Submitted
Daily billing PDFs · Awaiting state remittance
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Submitted Billings · 11 participants · Click to expand history
| Medicaid ID | Participant | Start Date | End Date | Service Code | Units | Billed | Submitted | Status | |
|---|---|---|---|---|---|---|---|---|---|
| 1234567890 | AKANA, KEONI(3) | 02/01 | 02/01 | T2025 | 4 | $250 | 02/02 | Pending | |
| 1234567891 | CHANG, LISA(2) | 02/01 | 02/01 | S5125 | 8 | $480 | 02/02 | Pending | |
| 1234567892 | FERNANDEZ, MARIA(2) | 02/02 | 02/02 | T2025 | 6 | $375 | 02/03 | Pending | |
| 1234567893 | GONZALES, JUAN | 02/02 | 02/03 | S5125 | 4 | $240 | 02/04 | Pending | |
| 1234567894 | HONDA, YUKI(2) | 02/03 | 02/03 | T2025 | 8 | $500 | 02/04 | Pending | |
| 1234567895 | INOUE, TAKESHI | 02/03 | 02/04 | S5125 | 6 | $360 | 02/05 | Pending | |
| 1234567896 | JOHNSON, MICHAEL | 02/04 | 02/04 | T2025 | 4 | $250 | 02/05 | Pending | |
| 1234567897 | KALANI, MALIA(3) | 02/04 | 02/05 | S5125 | 8 | $480 | 02/06 | Pending | |
| 1234567898 | LEE, DAVID | 02/05 | 02/05 | T2025 | 6 | $375 | 02/06 | Pending | |
| 1234567899 | MARTIN, SARAH | 02/05 | 02/05 | S5125 | 4 | $240 | 02/06 | Pending | |
| 1234567900 | NAKAMURA, YUKI | 02/05 | 02/06 | T2025 | 4 | $250 | 02/07 | Pending |