UMA OKAFOR
Dependent on policy B05M000255
Claims
3
Attributed to this person
Charged
1,274.00
Total submitted
Denied
0.00
0 denied claims
Patient responsibility
40.00
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 | UMA OKAFOR |
| Role on the policy | Dependent · relationship 19 |
| Policy | B05M000255 |
| Date of birth | 5 Oct 2017 |
| Plan | PLATINUM PPO |
| Covered from | 11 Oct 2024 |
| Covered to | 27 Feb 2025 |
Patient responsibility reported on the 835
| Reason | Adjustments | Amount reported |
|---|---|---|
| CARC 3 · Copay | 1 | 40.00 |
| Total | 40.00 |
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0001050 | 5 Jan 2025 | 355.00 | CASCADE CARE | Not denied | — |
| CLM0001048 | 19 Dec 2024 | 244.00 | CASCADE CARE | Not denied | — |
| CLM0001049 | 30 Oct 2024 | 675.00 | CASCADE CARE | Not denied | — |