| Invoice # | Provider Id | First Name | Last Name | Submit Date | Service Date | Billed | Remitted | Status | Reconcile | Re-bill |
|---|---|---|---|---|---|---|---|---|---|---|
| {{invoice.invoiceNumber}} | {{invoice.providerId}} | {{invoice.firstName}} | {{invoice.lastName}} | {{invoice.submitDate}} | {{invoice.dateOfService}} | {{invoice.invoicedAmount}} | {{invoice.paidAmount}} | {{invoice.status}} |