PRIYA OKAFOR
Subscriber on policy B05M000671
Claims
3
Attributed to this person
Charged
1,224.00
Total submitted
Denied
1,224.00
3 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 | PRIYA OKAFOR |
| Role on the policy | Subscriber |
| Policy | B05M000671 |
| Date of birth | 24 Jan 1976 |
| Plan | GOLD PPO |
| Covered from | 1 Jul 2024 |
| Covered to | 25 Jan 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 |
|---|---|---|---|---|---|
| CLM0002891 | 25 Feb 2025 | 624.00 | NORTHSTAR MUTUAL | CARC 27 · ELIGIBILITY | 624.00 |
| CLM0002889 | 4 Feb 2025 | 470.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 470.00 |
| CLM0002890 | 16 Oct 2024 | 130.00 | NORTHSTAR MUTUAL | CARC 18 · DUPLICATE | 130.00 |