IVAN OKAFOR
Subscriber on policy B05M000093
Claims
1
Attributed to this person
Charged
657.00
Total submitted
Denied
0.00
1 denied claims
Patient responsibility
427.05
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 | IVAN OKAFOR |
| Role on the policy | Subscriber |
| Policy | B05M000093 |
| Date of birth | 9 Feb 1975 |
| Plan | PLATINUM PPO |
| Covered from | 14 Dec 2024 |
| Covered to | open |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 96 · Other | 1 | 427.05 |
| Total | 427.05 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0000416 | 25 Mar 2026 | 657.00 | CASCADE CARE | CARC 96 · NON_COVERED | 0.00 |