Loading...
309068 03/07/17 Q CITY OF CARMEL, INDIANA VENDOR: 00350364 ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $•""""3,547.16' CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK NUMBER: 309068 INDIANAPOLIS IN 46204 CHECK DATE: 03/07/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4340701 100018 0030042 3,547.16 OFFICER PHYSICALS » # 0 / cli k # cc § E CL § 2 2 w « 2 k \ % m ) / CL ƒ R f $ Q \ K [ k § § / > # § C e 0 L ■ w COQ § \ 0 �f g 06 LL $ / Q ) ` ) 2 § \ ° k/ § U) | § E { m ff q « Z 0 - t it CN 2 � £ Q / k k I? k IL 0 '2� U 2 ` z � 7 § Q \ o /4) E k D 2 o ) _ ° b % $k a. k k c § § G T) E R § U ) ) 0 0 2 - 2 a $ m N $ 2 / . f § $ B m ¢ f 2 @ \ k E m § f § t _ f ? § S § E § § 2 . ; © 5 t 2 / R /_ t $ ] < z / E $ § ( % F- CO \ ( O § 7 § d LL < 2 [ F- R E F- w % k # E $ ƒ E b � / § ] ? - \ R $ Cl) o 0 � m % —1g ag U 3 k « } CN n [ # LU 0 / ® $ § % z ® § 4 O 2 0 Z § 2 n w ® - o LL § ® / z k < # # 20 \ o _j w Q 2 0 - kCo 2 � � � � 0 > > (L n - o Public,Safety Medical - INVOICE j. 0 Public Safety Medical Invoice Date: 02/25/2017 324 E. New York Street Invoice# 00-30042 E Suite 300 Terms: " W Indianapolis, IN 46204 .1 C Carmel Police Department/CARMEPD I Chief Tim Green (PO 34162) = 3 Civic Square to Carmel, IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due Total Charges-> $3,547.16 Total Payments&Balance Due-> $0.00 $3,547.16 Please write invoice number on payment check. Our Federal Employer identification number is 35-2079797. We greatly appreciate the opportunity to serve you. If you have any questions regarding this invoice, please contact Debbie Pieper at 317-964-2330. Public Safety Medical - INVOICE 0 Public Safety Medical Invoice Date: 02/25/2017 324 E. New York Street Invoice# 00-30042 E Suite 300 Terms: W Indianapolis, IN 46204 .ti C Carmel Police Department/CARMEPD F- Chief Tim Green(PO 34162) m 3 Civic Square Carmel, IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due 02/17/17 Collins, h n P. OnMed Program $0.00 Respirator/Medical Review $18.74 $18.7 Health Risk Appraisal Motivation $0.00 $0.00 Comprehensive Physical Exam $114.77 $114.77 Waist/Hi Ratio $3.53 $3.53 Body Fat Test-BIA Bio-Elec Imp Anal 16.40 $16.4 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.4 Flexibility Test $11.72 $11.72 Urinalysis-Di stick $3.53 $3.53 EKG W/Intem 23.42 $23.42 Audiometry $16.4 1 .4 PFT-Pulmonary Function Tet 38.65 Vision-Acuity $30.45 $30.4 Vital Signs-HT WT BP P R $0.00 $0.00 Driver Charles E. HIV-4th Gen Rapid Test Blood 25.93 25.9 Venipuncture $3.53 $3.53 Lipid Panel Blood 23.82 $23.82 CBC(Comp Blood Count 20.29 $20.29 CMP(Comp Metabolic Panel 22.41 $22.411 PSA-Prostate Specific A Blood 0.99 $40.9 OnMed Pro ram $0.00 $0.00 Respirator/Medical Review $18.74 $18.7 Health Risk Appraisal M tivati n 0. ComprehensivePhysical Exam $114.77 $114.77 Waist/Hi Ratio $3.53 $3.53 Body Fat Test-BIA Bio-Elec Imp Anal $16.40 $16.4 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.4 Flexibility Test $11.72 $11.72 Urinalysis-Di stick $3.53 $3.53 EKG W/Interp $23.42 $23.42 Audiometry 16.40 $16.40 PFT-Pulmonary Function Test $38.65 $38.65 Vision-Acuity 30.45 $30.45 Vital Sians-HT WT BP P R Michael G. OnMed Proaram $0.00 Public Safety Medical - INVOICE H Public Safety Medical Invoice Date: 02/25/2017 324 E. New York Street Invoice# 00-30042 E Suite 300 Terms: W Indianapolis, IN 46204 .i C Carmel Police Department/CARMEPD F- Chief Tim Green(PO 34162) m 3 Civic Square Carmel, IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due Respirator/Medical Review $18.74 $18.7 Health Risk Appraisal Motivation $0.00 $0.00 Comprehensive Physical Exam $114.77 $114.77 Waist/Hi Ratio $3.53 $3.53 Body Fat Test-BIA Bio-Elec Imp Anal 16.40 $16.40 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.4 Flexibility Test $11.72 $11.72 Urinalysis-Di stick $3.53 $3.53 EKG W/Intem $23.42 $23.42 Audiometry 16.40 $16.40 PFT-Pulmonary Function T t $38.65 Vision-Acuity 30.4 .4 Vital Signs-HT WT BP P R $0.00 $0.00 Moore Scott L. OnMed Program $0.00 $0.00 Respirator/Medical Review $18.74 $18.74 Health Risk Appraisal Motivation 0.00 $0.00 Comprehensive Physical Exam $114.77 $114.77 Waist/Hi Ratio $3.53 $3.53 Body Fat Test-BIA Bio-Elec Imp Anal 16.40 $16.4 Treadmill-Submax $179.11 $179.11 Muscular Stren th Endurance Test $30.45 $30.4 Flexibility Test $11.72 $11.72 Urinalysis-Dipstick EK Interp $23.42 $23.42 Audiometry $16.40 $16.4 PFT-Pulmonary Function Test $38.65 $38.6 Vision-Acuity $30.45 $30.4 Vital Signs-HT WT BP P R $0.00 $0.00 Tro er Darin M. OnMed Program $0.00 $0.00 Respirator/Medical Review $18.74 $18.7 Health Risk Avoraisal Motivation) $0.00 Comprehensive Physical Exam $114.77 $114.77 Waist/Hi Ratio 3.53 $3.53 Body Fat Test-BIA Bio-Elec Imo Anal 16.40 $16.40 Treadmill-Submax $179.11 $179.11 1 Muscular h Endurance Test $30.45 $30.4 Public Safety Medical - INVOICE r° Public Safety Medical Invoice Date: 02/25/2017 ._ 324 E. New York Street Invoice# 00-30042 E Suite 300 Terms: W Indianapolis, IN 46204 y.4 C Carmel Police Department/CARMEPD rr Chief Tim Green (PO 34162) m 3 Civic Square Carmel, IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due Flexibility Test $11.72 $11.72 Urinalysis-Dipstick $3.53 $3.53 EKG W/Interp $23.42 $23.42 Audiometry 16.40 $16.40 PFT-Pulmonary Function Test $38.65 $38.65 Vision-Acuity 30.45 $30.45 Vital Signs-HT WT BP P R $0.00 $0.00 Wiegman,Chad R. OnMed Program $0.00 $0.00 Res irator/Medical Review $18.74 $18.74 Health Risk Armraisal Motivation 0.00 $0.00 Com rehensive Physical Exam $114.77 $114.77 Waist/Hip Ratio Body Fat Test-BIA(Bio-Elec Imp Analy) $16.40 $16.4 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.4 Flexibility Test $11.72 $11.72 Urinalysis-Dipstick $3.53 $3.53 EKG W/Interp $23.42 $23.42 Audiometry 16.40 $16.40 PFT-Pulmonary Function Test $38.65 $38.65 Vision-Acuity 30.45 $30.4 Vital Sin -HT WT BP P R $0.00 $0.00 Williams Ashley L. OnMed Program $0.00 $0.00 Resr)irator/Medical Review 1 .74 1 .7 Health Risk Appraisal Motiv tion $0.00 Comprehensive Physical Exam $114.77 $114.77 Waist/Hi Ratio $3.53 $3.53 Body Fat Test-BIA Bio-Elec Imp Anal $16.40 $16.4 Treadmill-Submax $179.11 179.11 Muscular Strength Endurance Test $30.45 $30.45 Flexibility Test $11.72 $11.72 Urinalysis-Di stick $3.53 $3.53 EKG W/Inte 23.42 $23.42 Audiometry 16.40 $16.4d PFT-Pulmonary Function Test $38.65 $38.65 Vision-Ai .45 $30.4 Vit -HT