The URL can be used to link to this page

Home My WebLink About315005 08/15/2017 ''V 4�'"'� CITY OF CARMEL, INDIANA VENDOR: 00350364 �< ti ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $'`"`*4,564.57` M ,i° CARMEL, INDIANA 46032 324 INDIANAPOLISENEW YORK N ST SUITE 300 CHECK NUMBER: 315005 t �To»�°' CHECK DATE: 08/15/17 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4340701 100018 00-31050 2,109.54 OFFICER PHYSICALS 1120 4340701 100336 31089 2,455.03 FIRE DEPT PHYSICALS / -0 < < 0 mom O Q � E § X822 2 > m r- 0 0 \ 0 m # > / $ /? n 0 $ > o m {_ E m E 2 e < k q E O 7 o g E q# @ -n PO\ -41 \ / R CD -0 n I n 0 # « m q ® O � 2 / � 0 w m / i Gk En o < ƒ 3 / ; n 2 q z \ z 2 7 / > _n O ; k oO g / m | \ § % 4 i 2 § / z % g # k ƒ E o % k } ƒ J i ƒ m ? ; n _ = A / D 3 - F § # f ktc 2 : ICD \ CD \ « 0 k & k $ ƒ @ OSO K 2 . o o E a ° � » ƒa � 11) i § k CL < / » CL \ =r CD o = CD CD [ � k « 7 q Q 7 J � T m g # ( CL ° w m \ \ k § K > / -® ) \ t § k � � 0 � J 7 /} k § k m ƒ \ C o ) / k CL 3 \ C ik § k \ | 0_< D so a }o ( \ o= �o ) o r Co CD CL 2 CD 0 \ 0 / j E / \ r 0 E 3 yZ m § % 7 ; C % CD 7 )/ � q a [ 2 2. M \ k § /\ z § k § \ q 2 m CD \ g Ln § k \ Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 08/02/2017 324 E. New York Street Invoice# 00-31089 E Suite 300 Terms: ce Indianapolis, IN 46204 C Carmel Fire Department/CARMEFD Denise Snyder, Budget&Accred Mgr m Dsnyder@carmel.In.Gov(B) Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due 07/26/17 Brandt,Gary D. HIV-4th Gen Rapid Test(Blood) $25.93 $25.9 TSH-Thyroid Stim Hormone Blood 28.01 $28.01 Venipuncture $3.53 $3.53 Li id Panel Blood 23.82 $23.82 CBC(Comp Blood Count 20.29 $20.29 CMP(Comp Metabolic Panel 22.41 $22.41 PSA-Prostate Specific A Blood 0.99 $40.9 Malicoat Justin R. TSH-Thyroid Stim Hormone Blood 28.01 $28.01 Veni uncture $3.53 $3.531 Lioid Panel Blood) $23.82 $23.82 BC(Comp BloodCount) .2 2 .2 CMP(Comp Metabolic Panel) $22.41 $22.41 Maners.Jere y B. HIV-4th Gen Rapid Test(Blood) $25.93 $25.9 TSH-Thyroid Stim Hormone Blood 28.01 $28.01 Venipuncture $3.53 $3.53 Livid Panel Blood 23.82 $23.82 CBC(Comp Blood Count 20.29 $20.29 CMP(Como Metabolic Panel 22.41 $22.41, Steele Jeffrev A. Venipuncture $3.53 $3.53 Li id Panel Blood 23.82 $23.82 CBC(Comp Blood Count $20.29 $20.2 MP(Comp Metabolic Pan l 2.41 $22.41 PSA-Pr t ifi A I 07/27/17. Baskerville.Anthony A. HIV-4t1i Gen Rapod Test(Blood) $25.93 $25.93 Veniouncture $3.53 $3.53 Lipid Panel(Blood) 23.82 23.82 CBC Com Blood Count 20.29 20.2 CMP Com Metabolic Panel 22.41 22.41 PSA-Prostate S ecific A Blood 0.99 $40.99 Brant Kenneth E. HIV-4th Gen Ra id Test Blood 25.93 $25.93 TSH-Thyroid Stim Hormone Blood 28.01 $28.01 Venipuncture .53 $3.53 Lipid Panel Blood 23.82 $23.82 (CompCBC Blood Count) 2 .2 MP(Comp Metabolic Panel) 22.41 $22.41 Public Safety Medical - INVOICE Io- Public Safety Medical Invoice Date: 08/02/2017 324 E. New York Street Invoice# 00-31089 E Suite 300 Terms: ce Indianapolis, IN 46204 C Carmel Fire Department/CARMEFD I- Denise Snyder, Budget&Accred Mgr = Dsnyder@carmel.In.Gov(B) Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due TSH-Thyroid Stim Hormone(Bloodl $28.0 $28.01 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 $22.41 PSA-Prostate Specific A Blood 128.01 0.9 Freer Keith T. TSH-Thyroid Stim Hormone Blood 28.01 Veni uncture 3.53 Li id Panel Blood 23.8CBC m BI nt $20.2 MP(Comp Metabolic Panel) $22.41 $22.41 Prostate Frost.Bruce S. HIV-4th Gen Rapid Test(Blood) $25.93 $25.93 TSH-Thyroid Stim Hormone Blood $28.01 $28.01 Venipuncture $3.53 $3.53 Li id Panel Blood 23.82 $23.82 CBC(Comp Blood Count 20.29 $20.29 CMP(Comp Metabolic PanelW$22.41 22.41 PSA-Prostate S ecific A Blood 0.9 Hu hes Chad L. HIV-4th Gen Ra id Test Blood 25.9TSH-Th roid Stim Hormone Blood $28.01 VeniDuncture Lipid Panel Iood) $23.82 $23.82 CBC(Comp Blood Count) $20.29 $90.99 CMP(C rnp Metabofic Panel) $22.41 $22.41 PSA-Prostate Specific A Blood 0.99 $40.99 KnottBruce A. TSH-Th roid Stim Hormone Blood 28.01 $28.01 Veni uncture $3.53 $3.531 Lipid Panel Blood 23.82 $23.82 CBC(Comp Blood Count 20.29 $20.29 CMP(Comp Metabolic Panel 22.41 $22.41 PSA-Prostate Specific A Blood .99 $40.99 Mason,Bryan L. HIV-4th Gen Rapid Test Blood 25.93 $25.93 TSH- h r i tim Hormone(Blo2 1 $28,01 Venipuncture Public Safety Medical - INVOICE F Public Safety Medical Invoice Date: 08/02/2017 324 E. New York Street Invoice# 00-31089 E Suite 300 Terms: IY Indianapolis, IN 46204 C Carmel Fire Department/CARMEFD I- Denise Snyder, Budget&Accred Mgr m Dsnyder@carmel.In.Gov(B) Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due CMP(Comp Metabolic Panel) $22.41 $22.41 PSA-Prostate Specific A Blood 0.99 $40.9 Osborne Scott K. HIV-4th Gen Rapid Test Blood 25.93 $25.9 TSH-Thyroid Stim Hormone Blood V$2241 28.01 Veni uncture 3.53 Lipid Panel Blood 23.82 CBC Com Blood Count 20.2 CMP Com Metabolic Panel $22.41 PSA-Prostate Specific A Blood 0.99 $40.99 m II Th m D. HIV-4th Gen Rapid Test l 2 TSH-Th r i tim Hormone(Blood) $28.01 $28.01 Venwouncture $3.53 $3.53 Lip'd Panel(Blood) $23.82 $93.89 CBC(Comp Blood Count 20.29 $20.29 CMP(Comp Metabolic Panel 22.41 $22.41 PSA-Prostate Specific A Blood 0.99 $40.99 07/28/17 Cox Justin M. HIV-4th Gen Rapid Test Blood 25.93 $25.93 TSH-Thyroid Stim Hormone Blood 28.01 $28.01 Veni uncture $3.53 $3.53 Lipid Panel Blood 23.82 $23.82 CBC Com Blood Count 20.29 $20.29 MP Metabolic Pan I 22.41 $22.41 Hoover.Anthony B. HIV-4th Gen Rapid Test l 2 . TSH-Thyroid Sfirn Hormone(Blood) $28.01 $28.01 Ven'ouncture $3.53 $3.5 Lipid Panel Blood 23.82 $23.82 CBC(Comp Blood Count 20.29 $20.29 CMP(Comp Metabolic Panel 22.41 $22.41 PSA-Prostate Specific A Blood 0.99 $40.99 Philli s Michael J. TSH-Thyroid Stim Hormone Blood 28.01 $28.01 Venipuncture $3.53 $3.53 Li id Panel Blood 23. 2 23.82 CBC Com Blood Count 20.29 $20.2 MP(Comp Metabolic Panel) 2 .41 T.99.41 Total Charges-> $2,455.03 Total Payments&Balance Due > $0.001 $2,455.03 Public Safety Medical - INVOICE I I°— Public Safety Medical Invoice Date: 08/02/2017 324 E. New York Street Invoice# 00-31089 E Suite 300 Terms: W Indianapolis, IN 46204 C Carmel Fire Department/CARMEFD IDenise Snyder, Budget&Accred Mgr m Dsnyder@carmel.In.Gov(B) Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount I Balance Due 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. o w -0 < « k \ m O / k ms § O ? X222 2 m r- C J » # z 2 n ? M { 0 3 > o q I o 2 E 7 O k R I \ / � 2 f E . ( S M k q $ q 2 2 ° Ch. k 2 > m � o X I M@ e2 � w m k \ § § E \ � q E ƒ X / ^ > k 2 / w °r z 2 < f > O [ k / q CD | z k z =r _ ± § 6 � 5 U k [ � ƒ \ \ 3 CL n E 2 7 a k v � n ) Y) 7 k - E - ; / / ® > \ \ a k n 6 ° - E \ k \ $ \ 2 K 0 0 R. P, o a � k k ƒ CL < } ® ; ( i & & 7 / - ƒ § C ® B 0 7 � - f T K« § m Q E _ in U7 \ j m Cl) ( U) = I f \ D \ e ) \ 0 7 § \ _ $ ) \ } k 0 CD § \ § m / o R � o # Z / =r ° \ CD \ / �< T 7\ \ 0 > }_h ( ) ( �o & - D # ; m 7 i § \ r - \ $ M n / 0CD e \ ] i CD \ ƒ C 2 -00 c cn 23,° CD 0 CD 0 CL CD CDM CL \ c § m \ ) X ] CD ^ ] § ( \ f S CL E 2 \ ƒ 7 / $ ® \ Public Safety Medical - INVOICE H Public Safety Medical Invoice Date: 07/27/2017 324 E. New York Street Invoice# 00-31050 E Suite 300 Terms: W Indianapolis, IN 46204 C Carmel Police Department/CARMEPD I-- Pat Young m Pyoung@carmel.In.Gov Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due 07/18/17 h 'r r Clearance Chart Review/Completion $94.85 $94.8 Indiana PERF Exam $213.13 $213.13 Drug Screen 9 +Opiates&Oxycodone $46.85 $46.8 Tonometry Glaucoma Test 2.16 $42.16 Urinalysis-Dipstick $3.53 $3.53 EKG W/Interp23.42 23.4 Audiometry 16.40 $16.4 PFT-Pulmonary Function Test $38.65 $38.65 Vision-Color(Ishihara) .45 $30.4 Viin-A i .4 .4 Venipuncture Applicant Blood Panel-PERF $134.46 $134.46 Quantiferon-Tb Blood 58.55 $58.55 Chest X-Ray-PA/LAT(Digital) 70.26 $70.2 07/21/17 Amos Chad B. 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 $22.41 PSA-Pr t to Specific A I 0.9 Broadnax.M tth w L. Venipuncture Lipid Panel(Blood) $23.82 $23.82 CBC(Comp Blood Count) $20.29 $20.29 CMP(Comp Metabolic Panel 22.41 $22.41 PSA-Prostate Specific A Blood 0.99 $40.9 Cash II Steven H. HIV-4th Gen Rapid Test Blood 25.93 $25.9 Venipuncture $3.53 $3.531 Lipid Panel Blood 23.82 $23.8 CBC(Comp Blood Count 20.29 $20.29 CMP(Comp Metabolic Panel 22.41 $22.41 PSA-Prostate Specific A Blood 0.99 $40.9 Dewald.GreaoryVenipuncture Lipid Panel BI 2 $23.8d CBC(Comp Blood Count) Public Safety Medical - INVOICE Public Safety Medical Invoice Date: 07/27/2017 324 E. New York Street Invoice# 00-31050 E Suite 300 Terms: W Indianapolis, IN 46204 o Carmel Police Department/CARMEPD 12 Pat Young 0o Pyoung@carmel.In.Gov Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due PSA-Prostate Soecific Aa(Blood) $40.99 $40.9 Grose James E. HIV-4th Gen Rapid Test Blood $25.93 $25.93 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 $22.41 PSA-Prostate Specific A Blood 0.99 $40.9 Hams Robert P. HIV-4th Gen Rapid Test Blood 25.93 $25.93 Venipuncture $3.53 $3.53 Upid Panel BI 22 $23.82 BC m Blood Count) $20.29 2 .2 CMP(C mp Metabolic 1 PSA-Prostate Specific Hedrick Brad A. HIV-4th Gen Rapid Test Blood 25.93 $25.931 Venipuncture $3.53 3.53 Lipid Panel Blood 23.82 23.8 CBC(Comp Blood Count 20.29 20.2 CMP(Comp Metabolic Panel 22.41 22.41 PSA-Prostate Specific A Blood 0.99 $40.9 Locke Robert E. HIV-4th Gen Rapid Test Blood 25.93 $25.93 Venipuncture $3.53 $3.53 Lipid Panel BI 22 $23.8 BC(Comp Blood Count) $20.29 20.2 Panel)CMP(Comp Metabolic 1 $22.41 A-Prostate Specific Reynolds,Jamie N. HIV-4th Gen Rapid Test Blood 25.93 $25.9 Venipuncture $3.53 $3.53 Li id Panel Blood 23.82 $23.82 CBC(Comp Blood Count 20.29 $20.2 CMP(Comp Metabolic Panel 22.41 $22.41 Schmidt Brian E. HIV-4th Gen Rapid Test Blood 25.93 $25.93 Veni uncture $3.53 $3.53 Lipid Panel Blood 23.82 $23.82 BC(Comp Blood Count) $20.29 2 .2 MP(Comp Metabolic Panel) .41 22.41 PSA-Prostate Soecefic Aa(Blood) $40.99 $40-91 Total Charges-> $2,109.54 Public Safety Medical - INVOICE 1°- Public Safety Medical Invoice Date: 07/27/2017 324 E. New York Street Invoice# 00-31050 E Suite 300 Terms: W Indianapolis, IN 46204 o Carmel Police Department/CARMEPD I-- Pat Young m Pyoung@carmel.In.Gov Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount I BalanceDue Total Payments&Balance Due->1 $0.00 $2,109.54 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.