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HomeMy WebLinkAbout312757 06/16/17 @CITY OF CARMEL, INDIANA VENDOR: 370269 ONE CIVIC SQUARE ZIRMED CHECK AMOUNT: $*******224.70* CARMEL, INDIANA 46032 1311 SOLUTIONS CENTER CHECK NUMBER: 312757 CHICAGO IL 60677-1311 CHECK DATE: 06/16/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4355200 584144 224.70 SUBSCRIPTIONS 0 n N < « o . q � 0 I . k_ § O C) D 2 m ° n � ® n p m \ O e d z m K k q k % O % \ ° ® q ® § a) k/ / z / k Tm S -n > / Q d CL _0 m 3 © m f ° 7 } z 2 / > -n p | / / O m \ ) Z $ _ J a t 2 LT e k $ m / ƒ E § % i / / 0 m \ 0 ° � 7 - m # f O @ 2 I \ E k / : ( CL C_ § 0 ƒ 2% 3 8 \ ? « _ j r g E ZD @ ® o E R & °kƒ C \\ a CL CD � | 0 7 # 7 - « > C < \ Kƒ \ ® %\ ( ; G # J E {$ & D Cl) ) \ # \ k § k ( k 0 �CD # meq ƒ 7 \ C o ^ D 9 0 CD \ 2 ND \ / \/ | 0� $0D }f CD D �\ o o » > �7 CL / M - m 0 f n 6 = z CD ) \ C 0 % CD ƒ_ § m / 0 / \kCL M } \ / § \ q 2 m k 0 CD :-4 Z ° \ INVOICE Date 6/12/2017 (RIVEEY Invoice# 584144 zrAccount# 125191 www.t�wMEa.cc�M For overnight or Due Date 7/12/2017 correspondence ONLY: Customer PO# Invoice questions?Please call(877)494-7633 ZirMed, Inc. option 4 Attn: Accounting Dept Email:billinginquiry@zirmed.com 888 W.Market St., Ste 400 Louisville, KY 40202 Amount Paid Customer Support or Sales:(877)494-7633 Bill To PLEASE REMIT ONLY PAYMENTS City of Carmel Fire Department TO THE FOLLOWING: 2 Civic Square ZirMed Inc. Carmel IN 46032 1311 Solutions Center Chicago, IL 60677-1311 125191 Zirmed 584144 6/12/2017 7/12/2017 Professional Claims Non-Primary Paper Claim Fee 1 0.45 0.45 Professional Claims Non-Primary Paper EOB Page Fee 1 0.25 0.25 Monthly Professional Claims Management Fee 1 99.00 99.00 Monthly Eligibility System Access Fee 1 100.00 100.00 Monthly Remittance Advice Access Fee 1 25.00 25.00 Invoice Total $224.70 A640-141�...... _ uY.t,_ .h ON .,ass 224.70 0.00 0.00 0.00 0.00 ` $224.70 Would you like your invoice via email? Please email billinginquiry@zirmed.com