Invoice Detail: # 21033
- Invoice Date
- 08/31/2023
- Customer Name
- Sylvia Smilen Trust
- Statement Note
-
Invoice # 1095 (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 1, 2023@2:28PM. Successful fax confirmation Sep 1, 2023@2:34PM
-
Date Task Description Units Total 08/02/2023 Standing Unit of Care for Sylvia Smilen/hr. 08/02/2023 Care: 1:00PM-9:00PM 8.00 136.00 08/04/2023 Standing Unit of Care for Sylvia Smilen/hr. 08/04/2023 Care: 1:00PM-9:00PM 8.00 136.00 08/09/2023 Standing Unit of Care for Sylvia Smilen/hr. 08/09/2023 Care: 1:00PM-9:00PM 8.00 136.00 08/11/2023 Standing Unit of Care for Sylvia Smilen/hr. 08/11/2023 Care: 1:00PM-9:00PM 8.00 136.00 08/16/2023 Standing Unit of Care for Sylvia Smilen/hr. 08/16/2023 Care: 1:00PM-9:00PM 8.00 136.00 08/18/2023 Standing Unit of Care for Sylvia Smilen/hr. 08/18/2023 Care: 1:00PM-9:00PM 8.00 136.00 08/23/2023 Standing Unit of Care for Sylvia Smilen/hr. 08/23/2023 Care: 1:00PM-9:00PM 8.00 136.00 08/25/2023 Standing Unit of Care for Sylvia Smilen/hr. 08/25/2023 Care: 1:00PM-9:00PM 8.00 136.00 08/30/2023 Standing Unit of Care for Sylvia Smilen/hr. 08/30/2023 Care: 1:00PM-9:00PM 8.00 136.00 Invoice Totals: 72.00 $1,224.00 Invoice #21033 was created on Thursday, August 31, 2023
Source Document: Local Storage: Source Docs\John Hancock\JHLTC_DocScan_20230901.pdf;Local Storage: Source Docs\John Hancock\Confirmation_JHLTC_DocScan_20230901_Fax.pdf