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HomeMy WebLinkAbout233603 06/11/14 CITY OF CARMEL, INDIANA VENDOR: 360209 it ONE CIVIC SQUARE ST VINCENT HOSPITAL CHECK AMOUNT: $*****7,792.45* oATTN:CAROLYN TERRY,ACCT REPTNG CHECK NUMBER: 233603 CARMEL, INDIANA 46032 10330 N MERIDIAN ST SUITE 430 CHECK DATE: 06/11/14 INDIANAPOLIS IN 46290 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4239011 13334 1,540.52 SPECIAL DEPT SUPPLIES 102 4239011 13346 2,362.57 SPECIAL DEPT SUPPLIES 102 4239011 13367 1,144.35 SPECIAL DEPT SUPPLIES 102 4239011 13381 2,745.01 SPECIAL DEPT SUPPLIES St. Vincent Hospital&Healthcare Center, Invoice T-- Attn: ._..Attn: Carolyn Terry,Acct Rptg 10330 N. Meridian St., Suite 430 North DATE INVOICE# Indianapolis, IN 46290-1024 2/21/2014 13334 BILL TO Carmel Fire EMS Attn: Accounts Payable 2 Carmel Civic Square Carmel,IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies purchased January 2014,billed February 2014 1,540.52 Medical Supplies: 87.72 Transfer-Drugs: 1,452.80 Total January Due: $1,540.52 1-8766-1464. Please notate invoice number that you Total $1,540.52 are paying on check/stub. Thank you!! Inquiries: Carolyn Terry Payments/Credits $0.00 317.583.3301 cmterry@stvincent.org Balance Due $19540.52 St. Vincent Hospital&Healthcare Center, p T-^ Invoice Attn: Carolyn Terry,Acct Rptg 10330 N.Meridian St., Suite 430 North DATE INVOICE# Indianapolis, IN 46290-1024 3/20/2014 13346 BILL TO Carmel Fire EMS Attn: Accounts Payable 2 Carmel Civic Square Carmel,IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies purchased February 2014,billed March 2.014 2,362.57 Medical Supplies $424.80 Transfer-/Drugs 1,937.77 Total February due: $2,362.57 1-8766-1464. Please notate invoice number that you Total $29362.57 are paying on check/stub. Thank you!! Inquiries: Carolyn Terry Payments/Credits $0.00 317.583.3301 cmterry@stvincent.org Balance Due $2,362.57 St. Vincent Hospital&Healthcare Center, Invoice T-- Attn: Carolyn Terry,Acct Rptg 10330 N. Meridian St., Suite 430 North DATE INVOICE# Indianapolis, IN 46290-1024 4/21/2014 13367 BILL TO Carmel Fire EMS Attn: Accounts Payable 2 Carmel Civic Square Carmel,IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies Purchased March 2014 1,144.35 Medical supplies $ 787.39 Transfer-Drugs 356.96 March total: $1,144.35 1-8766-1464. Please notate invoice number that you Total $19144.35 are paying on check/stub. Thank you!! Inquiries: Carolyn Terry Payments/Credits $0.00 317.583.3301 cmterry@stvincent.org Balance Due $1,144.35 Depatmental Transfer of Supplies date submissed 02/04/14 Requesting Department: Carmel Fire Dept Supplying Department ER Cost Center 8213 Cost Center 27230 ITEM# I QUANTITY UNIT COST TOTAL COST Alcohol preps 9219 $2.67 $0.00 Angiocath 18g 1266 $1.50 $0.00 Angiocath 20g 1264 20 $1.50 $30.00 Angiocath 22g 1262 $1.50 $0.00 Angiocath 24g 1261 1.551 0.00 Basin kidney shaped 103021 $0.081 0.00 Basin round 10297 $0.31 $0.00 Coban 1' Roll ea 39 $1.75 $0.00 Cold paks 45779 $0.57 $0.00 EKG Electrodes . 72104 $3.12 $0.00 Emesis Bas(perpack) 118984 $11.52 $0.00 EZ-10 Adult Needles $495.00/box of 5) $99.00 $0.00 Foam-Quikcare 5033 $2.67 $0.00 Guaze,2 x 2 Cotton bail 9170 $1.88 $0.00 Gauze Kerlex 9217 $0.67 $0.00 Gloves-Med 985 $5.41 $0.00 Gloves-Large 986 5.411 $0.00 Gloves-Xlar a 34059 $5.95 $0.00 IV Adapter, Luerlock 1260 $0.151 $0.00 IV Dial a flow 17477 3.151 $0.00 IV Extension 19" 1223 1.911 $0.00 IV Lock with Ext 12211 $1.871 $0.00 IV Start Kits 100/bx 78663 $1;00 $0.00 IV Start Kits Sobraview 100/bx 116570 10 $2.66 $26.60 IV Tubing 15 tt 486 $1.17 $0.00 Kerlix 4.5"x6ply 201627 $0.73 $0.00 Microdot Xtra Test Strips $24.95 $0.00 Microdot Xtra Control Solutions $ 2.001 $0.00 Normal Saline 1000 cc bags/ca 446 9.481 $0.00 Razor, dis oseable 910 0.121 $0.00 Sca el#11 LUM1948 $1.301 0.00 Sharps Container 236361 $4.59 $0.00 Sterile H2O bottle 384 $0.71 $0.00 Suction Canister&top 3634 $3.26 $0.00 Suture Kit 1 $1.09 $0.00 Syringe w/Needle 1 ml 2028 $0.07 $0.00 Syringe w/Needle 3 ml 2014 $0.051 $0.00 5Srin a w/Needle 5ml 2030 10 $0.10 $1.00 in a w/Needle 10 ml 2031 11 $0.12 $1.32 rin e w Saline 3ml 105371 $0.28 $0.00 rin aw/Salinel0ml 37350 90 $0.32 $28.80 ml Is vials(per box 330 $9.63 $0.00 Tape 2" 6 rolls/box 159 $1.00 $0.00 Tae 1" 1581 0.50. $0.00 Tape 2"cloth adh 181 $1.29 $0.00 Tape Trans ore 1/2" $1.28 $0.00 Warm paks 3416 $1.46 $0.00 Wound Cleanser 17344 $5.04 $0.00 Suction Canister&top 3634 $3.26 $0.00 Yankauers 9377 $0.34 $0.00 Ambu Ba w/mask-Adult 18696 $8.60 $0.00 Ambu Ba w/mask-Peds 37012 $15.00 $0.00 Ambu Ba w/mask-Infant cs/10 15071 $16.00 $0.00 CPAP mask $50.00 $0.00 La Bitrac Full Face Mask $29.00 $0.00 ET Tube Stylette 716711 $0.00 Wipes Disenfect 211901 $11.52 $0.00 Grand Total $87.72 Control Control1 Control Contro12 TotalPic TotalPic1 02-8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 9 $24.21 02-8213 Carmel Fire Department Albuterol SULF NEB SOL(0.083%) ALBUTEROL SULFATE 0.083%NEB SOL(0.083%) 3 ML 30 $5.70 02-8213 Carmel Fire Department AMIODARONE HCL INJ 50 MG/mL AMIODARONE HYDROCHLORIDE INJ 50 MG/mL 3 ML 18 $14.04 02-8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 108 $3.24 02-8213 Carmel Fre Department Atropine Sulfate INJ-SYRNG 1 MG/10 mL ATROPINE SULFATE INJ-SYR 1 MG/10 mL 10 ML 18 $138.42 02-8213 Carmel Fre Department CALcium CHLORide INJ-SYRNG 100 MG/mL CALcium CHLORide INJ-SYRNG 100 MG/mL 10 ML 1 $7.29 02-8213 Carmel Fre Department Dextrose-DOPamine INJ 400 MG/250 mL DEXTROSE/DOPamine HCL INJ 400 MG/250 mL 250 ML 32 $213.76 02-8213 Carmel Fire Department Dextrose INJ-SYRNG 50% DEXTROSE INJ-SYRNG 50% 50 mL 4 $34.20 02-8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL DIPHENHYDRAMINE HYDROCHLORIDE INJ 50 MG/mL 1 ML 2 $1.40 02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MG/ML EPINEPHRINE HCl.INJ 0.1 MG/ML 10 ML 59 $253.70 02-8213 Carmel Fire Department Epinephrine INJ 1 MG/ML EpiNEPHrine INJ 1 MG/ML 30 ML 1 $2.54 02-8213 Carmel Fire Department FentaNYL INJ 100 MCG/2 mL FENTANYL CITRATE INJ 100 MCG!2 mL 2 ML 5 $3.75 02-8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGEN DIAG.KIT INJ 1 MG 1 EA 5 $515.80 02-8213 Carmel Fire Department Glucose(Dextrose)GEL 40% GLUTOSE 15 GEL 40% 15 GM 5 $29.05 02-8213 Carmel Fire Department Ketorolac INJ 60 MG12 mL KETOROLAC TROMETHAMINE INJ 60 MG/2 mL 2 ML 6 $4.08 02-8213 Carmel Fire Department Lidocaine HCL INJ-SYRNG 100 MG LIDOCAINE HCL INJ-SYRNG 100 MG 5 ML 1 $4.30 02-8213 Carmel Fire Department Lidocaine HCL JELLY 2%30 GM LIDOCAINE JELLY 2%JELLY 2%30 GM 30 2 $11.26 02-8213 Carmel Fire Department Naloxone INJ 1 MG/ML NALOXONE HYDROCHLORIDE INJ 1 MG/ML 2 ML 7 $91.42 02-8213 Carmel Fire Department' Nitroglycerin Tab 0.4 MG NITROSTAT Tab 0.4 MG 25 3 $28.02 02.8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 11 $3.52 02-8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab DDT 4 MG 30 EA 8 $1.28 02-8213 Carmel Fire Department Sodium Bicarbonate INJ 7.5% SODIUM BICARBONATE INJ 7.5% 50 ML 3 $25.23 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%1000 mL SODium CHLORide 0.9%INJ 0.9%1000 mL 1000 ML 29 $22.91 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%500 mL SODium CHLORide 0.9%INJ 0.9%500 mL 500 ML 18 $13.68 $1,452.80 Depatmental Transfer of Supplies date submissed 03/05/14 Requesting Department: Carmel Fire Dept Supplying Department ER Cost Center 8213 Cost Center 27230 ITEM# QUANTITY UNIT COST TOTAL COST Alcohol preps 9219 $2.67 $0.00 Angiocath 18g 1266 5 $1.50 $7.50 Angiocath 20g 1264 10 $1.50 $15.00 Angiocath 22g 1262 $1.50 $0.00 Angiocath 24g 1261 $1.551 $0.00 Basin kidney shaped 103021 $0.081 $0.00 Basin round 10297 $0.31 $0.00 Coban 1'Roll ea 39 $1.75 $0.00 Cold paks 45779 $0.57 $0.00 EKG Electrodes 72104 $3.12 $0.00 Emesis Bas(perpack) 118984 $11.52 $0.00 EZ-10 Adult Needles $495.00/box of 5 $99.00 $0.00 Foam-Quikcare 5033 $2.67 $0.00 Guaze, 2 x 2 Cotton bail 9170 $1.88 $0.00 Gauze Kerlex 9217 $0.67 $0.00 Gloves-Med 9851 $5.41 $0.00 Gloves-Large 986 $5.41 $0.00 Gloves-Xlar a 34059 5.951 $0.00 IV Adapter, Luerlock 1260 $0.151 $0.00 IV Dial a flow 17477 $3.151 $0.00 IV Extension 19" 1223 $1.911 $0.00 IV Lock with Ext 1221 5 $1.871 $9.35 IV Start Kits 100/bx 786631 $1.00 $0.00 IV Start Kits Sobraview 100/bx 116570 55 $2.66 $146.30 IV Tubing 15 tt 486 5 $1.17 $5.85 Kerlix 4.5"x6ply 201627 $0.73 $0.00 Microdot Xtra Test Strips $24.95 $0.00 Microdot Xtra Control Solutions $12.001 $0.00 Normal Saline 1000 cc bags/ca 446 $9.481 $0.00 Razor, dis oseable 910 0.121 $0.00 Sca el#11 LUM1948 $1.30 $0.00 Sharps Container 23636 $4.59 $0.00 Sterile H2O bottle 384 $0.71 $0.00 Suction Canister&to 3634 $3.26 $0.00 Suture Kit 1 $1.09 $0.00 Syringe w/Needle 1 ml 2028 0.071 $0.00 -Syringe w/Needle 3 ml 2014 0.061 $0.00 Syringe w/Needle 5ml 2030 0.101 $0.00 Syringe w/Needle 10 ml 20311 $0.12 $0.00 Syringe w Saline 3ml 1053711 $0.28 $0.00 Syringe w/Salinel0ml 37350 430 $0.32 $137.60 30 ml saline vials(per box 330 $9.63 $0.00 Tape 2" 6 rolls/box 159 $1.00 $0.00 Tape 1" 158 $0.50 $0.00 Tape 2"cloth adh 181 $1.291 $0.00 Tape Trans ore 1/2" 1.281 $0.00 Warm paks 3416 $1.46 $0.00 Wound Cleanser 17344 $5.04 $0.00 Suction Canister&top 3634 $3.26 $0.00 Yankauers 9377 $0.34 $0.00 Ambu Ba w/mask-Adult 18696 12 $8.60 $103.20 Ambu Ba w/mask-Peds 37012 $15.00 $0.00 Ambu Ba w/mask-Infant cs/10 15071 $16.00 $0.00 CPAP mask $50.00 $0.00 Lg Bitrac Full Face Ma I $29.00 $0.00 ET Tube Stylette 716711 $0.00 Wipes Disenfect 211901 $11.521 $0.00 Grand Total $424.80 Control Controll Control Contro12 TotalPic TotalPicl 02-8213 Carmel Fire Department Acetaminophen Tab 500 MG TYLENOL ES Tab 500 MG 1500 EA 16 $0.32 02-8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 23 $61.87 02-8213 Carmel Fire Department Albuterol SULF NEB SOL(0.083°/x) ALBUTEROL SULFATE 0.083%NEB SOL(0.0831/1.) 3 ML 26 $4.19 02-8213 Carmel Fire Department AMIODARONE HCL INJ 50 MG/mL AMIODARONE HYDROCHLORIDE INJ 50 MG/mL 3 ML 32 $24.96 02-8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 36 $1.08 02-8213 Carmel Fire Department Atropine Sulfate INJ-SYRNG 1 MG/10 mL ATROPINE SULFATE INJ-SYR 1 MG/10 mL 10 ML 4 $30.76 02-8213 Carmel Fire Department CALcium CHLORide INJ 100 MG/mL CALcium CHLORide INJ 100 MG/mL 10 ML" 1 $1.36 02-8213 Carmel Fire Department CALcium CHLORide INJ-SYRNG 100 MG/mL CALcium CHLORIde INJ-SYRNG 100 MG/mL 10 ML 13 $94.77 02-8213 Carmel Fire Department Dextrose-DOPamine INJ 400 MG 1250 ml- DEXTROSE/DOPamine HCL INJ 400 MG/250 mL 250 ML 1 $6.68 02-8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL DIPHENHYDRAMINE HYDROCHLORIDE INJ 50 MG/ml- 1 ML 8 $5.60 02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MGIML EPINEPHRINE HCL INJ 0.1 MGIML 10 ML 79 $339.70 02-8213 Carmel Fire Department Epinephrine INJ 1 MG/ML EpiNEPHrine INJ 1 MG/ML 30 ML 4 $10.16 02-8213 Carmel Fire Department FentaNYL INJ 100 MCG/2 mL FENTANYL CITRATE INJ 100 MCGI 2 mL 2 ML 30 $22.50 02-8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGEN DIAG.KIT INJ 1 MG 1 EA 8 $825.28 02-8213 Carmel Fire Department Glucose(Dextrose)GEL 40% GLUTOSE 15 GEL 40% 15 GM 3 $17.43 02-8213 Carmel Fire Department Ipratropium SOL 0.02% IPRATROPIUM BROMIDE SOL 0.02% 2.5 ML 2 $0.32 02-8213 Carmel Fre Department Lidocaine HCL INJ-SYRNG 100 MG LIDOCAINE HCL INJ-SYRNG 100 MG 5 ML 2 $8.60 02-8213 Carmel Fire Department' Magnesium SULF INJ 1000 MG/2 mL MAGNESIUM SULFATE INJ 1000 MG/2 mL 2 ML 2 $1.08 02-8213 Carmel Fire Department MIDAZOLAM INJ 10 MG/2 mL MIDAZOLAM HCL INJ 10 MG/2 mL 2 ML 6 $5.04 02-8213 Carmel Fire Department Naloxone INJ 1 MGIML NALOXONE HYDROCHLORIDE INJ-1 MG/ML 2 ML 20 $261.20 02-8213 Carmel Fire Department Naloxone SRN**CARMEL"' NALOXONE HCL SRN**CARMEL** 1 ML 5 $8.95 02-8213 Carmel Fire Department Nitroglycerin Tab 0.4 MG NITROSTAT Tab 0.4 MG 25 2 $211.56 02-8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 24 $7.68 02-8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab DDT 4 MG 30 EA 19 $3.04 02-8213 Carmel Fire Department Sodium Bicarbonate INJ 4.2% SODIUM BICARBONATE INJ 4.20/6 10 ML 9 $57.54 02-8213 Carmel Fire Department Sodium Bicarbonate INJ 7.5% SODIUM BICARBONATE INJ 7.5% 50 ML 7 $73.08 02-8213 Carmel Fire Department Sodium Bicarbonate INJ 8.4% SODIUM BICARBONATE INJ 8.4% 10 ML. 2 $19:62 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%1000 mL SODium CHLORide 0.9%INJ 0.9%1000 mL 1000 ML 28 $22:12 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%500 mL SODium CHLORide 0.9%INJ 0.9%500 mL 500 ML 3 $2:28 $1,937.77 Depatmental Transfer of Supplies date submissed 04/01/14 Requesting Department: Carmel Fire Dept Supplying Department ER Cost Center 8213 Cost Center 27230 ITEM# I QUANTITY UNIT COST TOTAL COST Alcohol preps 9219 1 $2.67 $2.67 Angiocath 18g 1266 43 $1.50 $64.50 Angiocath 20g 1264 106 $1.50 $159.00 Angiocath 22g 1262 $1.50 $0.00 Angiocath 24g 1261 1.551 0.00 Basin kidney shaped 10302 $0.081 0.00 Basin round 102971 5 $0.31 $1.55 Coban 1'Roll ea 39 $1.75 $0.00 Cold paks 45779 $0.57 $0.00 EKG Electrodes. 72104 $3.12 $0.00 Emesis Bas(perpack) 118984 $11.52 $0.00 EZ-10 Adult.Needles $495.00/box of 5 1 $99.00 $0.00 Foam-Quikcare 5033 $2.67 $0.00 Guaze,2 x 2 Cotton bail 9170 5 $1.88 $9.40 Gauze Kerlex 9217 3 $0.67 $2.01 Gloves-Med 985 $5.41 $0.00 Gloves-Large 986 5.411 $0.00 Gloves-Marge 34059 $5.95 $0.00 IV Adapter, Luerlock 1260 $0.15 $0.00 IV Dial a flow 174771 $3.15 $0.00 IV Extension 19" 1223 $1.91 $0.00 IV Lock with Ext 1221 83 $1.87 $155.21 IV Start Kits 100/bx 78663 80 $1.00 $80.00 IV Start Kits Sobraview 100/bx 116570 38 $2.66 $101.08 IV Tubing 15 tt 486 4 $1.17 $4.68 Kerlix 4.5"x6ply 2016271 $0.73 $0.00 Microdot Xtra Test Strips $24.95 $0.00 Microdot Xtra Control Solutions $ 2.001 $0.00 Normal Saline 1000 cc bags/ca 446 $9.481 0.00 Razor,dis oseable 910 $0.12 $0.00 Sca el#11 LUM1948 $1.30 $0.00 Sharps Container 23636 $4.59 $0.00 Sterile H2O bottle 384 $0.71 $0.00 Suction Canister&top 3634 1 $3.26 $3.26 Suture Kit 1 $1.09 $0.00 Syringe w/Needle 1 ml 2028 $0.07 $0.00 Syringe w/Needle 3 ml 2014 14 $0.05 $0.70 Syringe w/Needle 5ml 2030 5 $0.10 $0.50 S rin a w/Needle 10 ml 2031 125 $0.12 $15.00 Syringe w Saline 3ml 105371 $0.28 $0.00 Syringe w/Saline10ml 37350 $0.32 $0.00 30 ml saline vials(per box 330 1 $9.63 $9.63 Tape 2" 6 rolls/box 159 $1.00 $0.00 Tae 1" 158 $0.50 $0.00 Tape 2"cloth adh 181 1.291 $0.00 Tape Trans ore 1/2" 1.281 $0.00 Warm paks 3416 $1.46 -$0.00 Wound Cleanser 17344 $5.04 $0.00 Suction Canister&top 3634 $3.26 $0.00 Yankauers 93771 $0.34 $0.00 Ambu Ba w/mask-Adult 18696 $8.60 $0.00 Ambu Ba w/mask-Peds 37012 $15.00 $0.00 Ambu Ba w/mask-Infant cs/10 15071 $16.00 $0.00 CPAP mask $50.00 $0.00 Lg Bitrac Full Face Mask $29.00 $0.00 ET Tube St lette 716711 $0.00 Wipes Disenfect 211901 $11.52 a Oral Surefoot tem robes 63815 4 $44.55 $ Grand Total $787.39 Approved by date Control Controll Control Contro12 TotalPic TotalPlc1 02-6213 Carmel Fire Department Acetaminophen Tab 325 MG TYLENOL Tab 325 MG 3000 EA 2 $0.02 02-8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 3 $8.07 Fir Department Albuterol SULF NEB SOL 0.083% ALBUTEROL SULFATE 0.083%NEB SOL(0.083%) 3 ML 9 $1.44 02.8213 Carmel e p ( ) 02-8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew 81 MG 750 EA 36 $1.08 02-8213 Carmel Fire Department Dextrose INJ-SYRNG 50% DEXTROSE INJ-SYRNG 5.0% 50 mL 8 $68.40 02-8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL DIPHENHYDRAMINE HYDROCHLORIDE INJ 50 MG/mL 1 ML 3 $2.10 02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MG/ML EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 32 $137.60 02.8213 Carmel Fire Department FentaNYL INJ 100 MCG/2 mL FENTANYL CITRATE INJ 100 MCGI 2 mL 2 ML 27 $20.25 02-8213 Carmel Fire Department Glucose(Dextrose)GEL 40% GLUTOSE 15 GEL 40% 15 GM 1 $5.81 02.8213 Carmel Fire Department Ibuprofen SUS 100 MG IBUPROFEN CHILDREN'S SUS 100 MG 5 ML 1 $0.55 02-8213 Carmel Fire Department Lidocaine HCL JELLY 2%30 GM LIDOCAINE JELLY 2%JELLY 2%30 GM 30 1 $5.63 02-8213 Carmel Fire Department MIDAZOLAM INJ 10 MG/2 mL MIDAZOLAM HCL INJ 10 MG/2 mL 2 ML 5 $4.20 02-8213 Carmel Fire Department Naloxone INJ 1 MG/ML NALOXONE HYDROCHLORIDE INJ 1 MG/ML 2 ML 3 $39.18 02-8213 Carmel Fire Department Nitroglycerin Tab 0.4 MG NITROSTAT TAB 0.4 MG 100 ea 1 $10.28 02-8213 Carmel Fire Department Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 11 $3.52 02-8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab ODT 4 MG 30 EA 3 $0.48 02-8213 Carmel Fire Department Sodium Bicarbonate INJ 7.5% SODIUM BICARBONATE INJ 7.5% 50 ML 2 $20.88 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%1000 mL SODium CHLORide 0.9%INJ 0.9%1000 mL 1000 ML 29 $22.91 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%500 mL SODium CHLORide 0.9%INJ 0.9%500 mL 500 ML 6 $4.56 $356.96 St. Vincent Hospital&Healthcare Center, Invoice T..... Attn: Carolyn Terry,Acct Rptg 10330 N. Meridian St., Suite 430 North DATE INVOICE# Indianapolis, IN 46290-1024 5/23/2014 13381 BILL TO Carmel Fire EMS Attn: Accounts Payable 2 Carmel Civic Square Carmel,IN 46032 TERMS Due on receipt DESCRIPTION AMOUNT EMS Supplies Purchased April 2014 2,745.01 Medical Supplies $884.42 Transfer Drugs 1,860.59 Aril total: $2,745.01 1-8766-1464. Please notate.invoice number that you Total $29745.01 are paying on check/stub. Thank you!! Inquiries: Carolyn Terry Payments/Credits $0.00 317.583.3301 cmterry@stvincent.org Balance Due $2,745.01 Depatmental Transfer of Supplies date submissed May-13 Requesting Department: Carmel Fire Dept Supplying Department ER Cost Center 8243 Cost Center 27230 ITEM# QUANTITY UNIT COST TOTAL COST Alcohol preps 9219 $2.67 $0.00 Angiocath 18g 1266 $1.50 $0.00 Angiocath 20g 1264 15 $1.50 $22.50 Angiocath 22g 1262. 1.501 $0.00 Angiocath 24g 12611 $1.55 $0.00 Basin kidney shaped 103021 $0.08 $0.00 Basin round 102971 $0.31 $0.00 Cold paks 457791 $0.57 $0.00 EKG Electrodes 721041 $3.12 $0.00 Emesis Bas (perpack) 1189841 $11.52 $0.00 EZ-10 Adult Needles $495.00/box of 5 $99.00 $0.00 Foam-Quikcare 5033 $2.67 $0.00 Guaze,2 x 2 Cotton bail 9170 $1.88 $0.00 Gauze Kerlex 9217 0.671 $0.00 Gloves-Med 985 $5.41 $0.00 Gloves-Large 986 $5.41 $0.00 Gloves-Marge 34059 $5.95 $0.00 IV Adapter, Luerlock 1260 $0.15 $0.00 IV Dial a flow 17477 $3.15 $0.00 IV Extension 19" 1223 $1.91 $0.00 IV Lock with Ext 1221 20 $1.87 $37.40 IV Start Kits 100/bx 78663 20 $1.00 $20.00 IV Start Kits Sobraview 100/bx 116570 300 $2.66 $798.00 IV Tubing 15 tt 486 $1.17 $0.00 Kedix 4.5"x6ply 201627 $0.73 $0.00 Razor, dis oseable 9101 $0.12 $0.00 Normal Saline 1000 cc bags/ca 4461 $9.48 $0.00 Sca el#11 LUM19481 $1.30 $0.00 Sharps Container 23636 4.591 0.00 Sterile H2O bottle 384 $0.71 $0.00 Suction Canister&top 3634 2 $3.26 $6.52 Suture Kit 1 $1.09 $0.00 S rin a w/Needle 1 ml 2028 . $0.07 $0.00 Syringe w/Needle 3 ml 20141 $0.05 $0.00 Syringe w/Needle 5ml 2030 0.101 0.00 Syringe w/Needle 10 ml 2031 $0.12 $0.00 S rin e w Saline 3ml 105371 $0.28 $0.00 Syringe w/Salinel0ml 37350 $0.32 $0.00 30 ml saline vials(per box) 330 $9.63 $0.00 Tape 2" 6 rolls/box 159 $1.00 $0.00 Tape 1" 158 $0.50 $0.00 Tape 2"cloth adh 181 $1.29 $0.00 Tape Trans ore 1/2" $1.28 $0.00 Ultra Trak Ultimate Test Control $83.30 Ultra Trak Ultimate Test Strips/1 0 BX $330.00 $0.00 Warm paks 3416 $1.46 $0.00 Wound Cleanser 17344. $5.04 $0.00 Suction Canister&top 3634 $3.26 $0.00 Yankauers 9377 $0.34 $0.00 Ambu Ba w/mask-Adult 18696 $8.60 $0.00 Ambu Ba w/mask-Peds 37012 $15.00 $0.00 Ambu Ba w/mask-Infant cs/10 15071 $16.00 $0.00 CPAP mask $50.00 $0.00 Lg Bitrac Full Face Mask $29.00 $0.00 ET Tube Stylette 71671 $0.00 Wi es Disenfect 211901 $11.521 $0.00 Grand Total $884.42 Control Controll Control Control2 TotalPic TotalPicl 02-8213 Carmel Fire Department Acetaminophen Tab 325 MG TYLENOL Tab 325 MG 3000 EA 45 $0.45 02-8213 Carmel Fire Department ADENOSINE INJ 6 MG ADENOSINE INJ 6 MG 2 ML 20 $177.73 02-8213 Carmel Fire Department Albuterol SULF NEB SOL(0.083%) ALBUTEROL SULFATE 0.083%NEB SOL(0.083%) 3 ML 26 $4.16 02-8213 Carmel Fire Department AMIODARONE HCL INJ 50 MG/mL AMIODARONE HYDROCHLORIDE INJ 50 MG/mL 3 ML 4 $3.12 02-8213 Carmel Fire Department Aspirin Tab Chew 81 MG ASPIRIN Tab Chew,81 MG 750 EA 180 $5.40 02-8213 Carmel Fire Department Atropine Sulfate INJ-SYRNG 1 MG/10 mL ATROPINE SULFATE INJ-SYR 1 MGI 10 mL 10 ML 6 $46.14 02-8213 Carmel Fire Department CALcium CHLORide INJ-SYRNG 100 MG/mL CALcium CHLORtde INJ-SYRNG 100 MG/ml. 10 ML 1 $7.29 02-8213 Carmel Fire Department Dextrose INJ-SYRNG 50% DEXTROSE INJ-SYRNG 50% 50 mL 7 $59.85 02.8213 Carmel Fire Department DiphenhydrAMINE INJ 50 MG/mL DIPHENHYDRAMINE HYDROCHLORIDE INJ 50 MG/mL 1 ML 3 $2.10 02-8213 Carmel Fire Department EpiNEPHrine HCL INJ 0.1 MGIML EPINEPHRINE HCL INJ 0.1 MG/ML 10 ML 22 $94.60 02-8213 Carmel Fire Department Epinephrine INJ 1 MGIML EpiNEPHrine iNJ 1 MGIML 30 ML 4 $10.16 02-8213 Carmel Fire Department Glucagon INJ 1 MG GLUCAGEN DIAG.KIT INJ 1 MG 1 EA 2 $206.32 02-8213 Carmel Fire Department Glucose(Dextrose)GEL 40% GLUTOSE 15 GEL 40% 15 GM 2 $11.62 02-8213 Carmel Fire Department HYDROXOCOBALAMIN KIT INJ 5 gm CYANOKIT INJ 5 gm 5 GM 1 $715.00 02-8213 Carmel Fire Department Ipratropium SOL 0.02% IPRATROPIUM BROMIDE SOL 0.02% 2.5 ML 3 $0.48 02-8213 Carmel Fire Department Ketorolac INJ 60 MG/2 mL KETOROLAC TROMETHAMINE INJ 60 MG/2 mL 2 ML 27 $18.36 02-8213 Carmel Fire Department Lidocaine HCL JELLY 2%30 GM LIDOCAINE JELLY 2%JELLY 2%30 GM 30 5 $28.15 02-8213 Carmel Fire Department Naloxone INJ 1 MGIML NALOXONE HYDROCHLORIDE INJ 1 MGIML 2 ML 2 $26.12 02-8213 Carmel Fire Department Nitroglycerin Tab 0.4 MG NITROSTAT TAB 0.4 MG 100 ea 4 • $41.12 02-8213 Carmel Fire Department' Ondansetron INJ 2 mg/mL ONDANSETRON INJ 2 mg/mL 2 ML 16 $5.12 02-8213 Carmel Fire Department Ondansetron Tab ODT 4 MG ONDANSETRON Tab ODT 4 MG 30 EA 17 $2.72 02-8213 Carmel Fire Department Racemic Epinephrine SOL 2.25%UD S-2 INHALANT SOL 2.25%UD 0.5 ML 5 $5.75 02-8213 Carmel Fire Department Sodium Bicarbonate INJ 4.2% SODIUM BICARBONATE INJ 4.2% 10 ML 7 $50.61 02-8213 Carmel Fire Department Sodium Bicarbonate INJ 7.5% SODIUM BICARBONATE INJ 7.5% 50 ML 29 $302.76 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%1000 mL SODium CHLORide 0.9%INJ 0.9%1000 mL 1000 ML 23 $18.17 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%50 mL SODium CHLORide 0.9%INJ 0.9%50 mL 50 ML 5 $10.45 02-8213 Carmel Fire Department Sodium Chloride INJ 0.9%500 mL SODium CHLORide 0.9%INJ 0.9%500 mL 500 ML 9 $6.84 $1,860.59 VOUCHER NO. WARRANT NO. ALLOWED 20 St. Vincent Hospital Attn: Carolyn Terry, Acct. Reporting IN SUM OF$ 10330 N. Meridian Street, Ste. 430 N Indianapolis, IN 46290 $7,792.45 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 13381 102-390.11 $2,745.01 1 hereby certify that the attached invoice(s), or 1120 13367 102-390.11 $1,144.35 bill(s) is (are)true and correct and that the 1120 13346 102-390.11 $2,362.57 materials or services itemized thereon for 1120 13334 102-390.11 $1,540.52 which charge is made were ordered and received except Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by whom, rates per day, number of hours,rate per hour, number of units, price per unit,etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s)or bill(s)) 13381 $2,745.01 13367 $1,144.35 13346 $2,362.57 13334 $1,540.52 I hereby certify that the attached invoice(s),or bill(s), is (are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer