Order Detail: # 20967
- Order Date
- 01/31/2023
- Customer Name
- Sylvia Smilen Trust
- Statement Note
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Invoice # 1088 (Old Invoice # system). Customer Sylvia Smilen Trust: Rate = 17.00/hr. Mrs. Sherman: I submitted to JH for Claim #: R12 004 977 via fax @800.638.4040 on Feb 6, 2023@12:40PM. Successful confirmation Feb 6, 2023@12:55PM
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Date Task Description Units Total 01/04/2023 Standing Unit of Care for Sylvia Smilen/hr. 01/04/2023 Care: 3:00PM-9:00PM 6.00 102.00 01/06/2023 Standing Unit of Care for Sylvia Smilen/hr. 01/06/2023 Care: 3:00PM-9:00PM 6.00 102.00 01/11/2023 Standing Unit of Care for Sylvia Smilen/hr. 01/11/2023 Care: 3:00PM-9:00PM 6.00 102.00 01/13/2023 Standing Unit of Care for Sylvia Smilen/hr. 01/13/2023 Care: 3:00PM-9:00PM 6.00 102.00 01/18/2023 Standing Unit of Care for Sylvia Smilen/hr. 01/18/2023 Care: 3:00PM-9:00PM 6.00 102.00 01/20/2023 Standing Unit of Care for Sylvia Smilen/hr. 01/20/2023 Care: 3:00PM-9:00PM 6.00 102.00 01/25/2023 Standing Unit of Care for Sylvia Smilen/hr. 01/25/2023 Care: 3:00PM-9:00PM 6.00 102.00 01/27/2023 Standing Unit of Care for Sylvia Smilen/hr. 01/27/2023 Care: 3:00PM-9:00PM 6.00 102.00 Order Totals: 48.00 $816.00 Invoice #20967 was created on Tuesday, January 31, 2023 This Invoice was paid on Monday, February 14, 2022
Source Document: Local Storage: Source Docs\John Hancock\JHLTC_DocScan_20230131.pdf;Local Storage: Source Docs\John Hancock\Confirmation_JHLTC_DocScan_20230131_Fax.pdf