TF
Note · Taylor Frey
completedEVV pendingclient signed·Aug 14, 2026, 5:30 PM · 120 min
Service record
Taylor Frey · Independent living skills, individual
Authorization SA-2026-00131PMI 45678901UMPI A100000004POS 12
Accepted Aug 14, 2026, 7:32 PM
Aggregator record
Exactly what the EVV aggregator and the 837P claim line receive
- Provider tax ID
- 41-0000000
- PMI #
- 45678901
- Service code
- H2032 TG
- Units
- 8 × 15 min
- Place of service
- 12 · Home
- Rendering staff
- Tobi Okafor · UMPI A100000004
- Authorization
- SA-2026-00131
- Clock in
- Aug 14, 2026, 5:30 PM
- Clock out
- Aug 14, 2026, 7:30 PM
- GPS at clock in
- 44.98439, -93.25510 · ±8 m
- GPS at clock out
- 44.98139, -93.25549 · ±10 m
- Manual entry
- No
- Client signature
- Signed with code Aug 14, 2026, 7:31 PM
Tasks
2 of 2 completed
- Personal care / ADLs
- Skill building per support plan
Shift note
Independent living skills. Taylor planned and cooked stir fry, using a knife safely with staff nearby. Cleaned up without prompting. Reviewed the apartment inspection checklist for next week.
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Kept with the note and exported as EVV evidence
No edits since creation.
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