Invoice Detail: # 21035
- Invoice Date
- 10/31/2023
- Customer Name
- Sylvia Smilen Trust
- Statement Note
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Invoice # 1097 (Old Invoice # system). Customer Sylvia Smilen Trust: Rate = 17.00/hr. Mrs. Sherman: Submitted to JH for Claim #: R12 004 977 via jh.com/submitinvoices on Nov 8, 2023@11:28AM. Successful fax confirmation Nov 9, 2023@12:06PM
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Date Task Description Units Total 10/04/2023 Standing Unit of Care for Sylvia Smilen/hr. 10/04/2023 Care: 1:00PM-9:00PM 8.00 136.00 10/06/2023 Standing Unit of Care for Sylvia Smilen/hr. 10/06/2023 Care: 1:00PM-9:00PM 8.00 136.00 10/11/2023 Standing Unit of Care for Sylvia Smilen/hr. 10/11/2023 Care: 1:00PM-9:00PM 8.00 136.00 10/13/2023 Standing Unit of Care for Sylvia Smilen/hr. 10/13/2023 Care: 3:00PM-9:00PM 6.00 102.00 10/18/2023 Standing Unit of Care for Sylvia Smilen/hr. 10/18/2023 Care: 1:00PM-9:00PM 8.00 136.00 10/20/2023 Standing Unit of Care for Sylvia Smilen/hr. 10/20/2023 Care: 1:00PM-9:00PM 8.00 136.00 10/25/2023 Standing Unit of Care for Sylvia Smilen/hr. 10/25/2023 Care: 1:00PM-9:00PM 8.00 136.00 10/27/2023 Standing Unit of Care for Sylvia Smilen/hr. 10/27/2023 Care: 1:00PM-9:00PM 8.00 136.00 Invoice Totals: 62.00 $1,054.00 Invoice #21035 was created on Tuesday, October 31, 2023
Source Document: Local Storage: Source Docs\John Hancock\JHLTC_DocScan_20231101.pdf;Local Storage: Source Docs\John Hancock\Confirmation_JHLTC_DocScan_20231101_Fax.pdf