 | 666.00 | NORTHSTAR MUTUAL | CARC 11 · CODING | 256.44 |