JA
Note · Jordan Abelard
completedEVV pendingclient signed·Jul 8, 2026, 1:00 PM · 120 min
Service record
Jordan Abelard · Employment exploration
Medications on 2026-07-08
- 09:15Omeprazole20 mg
Authorization SA-2026-00103PMI 12345678NPI 1234567893POS 12
Accepted Jul 8, 2026, 3:02 PM
Aggregator record
Exactly what the EVV aggregator and the 837P claim line receive
- Provider tax ID
- 41-0000000
- PMI #
- 12345678
- Service code
- T2019 U2
- Units
- 8 × 15 min
- Place of service
- 12 · Home
- Rendering staff
- Maria Peters · NPI 1234567893
- Authorization
- SA-2026-00103
- Clock in
- Jul 8, 2026, 1:00 PM
- Clock out
- Jul 8, 2026, 3:00 PM
- GPS at clock in
- 44.97946, -93.25604 · ±8 m
- GPS at clock out
- 44.98441, -93.25771 · ±10 m
- Manual entry
- No
- Client signature
- Signed with code Jul 8, 2026, 3:01 PM
Tasks
2 of 2 completed
- Personal care / ADLs
- Skill building per support plan
Shift note
Employment exploration. Visited Goodwill and spoke with the floor lead about stocking and donation intake. Jordan asked two questions about hours. Afterwards listed what was liked (moving, sorting) and disliked (noise at the register).
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Kept with the note and exported as EVV evidence
No edits since creation.
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