Billing Ledger
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Total Paid
$6,730
of $8,685 billed
Pending
4
claims awaiting payment
Denied
1
need resubmission
Claims Ledger · 18 participants · Click to expand history
| Medicaid ID | Participant | Start Date | End Date | Service Code | Units | Billed | Paid | Status | |
|---|---|---|---|---|---|---|---|---|---|
| 1234567890 | AKANA, KEONI(3) | 02/01 | 02/01 | T2025 | 4 | $250 | $250 | Paid | |
| 1234567891 | CHANG, LISA(2) | 02/01 | 02/01 | S5125 U4 | 8 | $480 | $480 | Paid | |
| 1234567892 | FERNANDEZ, MARIA(2) | 02/02 | 02/02 | T2025 | 6 | $375 | $0 | Pending | |
| 1234567893 | GONZALES, JUAN | 02/02 | 02/03 | S5125 U3 | 4 | $240 | $240 | Paid | |
| 1234567894 | HONDA, YUKI(2) | 02/03 | 02/03 | T2025 | 8 | $500 | $0 | Denied | |
| 1234567895 | INOUE, TAKESHI | 02/03 | 02/04 | S5125 U4 | 6 | $360 | $360 | Paid | |
| 1234567896 | JOHNSON, MICHAEL | 02/04 | 02/04 | T2025 | 4 | $250 | $250 | Paid | |
| 1234567897 | KALANI, MALIA(3) | 02/04 | 02/05 | S5125 U2 | 8 | $480 | $0 | Pending | |
| 1234567898 | LEE, DAVID | 02/05 | 02/05 | T2025 | 6 | $375 | $375 | Paid | |
| 1234567899 | MARTIN, SARAH | 02/05 | 02/05 | S5125 U4 | 4 | $240 | $240 | Paid | |
| 1234567900 | NAKAMURA, YUKI | 02/05 | 02/06 | T2025 | 4 | $250 | $250 | Paid | |
| 1234567901 | ORTEGA, CARLOS | 02/05 | 02/05 | S5125 U3 | 6 | $360 | $0 | Pending | |
| 1234567902 | PARK, JENNY | 02/06 | 02/06 | T2025 | 8 | $500 | $500 | Paid | |
| 1234567903 | QUINN, MICHAEL | 02/06 | 02/06 | S5125 U4 | 4 | $240 | $240 | Paid | |
| 1234567904 | REYES, ANA | 02/06 | 02/07 | T2025 | 6 | $375 | $375 | Paid | |
| 1234567905 | SANTOS, JOSE | 02/06 | 02/06 | S5125 U2 | 4 | $240 | $0 | Pending | |
| 1234567906 | TANAKA, KENJI | 02/06 | 02/06 | T2025 | 8 | $500 | $500 | Paid | |
| 1234567907 | UEDA, MIKA | 02/06 | 02/07 | S5125 U4 | 6 | $360 | $360 | Paid |