Invoice Detail: # 21029
- Invoice Date
- 07/31/2023
- Customer Name
- Sylvia Smilen Trust
- Statement Note
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Invoice # 1094 (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 Aug 1, 2023@9:56AM. Successful confirmation Aug 1, 2023@10:02AM
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Date Task Description Units Total 07/05/2023 Standing Unit of Care for Sylvia Smilen/hr. 07/05/2023 Care: 1:00PM-9:00PM 8.00 136.00 07/07/2023 Standing Unit of Care for Sylvia Smilen/hr. 07/07/2023 Care: 1:00PM-9:00PM 8.00 136.00 07/12/2023 Standing Unit of Care for Sylvia Smilen/hr. 07/12/2023 Care: 1:00PM-9:00PM 8.00 136.00 07/14/2023 Standing Unit of Care for Sylvia Smilen/hr. 07/14/2023 Care: 1:00PM-9:00PM 8.00 136.00 07/19/2023 Standing Unit of Care for Sylvia Smilen/hr. 07/19/2023 Care: 1:00PM-9:00PM 8.00 136.00 07/21/2023 Standing Unit of Care for Sylvia Smilen/hr. 07/21/2023 Care: 1:00PM-9:00PM 8.00 136.00 07/26/2023 Standing Unit of Care for Sylvia Smilen/hr. 07/26/2023 Care: 1:00PM-9:00PM 8.00 136.00 07/28/2023 Standing Unit of Care for Sylvia Smilen/hr. 07/28/2023 Care: 1:00PM-9:00PM 8.00 136.00 Invoice Totals: 64.00 $1,088.00 Invoice #21029 was created on Monday, July 31, 2023
Source Document: Local Storage: Source Docs\John Hancock\JHLTC_DocScan_20230801.pdf;Local Storage: Source Docs\John Hancock\Confirmation_JHLTC_DocScan_20230801_Fax.pdf