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Home My WebLink About310638 04/24/17 +m COMM „� '� CITY OF CARMEL, INDIANA VENDOR: 00350364 ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $'''"*6,339.64` ,r CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK NUMBER: 310638 oy. INDIANAPOLIS IN 46204 CHECK DATE: 04/24/17 <<ON DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4340701 0030255 99.12 MEDICAL EXAM FEES 1110 4340701 100018 0030307 5,728.791✓ OFFICER PHYSICALS 1120 4340701 30306 511.73,,� MEDICAL EXAM FEES 0z % _0 < « o m 0 Q 2 -Ah O CA § 2 2 > m 9 0 c i ® > > f / # ? n 3 > o q \ O E T o ( Cl) k q k O $ \ m n 0 / q f k # @ -n f O_ 2 � 2 C: > } -0 4 -4 / « � 2 / � 0 � q » / g k E 0 o < 3 # # d CL ® zz } f o 0 . O | \ � Z % } a i ; 9 - z / z k $ g / / k k % \ } i m M 0 2 G k = CD AD ƒ - - m # f CD _ 2 \ / O CD / : E m _ E - CD \ƒ > % 3 8 / ? _ a t @ o k R ° = / ƒ - ° k CL / �CL / / x $ � k ƒ R c |� [ t %E § m § k e CD / \ j m \ / CYCD ; ; CL7 \ (D & = D ) \ t § \ C0 aQ o 0 C) Z o - k} \ / § m ƒ \ k C o 00) CD� 3 \ N CL =r § k } OR \ 2 C"_° 0 D . }f CD \ *0 � � §\ & - > §� CD \ } § 0 / � j _E / \ \ r- O E ¥ « d \ CD C $ \ ¥ m CD m / CD n , g \ g M \ 7 f f / § ] ƒ P 2. k § \ f 0 \ D } j § Public Safety Medical - INVOICE H Public Safety Medical Invoice Date: 04/07/2017 324 E. New York Street Invoice# 00-30306 m Suite 300 Terms: W. Indianapolis, IN 46204 C Carmel Fire Department/CARMEFD I Denise Snyder, Budget&Accred Mgr m 2 Civic Square(PO#24831) Carmel, IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due 17 Knott.Bruce A. OnMed Pr r m $0.00 Respirator/Medical Review $18.74 $18.74 Health Risk Appraisal Motivation $0.00 $0.00 Comprehensive Physical Exam $114.77 $114.77 Body Fat Test-BIA Bio-Elec Imp Anal 16.40 $16.40 Treadmill-Submax $179.11 $179.11 Chest X-Ray-PA/LAT Di ital 70.26 $70.2 Urinalysis-Dipstick $3.53 $3.53 EKG W/Intem $23.42 $23.42 Audiometry 16.40 $16.40 PFT-Pulmonary Function Test $38.65 $38.65 Vision-Acuity .4 30.45 Vital SiQns-HT WT BP P R 0 Total Charges-> $511.73 Total Payments&Balance Due->1 $0.00 $511.73 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. 0 _ 2 / � $ « k mc � � � ? ) -0-i z > m r- / n K = # z 2 6 itcr 2 5 0 k > o q \ § k /CD O w 2 � \ } k 7 & q0 k / N) � C > 90 Q r \ 0 2 2 m « / \ / k / q k < X m § # X 3 m C 2 z 2 < 7 K - / § \ q / ± _ J % B9 z # /< g (� /0 @ E n E 7 k H q / \ a S k § 7 - E i } m 2 0 E 2 » / a CL § , k a \ § k CD \ \ \ R 3 0 k k\ B % 7 E 2 cu \ / g E § » k ƒ § CD 3 3 o [ k Z t q e \ 7 i t j j -1 7 \ 0. ; n # k 2i \ E D \ ) \ C 7 § k ) -n < a ® 0 ca 87 w Co E ] Q k m C ° n ƒ -4 # % ® Z 0> , n m \ 3 § 0 %k k k \ �< O _0 } D _ƒ D §k } e a « nm D \ \ ; \ K M ƒ , 0 7 0 / ƒ ( 0 E CD c § & O ¥ f % cn§ \ E ; C / C E m/ } q 2 d � 2 / U) § m ] \ CD \ { \ R. m \ 7 K & ƒ w a \ 0 . � k � ® k Public Safety Medical - INVOICE 0 Public Safety Medical Invoice Date: 04/07/2017 324 E. New York Street Invoice# 00-30307 CD Suite 300 Terms: Indianapolis, IN 46204 C Carmel Police Department!CARMEPD I— Pyoung@carmel.In.Gov m ' Exclusively Serving Public Safety Professionals Since 9990. Date Employee Description Amount Balance Due Total Payments&Balance Due-> $0.001 $5,728.79 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 Fo Public Safety Medical Invoice Date: 04107/2017 324 E.New York Street Invoice# 00-30307 Suite 300 Terms: Indianapolis, IN 46204 Carmel Police Department/CARMEPD H Pyoung@carmel.In.Gov m ' Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due 03t28117 Bodenhom.Wendy M. OnMed Proaram $0.00 S0.00 Respirator/Medical Review $18.74 $18.74 Health Risk Appraisal Motivation 0.00 $0.00 Comprehensive Physical Exam $114.77 $114.T7 Waist/Hi Ratio $3.53 $3.53 Body Fat Test-BIA Bio-Elec Imp Analy) $16.40 $16. Treadmill-Submax $179.11 $179.11 Muscular Stren th Endurance T Flexibility Test $11.72 $11.72 Urinalysis-Dipstick K $23. Audiometry $16.40 S16. PFT- ulmonary Function Test $38.65 $38, Vision-Acuity 30.45 $30.45 Vital S' ns-HT WT BP P R $0.00 $0.00 Collins Jr Willie H. OnMed Program $0.00 $0.00 Res irator/Medical Review $18.74 $18.74 Health Risk aisal Motivation 0.00 $0.00 Hemoccult $0.00 $0.00 Comprehensive Physical Ex 114.77 $114.77 Waist/Hi Ratio Body Fat T Treadmill-Submax $179.11 $179.11 Muscular Strenoth Endurance Test $30.45 $30, Flexibility" Urinalysis-Dipstick $3.53 $3.53 EKG W/Interp $23.42 $23.42 Audiometry 16.40 $16. PFT-Pulmonary Function Test $38.65 $38. Vision-Acuity 30.45 $30.45 Vital Si ns-HT WT BP P R $0.00 $0.00 Goodman. eland C. OnMed Proaram $0.00 $0.00 Respirator/Medical i 18.7 Health Risk Appraisal 0 PhysicalI Comprehensive Exam $114.77114. Public Safety Medical - INVOICE t°- Public Safety Medical Invoice Date: 04/0712017 ._ 324 E. New York Street Invoice# 00-30307 E Suite 300 jr Indianapolis, IN 46204 Terms: C Carmel Police Department!CARMEPD t- Pyoung@carmel.In.Gov Exclusively Serving Public Safety Professionals Since 9990. Date Employee Description Amount Balance Due Treadmill-Submax $179.11 $179.11 Muscular Strenath 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 Audiornetry $16.40 $16.4 PFT-Pulmonary Function Test $38.65 $38.6 Vision-Acuity 30.45 $30.45 Vital Sions-HT WT BP P R $0.00 HIV-4h Gen Rapid Test(Blood) $25.93 $25. Venipuncture Upid Panel I CBC(Comp Blood Count) $20.29 $70.29 CMP(Comp Metabolic Panel 22.41 $22.41 PSA-Prostate Specific A Blood 0.99 $40.99 Kin horn Kevin M. OnMed Program $0.00 $0.00 Respirator/Medical Review $18.74 $18.74 Health Risk Appraisal Motivation 0.00 $0.00 Comprehensive Ph sical Exam $114.77 $114.77 Waist/Hip Ratio $3.53 $3.53 Body Fat Test-BIA Bi -Elec Imp Analy) 16.4 4 Treadmill- x $179.11 Muscular n th Endurance Test Test $11.72 $11.72 Urinalysis-Dipsfick EKG W/Interp $23.42 $23.4 Audiornetry $16.40 $16.4 PFT-Pulmonary Function Test $38.65 $38.6 Vision-Acuity 30.45 $30.45 Vital Si ns-HT WT BP P R $0.00 $0.00 Sedberrv.Jeffrey T. OnMed Proararn $0.00 $0.00 s irator/Medical Review .74 $18,7 Health Risk Appraisal(Motivation) Comprehensive Physical Exam Waist/Hi Ratio Body Fat Test-BIA (Bio-El n Treadmill Public Safety Medical - INVOICE 12 Public Safety Medical Invoice Date: 04/07/2017 324 E. New York Street Invoice# 00-30307 Suite 300 Terms: Indianapolis,IN 46204 c Carmel Police Department/CARMEPD H Pyoung@carmel.In.Gov m ' Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due I tridurance Test $30.45 $30.45 Flexibility Test $11.72 $11.72 Urinal sis-Di stick $3.53 $3.53 EKG W/Interp $23.42 $23.4 Audiometry 16.40 $16.401 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 Theis.Adam G. OnMed Prooram Respirator/Medical w S18.74 $18.74 Health Risk (Motivation) Comorahensive Walst/Hip 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 $30.451 Flexibility Test $11.72 $11.7 Urinalysis-Di stick $3.53 $3.53 EKG W/Inte 23.42 $23.4 Audiometry 16.4 16.4 PFT-Pulmonary Function Test $38.65 $38.6 Vision-Acuity $30.45 .4 Vital Sions-HT WT BP P R $0.00 $0.00 Tilson.Travis C. OnMedProaram $0.00 $0.00 Respirator/Medical w Health Risk Appraisal Motivation .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 i k EKG W1 Interp $23.42 $23.4 Audiometry 1 $15.4 Pulmonary t 4 Public Safety Medical - INVOICE Public Safety Medical Invoice Date: 04/0712017 324 E.New York Street Invoice# 00-30307 Suite 300 Terms: r Indianapolis,IN 46204 o Carmel Police Department/CARMEPD H Pyoung@carmel.In.Gov m ' Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due T WT BP P R 03/30/17 Hastv.Zachery R. OnMed Pr ram $0.00 $0.00 Respirator/Medical Review $18.74 $18.74 Health Risk Appraisal Motivation 0.00 $0.00 Comprehensive Physical Exam $114.77 $114.71 Waist/Hi Ratio $3.53 $3.53 Body Fat Test-BIA Imo Anal 16.40 $16.4 Treadmill-Submax $179.11 $179.11 Muscular Strenoth Endurance Test $30.45 Flexibility Test $11.72 Urinalysis-Dipstick EKG W/Interp $23-4A Audiometry $16.40 $16.40 PFT-Pulmonary Function Test $38.65 $38.6 Vision-Acuity 30.45 $30.45 Vital Signs-HT WT BP P R $0.00 $0.00 Jent Danny N. OnMed Program $0.00 $0.00 Respirator/Medical Review $18.74 $18.74 Health Rik Appraisal(Motivation) 0.00 $0.00 Comprehensive Physical Exam $114.77 $114.77 We! ip Ratio S3.53 $3.53 B IA(Bio-Elec Imp I .4 Treadmill- max $179.11 $179.11 Muscular Strenath Endurance Test $30.45 4 Flexibility Urinalysis-Dipstick $3.53 $3.53 EKG W/Interp $23.42 $23.42 Audiornetry $16.40 $16.40 PFT-Pulmonary Function Test $38.65 $38.6 Vision-Acuity 0.45 $30.45 Vital Si ns-HT WT BP P R $0.00 $0.00 HI - (Blood) 25.93 $25.93 V 3.53 $3.53 LiDid Panel I 3.8 CBC(Comp Blood Count) Metabolic Panel) PSA-Prostate Specific Ag(Blo 1 $40-99 S40. Public Safety Medical - INVOICE 1°- Public Safety Medical Invoice Date: 04/07/2017 324 E. New York Street Invoice# 00-30307 m Suite 300 Terms: W Indianapolis, IN 46204 1 C Carmel Police Department r'CARMEPD F- Pyoung@carmel.In.Gov m ' Exclusively Serving Public Safety Professionals Since 9990. Date Employee Description Amount Balance Due Robbins,Todd E. OnMed Proarem $0.00 $0.00 Respirator/Medical Review $18.74 li§ii Health Risk Appraisal Motivation .00 $0.00 Comprehensive Physical Exam $114.77 $114.77 WaistlHip Ratio S3.53 $3.53 Body Fat Test-BIA Bio-Elec Imp Anal 16.40 $16.4 Tread ill-Submax $179.11 $179.11 Muscular Strencrth Endurance Test $30.45 $30.4 Flexibility Test $11.72 Divstick S3.53 $3.53 EKG W/Interp $23.42 3.42 Audiometry $16.40 $16.4 PPulmonary Vision-Acuity 30.45 $30.4 Vital Signs-HT WT BP P R $0.00 $0.00 Strong,David C. OnMed Program $0.00 $0.00 Respirator/Medical Review $18.74 $18.7 Health Risk Appraisal Motivation .00 $0.00 Comprehensive Physical Exam $114.77 $114.77 Waist/Hi Ratio $3.53 $3.53 Body Fat Test-BIA Bio-Elec Imp AnalAnalyl $16.40 Treadmill- x $179.11 $179.11 Muscular Strenoth Endurance Test $30,4 4 Flexibility Test $11.72 11. EKG W/Interp $23.42 $23.4A Audiometry $16.40 $16. PFT-Pulmonary Function Test $38.65 $38.61 Vision-Acuity 30.45 $30.4 Vital Signs-HT WT BP P R $0.00 $0.00 Theis Adam G. HIV-4th Gen Rapid Test Blood 25.93 $25.9 Veripu cture $3.533.53 Lipid nel Blood) $23.82 23.8 BloodCBC(Como 2 (ComoCMP Metabolic P .41 Total Charges->1 $5,728.79 E / -0 < < 0 q Q c 6 % q O � j OL c k 2 / 0 \ 0 0 n R O E -< $ $ < k q k O b 0 0 S m n O A Cl) q s a # ■ -n 4.9q ® _ ] > $ 2 ? 0 7 m $ / / « 0 q S q D G $ ' 0 o < m 3 # 5 L d q -i \ > - O C \ \ CD | � H / t 2 / § ƒ $ m 0 % E ° 7 ƒ E o m ¥ CD / a ; o § ° w 7 - Z # / E E 3 ƒ [ E $ m CL \ / . ƒ / 0 / ? % @ 0 o & N) C - ° k 2 [ 7 E E w , t / \ \ E ( - k ƒ ) CD c � / CL(D m0 ` / r \ \ D \ I$ 0 E § \ S 2 < j \ j 22 0 E \ \ § ƒ \ k � ( 20 a \ f 3 / ik § \ I 0 | 0< (CDT 3 D e� © }_ƒ CD \ { o > �/ ) _ @ M CL > CD CD 2 0 / G 0 2 / --j E \ \ r Q E ¥ 3 \ j / E CD % CD $ q } & p CD ° / CD m\ \ k \ CL- / } § CR � \ \ E 2 k ; \ / ƒ / § ) Public Safety Medical - INVOICE 0 Public Safety Medical Invoice Date: 03/31/2017 = 324 E. New York Street Invoice# 00-30255 E Suite 300 Terms: W Indianapolis, IN 46204 C Carmel Fire Department/CARMEFD I— Denise Snyder, Budget&Accred Mgr m 2 Civic Square(PO#24831) Carmel, IN 46032 Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description U$20.00 e Due 217 Knott.Bruce A. MP m Metabolic Panel) 2 .CBC Com Blood Count $18.13Liid Panel Blood $21.2Veni uncture 3.14PSA-Prostate S ecific A Blood 36.5 Total Charges->1 $99.12 Total Payments&Balance Due-> $0.001 $99.12 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.