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HomeMy WebLinkAbout321038 1/17/2018 t ''''' -4,,F. CITY OF CARMEL, INDIANA VENDOR: 00350364 6 / I• ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES CHECK AMOUNT: $**"13,640.76* bi t 324 E NEW YORK ST SUITE 300 CHECK NUMBER: 321038 9 1-µ;=°,i0 CARMEL, INDIANA 46032 INDIANAPOLIS IN 46204 CHECK DATE: 01/25/18 «ON� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4340701 100018 12,841.02 OFFICER PHYSICALS 1110 R4340701 100018 799.74 OFFICER PHYSICALS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 00350364 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PUBLIC SAFETY MEDICAL SERVICES IN SUM OF$ CITY OF CARMEL 324 E NEW YORK ST SUITE 300 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. INDIANAPOLIS, IN 46204 Payee $13,640.76 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Carmel Police Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 100018 00-31958 43-407.01 $13,640.76 1 hereby certify that the attached invoice(s),or 1/3/18 00-31958 officer physicals $13,640.76 1110 t`ar4r r Gcrerd 101 1110 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for 1 - which charge is made were ordered and received except ;�kxJ p Wednesday,January 3,2018 Jim Barlowl Chief ' 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Public Safety Medical - INVOICE o.' Public Safety Medical Invoice Date: 12/21/2017 _ja I r 324 E. New York Street Invoice# 00-31958 Suite 300 Terms: j a:- ; Indianapolis, IN 46204 •.6 i o ! Carmel Police Department/CARMEPD - Pyoung@carmel.In.Gov (W) G0 Exclusively Serving Public Safety Professionals Since 1990. Date Employee " - Description,- Amount ,Balance Due 12/13/17 Barlow.James C. OnMed Pro ram $0.00 $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 $16.40 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.45 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 Bickel Jose h E. OnMed Program 0.00 0.00 Respirator/Medical Review 18.74 18.7 Health Risk Appraisal Motivation 0.00 0.00 Com rehensive Physical Exam 114.77 114.77 Waist/Hi Ratio 3.53 3.53 Bodv Fat Test-BIA Bio-Elec Imp Anal 16.40 $16.40 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.45 Flexibility Test $11.72 11.72 Urinalysis-Dipstick $3.53 $3.53 EKG W/Interp $23.42 $23.42 Audlometry $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 Brady,Sean P. 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 Im Anal 16.40 $16.40 T x $179.11 $179.11 Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 12/21/2017 r j 324 E. New York Street Invoice# 00-31958 I E Suite 300 l Indianapolis, IN 46204 Terms: L-_< •.S i, c Carmel Police Department/CARMEPD m Pyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description' Amount Balance Due Muscular Stren th Endurance Test $30.45 $30.45 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 Devenport,Adam M. OnMed Program $0.00 $0.001 Res irator/Medical Review $18.74 $18.74 Health Risk Appraisal Motivation 0.00 $0.00 Com rehensive Physical Exam $114.77 $114.77 Waist/Hi Ratio $3.53 $3.53 Bodv Fat Test-BIA Bio-Elec Imp Anal $16.40 $16.40 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.45 Flexibility Test $J1.72 $11.72 Urinalysis-Dipstick $3.53 $3.53 EKG W/Intery $23.42 $23.42 Audiometry 16.40 $16.40 PFT-Pulmonary Function Test $38.65 $38.65 Vision-Acuity 30.45 $30.45 Vital Skins-HT WT BP P R $0.00 $0.00 Hobson Phillio L. OnMed Pro ram $0.00 $0.00 Resnirator/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 $30.45 Flexibility Test $11.72 $11.72 Urinalysis-Dipstick $3.53 $3.53 EKG W/Inte 23.42 23.42 Audlometry $16.40 16.40 PFT-Pulmonary Function Test $38.65 38.65 Viso - 3 5 30 Public Safety Medical - INVOICE 1 6 Public Safety Medical Invoice Date: 12/21/2017 324 E. New York Street Invoice# 00-31958 i . E ; Suite 300 0- Indianapolis, IN 46204 Terms: ,.s i Carmel Police Department/CARMEPD fm. Pyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description,, Amount Balance Due Vital Si ns-HT WT BP P R $0.00 $0.00 Horner,Jeffrey J. 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 $16.40 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 Interp $23.42 $23.42 Audiomet $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 McAllister John W. OnMed Program $0.00 $0.00 Respirator/Medical Review $18.74 $18.74 Health Risk Appraisal Motivation 0.00 $0.00 Hemoccult $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 Stren th Endurance Test $30.45 $30.45 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 Pirics John D. OnMed Pro ram $0.00 $0.00 Respirator/Medical Review $18.74 $18.74 Health Risk AoDralsal Motivation 0.00 $0.00 Com rehensive Physical Exam $114.77 $114.77 Waist/Hip Ratio $3.53 Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 12/21/2017 324 E. New York Street Invoice# 00-31958 E Suite 300 Terms: Indianapolis, IN 46204 o Carmel Police Department/CARMEPD i m Pyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount Balance Due Bodv Fat Test-BIA Bio-Elec Im Anal 16.40 $16.40 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.45 FlexibilitV 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 Striker.Nicholas W. OnMed Pro ram $0.00 $0.00 Res irator/Medical Review $18.74 $18.74 Health Risk Arwraisal 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 $30.45 Flexibility Test $11.72 $11.72 Urinalysis-Dipstick $3.53 $3.53 EKG W/Intern 23.42 $23.42 Audiometry 16.40 $16.40 PFT-Pulmonary Function Test $38.65 $38.65 Vision-Acuity 30.45 $30.45 Vital Si ns-HT WT BPP 0.00 $0.00 Zellers Nancy L. OnMed Program $0.00 $0.00 Respirator/Medical Review $18.74 118.74 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 $16.40 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.45 Flexibility Test $11.72 $11.72 Urinal sis-Di stick $3.53 $3.53 EKG W Intem $23.42 23.42 Audiometry 1 .4 Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 12/21/2017 324 E. New York Street Invoice# 00-31958 E Suite 300 Terms: Indianapolis, IN 46204 Carmel Police Department CARMEPD Pyoung@carmel.1n.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. Date. .. :'Ernploype. DescripflohArnouni-': Balance Due 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 Zellers,Timothy And A. OnMed Program $0.00 $0.00 Resdrator/Medical Review $18.74 $18.74 Health Risk Appraisal(Motivation) $0.00 $0.00 Comprehensive Physical Exam $114.77 $114.77 Waist/Hi r)Ratio $3.53 $3.53 Body Fat Test-BIA(Bio-El C IMD Anal v) $16.40 $16.4 Treadmill-Submax $179.11 $179.11 Muscular Strenoth Endurance Test $30.45 $30.4 Flexibility Test $11.72 $11.72 Urinaivsis-Di stick $3.53 $3.53 EKG W/Interp $23.42 $23.42 Audiometry $16.40 $16.401 PFT-Pulmonary Function Test $38.65 a$38.65 Vision-Acuity $30.45 $30.45 Vital Signs-HT WT BP P R $0.00 0.00 12/14/17 Barlow,Cody J. OnMed Program $0.00 0.00 $0.00 Respirator/Medical Review $18.74 $18.74 Health Risk Ar)r)ralsal(Motivation) $0.00 $0.00 Commehensive Physical Exam 114.77 $114.77 Waist/Hi n Ratio $3.53 $3.53 Body Fat Test-BIA(Bio-Elec 1mr)Anal y) 16.40 $16.4 Treadmill-Submax 179.11 $179.11 Muscular Strength Endurance Test $30.45 1 $30.45 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 Leach.Aaron M. OnMed Pro ram $0.00 0.00 Res nirator/Medical Review $18.74 18.74 Health Risk Aor)raisal(Motivation) $0.00 0.00 Corngrehensive Physical Exam $114.77 110.717 Public Safety Medical - INVOICE o ' Public Safety Medical Invoice Date: 12/21/2017 324 E. New York Street Invoice# 00-31958 E Suite 300 Terms: w ' Indianapolis, IN 46204 Carmel Police Department/CARMEPD Ir Pyoung@carmel.In.Gov (W) m , Exclusively Serving Public Safety Professionals Since 1990. . .Date. Employee Description Amount Balance Due Waist/Hi Ratio $3.53 $3.53 Bodv Fat Test-BIA Bio-Elec Imp Anal $16.40 $16.40 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.45 Flexibility Test $11.72 $11.721 Urinalysis-Dipstick $3.53 $3.53 EKG W/Interp $23.42 $23.42 Audiornetry $16.40 $16.40 PFT-Pulmonary Function Test $38.65 $38.65 Vision-Acuity 30.45 $30.45 Vital Si ns-HT WT BP P R $0.00 $0.00 Martin Brian A. OnMed Pro ram $0.00 $0.00 Res irator 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 $16.40 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.45 Flexibility Test $11.72 $11.72 Urinal sis-Dipstick $3.53 $3.53 EKG W/Interp $23.42 $23.42 Audiornetry $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 Meyer,Ryan J. 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 Imo Anal 16.40 $16.40 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 $23.42 $23.42 Public Safety Medical - INVOICE `-:o Public Safety Medical Invoice Date: 12/21/2017 324 E. New York Street Invoice# 00-31958 Suite 300 Terms: w Indianapolis,IN 46204 c Carmel Police Department/CARMEPD mPyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. Date Employee; Description Amount..: 'Balance Due 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 Miller.Adam C. OnMed Program $0.00 $0.00 Res irator/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 Im Anal $16.40 $16.40 Treadmill-Submax 179.11 $179.11 Muscular Stren th Endurance Test 30.45 $30.45 Flexibility Test =$23.42 $23.42 Urinal sis-Dipstick EKG W/Inte Audiomet 0PFT-Pulmona Function Test 5Vision-Acui 5 Vital Signs-HT WT BP P R $0.00 $0.00 Rodri uez Cristhian R. 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 Bodv Fat Test-BIA Bio-Elec Im Anal 16.40 16.40 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.45 Flexibilltv 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 Si ns-HT WT BP P R 418.d74 0.00 Vanderbeck David R. OnMed Program 0.00 Res rator/Medical Review 18.74 eal h isk A rai I Mo iv i n Public Safety Medical - INVOICE o.` Public Safety Medical Invoice Date: 12/21/2017 . 324 E. New York Street Invoice# 00-31958 E "E Suite 300 m ; Terms: Indianapolis, IN 46204 J Carmel Police Department/CARMEPD Pyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description Amount"` . :'Balance Due'; 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 $30.45 Flexibility Test $11.72 $11.72 Urinalysis-Dipstick $3.53 $3.53 EKG W/Interp $23.42 $23.42 Audiometry 16.40 $16.401 PFT-Pulmonary Function Test $38.65 38.65 Vision-Acuity30.45 30.45 Vital Si ns-HT WT BP P R 0.00 0.00 12/15/17 Clark Sr. Todd C. OnMed Pro 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 $114.77 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 $30.45 Flexibility Test $11.72 $11.72 Urinal sis-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 GilbertWilliam J. OnMed Program $0.00 1 $0.00 Respirator/Medical ReviewMAnaI16.40 74 18.74 Health Risk Appraisal Motivation00 0.00 Comore ensive Physical Exam77 114.77 Waist/Hi Ratio53 3.53 BodyFat Test-BIA Bio-Elec Im $16.40 Treadmill-Submax $176.11 179.11 Muscular Strength Endurance Test $30.45 $30.45 Flexibility Test $11.72 $11.72 Urinalysis-Dinstick $3.53 3.5 Public Safety Medical - INVOICE o Public Safety Medical Invoice Date: 12/21/2017 324 E. New York Street Invoice# 00-31958 E- Suite 300 Terms: Indianapolis, IN 46204 o Carmel Police Department/CARMEPD Pyoung@carmel.In.Gov (W) ' m Exclusively Serving Public Safety Professionals Since 1990. . Date Employee Description • Amount Baiance Due. EKG W Interp $23.42 $23.42 Audiornetry $16.40 $16.40 PFT-Pulmonary Function Test $38.65 $38.65 Vision-AcuitV $30.45 $30.45 Vital Signs-HT WT BP P R $0.00 $0.00 Howard Lana M. 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 Im Anal 16.40 $16.40 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.45 Flexibilitv 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 Keith Brett A. OnMed Program $0.00 $0.00 Respirator/Medical Review $18.74 $18.74 Health Risk ftvralsal Motivation 0.00 $0.00 Comprehensive Physical Exam $114.77 $114.77 Waist/Hip Ratio 3.53 $3.53 Body Fat Test-BIA Bio-Elec Imp Anal $16.40 $16.40 Treadmill-Submax $179.11 $179.11 Muscular Stren th Endurance Test $30.45 $30.45 Flexibility Test $11.72 $11.72 Urinalysis-Dipstick $3.53 $3.53 EKG W/Interp $23.42 23.42 Audiornetry $16.40 $16.40 PFT-Pulmonary Function Test $38.65 $38.65 Vision-Acuity 30.45 30.45 Vital Signs-HT WT BP P R 0.00 0.00 Kinkade Matthew P. OnMed Pro ram 0.00 0.00 e it e i I Review 1 .7 7 Public Safety Medical - INVOICE I 0 Public Safety Medical Invoice Date: 12/21/2017 324 E. New York Street Invoice# 00-31958 d Suite 300 Terms: w Indianapolis, IN 46204 Carmel Police Department/CARMEPD m Pyoung@carmel.In.Gov (W) Exclusively Serving Public Safety Professionals Since 1990. Date Employee Description. Amount Balance Due Health Risk Arwraisal 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 ImD Anal 16.40 $16.40 Treadmill-Submax $179.11 $179.11 Muscular Strength Endurance Test $30.45 $30.45 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 Si ns-HT WT BP P R $0.00 $0.00 McNair Harland J. 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 IMD Anal 16.40 $16.40 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 Intern 23.42 $23.42 Audiometry 16.40 $16.40 PFT-Pulmonary Function Test $38.65 $38.65 Vision-Acuity $30.45 $30.45 Vital Si ns-HT WT BP P R $0.00 $0.00 Myers,Brady R. OnMed Program $0.00 $0.00 Respirator/Medical Review $18.74 $18.741 Health Risk Appraisal Motivation 0.00 0.00 Comprehensive Physical Exam $114.77 114.77 Waist/Hi Ratio $3.53 3.53 Bodv Fat Test-BIA Bio-Elec Imp Anal 16.40 16.40 Treadmill-Submax $179.11 $179.111 Muscular Strength Endurance Test $30.45 30.45 Flexibility Test 2 $11.721 Public Safety Medical - INVOICE ! o 1 Public Safety Medical Invoice Date: 12/21/2017 '� o 324 E. New York Street Invoice# 00-31958 1 E ; Suite 300 Indianapolis, IN 46204 Terms: d 0-( Carmel Police Department/CARMEPD Pyoung@carmel.In.Gov (W) Im Exclusively Serving Public Safety Professionals Since 1990. -Date Employee Description ; • Amount Balance Due.' 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 Si ns-HT WT BP P R $0.00 io.00 Smiley,Landry D. OnMed Pro ram $0.00 $0.00 Respirator/Medical Review $18.74 $18.74 Health Risk Appraisal Motivation 0.00 $0.00 Com rehensive 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 $30.45 Flexibility Test 1 $11.72 $11.72 Urinalysis-Dipstick $3.53 $3.63 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 Soultz Me an D. OnMed Program 0.00 $0.00 Res irator/Medical Review $18.74 $18.741 Health Risk Armraisal(Motivation) 0.00 $0.00 Com rehensive 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 $30.45 Flexibility Test $11.72 $11.72 Urinalysis-Dipstick $3.53 $3.53 EKG W/Intem $23.42 $23.42 Audiometry 16.40 $16.40 PFT-Pulmonary Function Test A30.45 8.65 38.65 Vision-Acuity 30.45 Vital Si ns-HT WT BP P R 0.00 0.00 12/19/17 Schalbura,Randy S OnMed Pro r m 000 0.00 Public Safety Medical - INVOICE } o Public Safety Medical Invoice Date: 12/21/2017 324 E. New York Street Invoice# 00-31958 E Suite 300 Terms: Indianapolis, IN 46204 c Carmel Police Department/CARMEPD f ' - I Pyoung@carmel.In.Gov (W) 00 Exclusively Serving Public Safety Professionals Since 1990. Date;. Employee Description-,, Amount 'Balance Due Res irator Medical Review $18.74 $18.74 Health Risk Appraisal Motivation $0.00 $0.00 Comprehensive Physical Exam $114.77 $114.77 Waisttft 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 $30.45 Flexibilltv 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- cuity $30.45 $30.45 Vital Signs-HT WT BP P R $0.00 $0.00 Total Charges-> ;_...,$13,640:76" -ToWPayments.&"BalanceDue->Please write 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 Michelle McClure at 317-964-2364.