Azure issues invoicing at a different cadence than CloudHealth which can lead to inconsistencies.
To generate the Azure invoice we call Microsofts Azure API to retrieve it and the statement is created by applying the Azure rate cards to Microsofts usage API. This results in the CloudHealth statement being based on calendar month date ranges (i.e. activity between January 1st - January 31st for "January"), which is different from Azure which may release invoices that may include dates from multiple months. To spot check, adjust CloudHealth reporting to "Daily" and reflect the date ranges listed in Azure invoices and the totals should line up correctly.