Invoice Detail: # 21025
- Invoice Date
- 06/30/2023
- Customer Name
- Sylvia Smilen Trust
- Statement Note
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Invoice # 1093 (Old Invoice # system). Customer Sylvia Smilen Trust: Rate = 17.00/hr. Mrs. Sherman: Submitted this to JH for Claim #: R12 004 977 via fax @800.638.4040 on July 6, 2023@9:32PM. Successful fax confirmation July 6, 2023@9:40PM
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Date Task Description Units Total 06/02/2023 Standing Unit of Care for Sylvia Smilen/hr. 06/02/2023 Care: 1:00PM-9:00PM 8.00 136.00 06/07/2023 Standing Unit of Care for Sylvia Smilen/hr. 06/07/2023 Care: 3:00PM-9:00PM 6.00 102.00 06/09/2023 Standing Unit of Care for Sylvia Smilen/hr. 06/09/2023 Care: 1:00PM-9:00PM 8.00 136.00 06/14/2023 Standing Unit of Care for Sylvia Smilen/hr. 06/14/2023 Care: 1:00PM-9:00PM 8.00 136.00 06/16/2023 Standing Unit of Care for Sylvia Smilen/hr. 06/16/2023 Care: 1:00PM-9:00PM 8.00 136.00 06/21/2023 Standing Unit of Care for Sylvia Smilen/hr. 06/21/2023 Care: 1:00PM-9:00PM 8.00 136.00 06/23/2023 Standing Unit of Care for Sylvia Smilen/hr. 06/23/2023 Care: 1:00PM-900PM 8.00 136.00 06/28/2023 Standing Unit of Care for Sylvia Smilen/hr. 06/28/2023 Care: 1:00PM-9:00PM 8.00 136.00 06/30/2023 Standing Unit of Care for Sylvia Smilen/hr. 06/30/2023 Care: 1:00PM-9:00PM 8.00 136.00 Invoice Totals: 70.00 $1,190.00 Invoice #21025 was created on Friday, June 30, 2023
Source Document: Local Storage: Source Docs\John Hancock\JHLTC_DocScan_20230706.pdf;Local Storage: Source Docs\John Hancock\Confirmation_JHLTC_DocScan_20230706_Fax.pdf