Invoice  Detail: # 20962

Invoice  Date
08/31/2022
Customer Name
Sylvia Smilen Trust
Statement Note
Invoice # 1083 (Old Invoice # system). Customer Sylvia Smilen Trust: Rate = 17.00/hr. Mrs. Sherman: Submitted to JH for Claim #: R12 004 977 via fax @800.638.4040 on Sep 26@6:46PM. Successful confirmation Sep 26@7:12PM  
Date Task Description Units Total
08/03/2022 Standing Unit of Care for Sylvia Smilen/hr. 08/03/2022 Care: 3:00PM-9:00PM 6.00 102.00
08/05/2022 Standing Unit of Care for Sylvia Smilen/hr. 08/05/2022 Care: 3:00PM-9:00PM 6.00 102.00
08/10/2022 Standing Unit of Care for Sylvia Smilen/hr. 08/10/2022 Care: 3:00PM-9:00PM 6.00 102.00
08/17/2022 Standing Unit of Care for Sylvia Smilen/hr. 08/17/2022 Care: 3:00PM-9:00PM 6.00 102.00
08/19/2022 Standing Unit of Care for Sylvia Smilen/hr. 08/19/2022 Care: 3:00PM-9:00PM 6.00 102.00
08/24/2022 Standing Unit of Care for Sylvia Smilen/hr. 08/24/2022 Care: 3:00PM-9:00PM 6.00 102.00
08/26/2022 Standing Unit of Care for Sylvia Smilen/hr. 08/26/2022 Care: 3:00PM-9:00PM 6.00 102.00
08/31/2022 Standing Unit of Care for Sylvia Smilen/hr. 08/31/2022 Care: 3:00PM-9:00PM 6.00 102.00
    Invoice Totals: 48.00 $816.00
Invoice #20962 was created on Wednesday, August 31, 2022
This Invoice was paid on Wednesday, October 5, 2022

Source Document: Local Storage: Source Docs\John Hancock\Confirmation_JHLTC_DocScan_20220926_Fax.pdf;Local Storage: Source Docs\John Hancock\JHLTC_DocScan_20220926.pdf