GRACE OKAFOR
Subscriber on policy B05M000255
Claims
3
Attributed to this person
Charged
1,463.00
Total submitted
Denied
336.00
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 | GRACE OKAFOR |
| Role on the policy | Subscriber |
| Policy | B05M000255 |
| Date of birth | 22 Nov 2001 |
| Plan | PLATINUM PPO |
| Covered from | 11 Oct 2024 |
| Covered to | 27 Feb 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 |
|---|---|---|---|---|---|
| CLM0001040 | 16 Apr 2025 | 896.00 | CASCADE CARE | Not denied | — |
| CLM0001039 | 11 Jan 2025 | 231.00 | CASCADE CARE | Not denied | — |
| CLM0001041 | 15 Sep 2024 | 336.00 | CASCADE CARE | CARC 26 · ELIGIBILITY | 336.00 |