Invoice # 1075 (Old Invoice # system). Customer Sylvia Smilen Trust: Rate = 15.00/hr.
Mrs. Sherman: I submitted to John Hancock for Claim #: R12 004 977 via fax @800.638.4040 on Jan 3, 2022@11:00AM.
Successful fax confirmation Jan 3, 2022@11:10AM
Date
Task
Description
Units
Total
12/01/2021
Standing Unit of Care for Sylvia Smilen/hr.
12/01/2021 Care: 3:00PM-9:00PM
6.00
90.00
12/03/2021
Standing Unit of Care for Sylvia Smilen/hr.
12/03/2021 Care: 3:00PM-9:00PM
6.00
90.00
12/08/2021
Standing Unit of Care for Sylvia Smilen/hr.
12/08/2021 Care: 3:00PM-9:00PM
6.00
90.00
12/10/2021
Standing Unit of Care for Sylvia Smilen/hr.
12/10/2021 Care: 3:00PM-10:00PM
7.00
105.00
12/15/2021
Standing Unit of Care for Sylvia Smilen/hr.
12/15/2021 Care: 3:00PM-10:00PM
7.00
105.00
12/16/2021
Standing Unit of Care for Sylvia Smilen/hr.
12/16/2021 Care: 2:00PM-6:00PM
4.00
60.00
12/17/2021
Standing Unit of Care for Sylvia Smilen/hr.
12/17/2021 Care: 3:00PM-9:00PM
6.00
90.00
12/18/2021
Standing Unit of Care for Sylvia Smilen/hr.
12/18/2021 Care: 1:30PM-4:30PM
4.00
60.00
12/22/2021
Standing Unit of Care for Sylvia Smilen/hr.
12/22/2021 Care: 3:00PM-9:00PM
6.00
90.00
12/24/2021
Standing Unit of Care for Sylvia Smilen/hr.
12/24/2021 Care: 3:00PM-9:00PM
6.00
90.00
12/29/2021
Standing Unit of Care for Sylvia Smilen/hr.
12/29/2021 Care: 3:00PM-9:00PM
6.00
90.00
Invoice Totals:
64.00
$960.00
Invoice #20919 was created on Friday, December 31, 2021
This Invoice was paid on Wednesday, January 19, 2022
