Tyler Martinez
7 lines
1.1 KiB
CSV
7 lines
1.1 KiB
CSV
"Client","Visit Date","Payer","Authorized","Member ID","Auth Start Date","Auth End Date","Authorization #","ICD-10","Service","Procedure Code","Modifiers","Client Classes","Billable Hours","Billable Amount","Invoice #","Claimed"
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"Roberts, Alice","02/05/2026","CO Medicaid","Yes","Q944140","01/01/2026","12/31/2026","3125","R69","PCS T1019","T1019","U1","DD Waiver","1","$333.62","INV-2026-02-05-Q944140","Yes"
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"Smith, Bob","06/25/2026","CO Medicaid","Yes","R649327","01/01/2026","12/31/2026","4521","R69","S5150","S5150","U8","DD Waiver","1","$235.55","INV-2026-06-25-R649327","Yes"
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"Davis, Carol","02/25/2026","CO Medicaid","Yes","Y188426","01/01/2026","12/31/2026","2890","R69","PCS T1019","T1019","KX:SC:U2","DD Waiver","1","$222.72","INV-2026-02-25-Y188426","Yes"
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"Lee, David","06/04/2026","CO Medicaid","Yes","R649327","01/01/2026","12/31/2026","4521","R69","S5150","S5150","U8","DD Waiver","1","$214.22","INV-2026-06-04-R649327","Yes"
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"Garcia, Eve","06/22/2026","CO Medicaid","Yes","R649327","01/01/2026","12/31/2026","4521","R69","S5150","S5150","U8","DD Waiver","1","$213.25","INV-2026-06-22-R649327","Yes"
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