HomeMy WebLinkAbout325164 05/09/18 CITY OF CARMEL, INDIANA VENDOR: 00350364
CHECK AMOUNT: $.....6,738.29*
ONE CIVIC SQUARE PUBLIC SAFETY MEDICAL SERVICES
CARMEL, INDIANA 46032 324 E NEW YORK ST SUITE 300 CHECK NUMBER: 325164
INDIANAPOLIS IN 46250 CHECK DATE: 05/09/18
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4340701 100944 00322770 858.51 OFFICER PHYSICALS
1110 4340701 100944 0032827 t.t 5,316.21 OFFICER PHYSICALS
1120 4340701 32769 563.57 MEDICAL EXAM FEES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 00350364 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PUBLIC SAFETY MEDICAL SERVICES IN SUM OF$ 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 46250
Payee
$563.57
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Carmel Fire 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
32769 43-407.01 $563.57 1 hereby certify that the-attached invoice(s),or 5/3/18 32769 $563.57
1120 101 1120 101
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday, May 03, 2018
David Haboush
Fire 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
NO:R
moo"= Public Safety Medical Invoice Date: 04126/2018
6612 L 75th Street Invoice# 00-32769
L�....
:TFloor 2 Terms:
'' Indianapolis,IN 46250
Nil
l.
f` Carmel Fire Department 1 CARMEFD
i,
j 'Denise Snyder,Budget&Accred Mgr
"- Dsnyder@carmel.In.Gov(B)
Exclusively Serving Public-Safety Professionals Since 1990.
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04118118- Sharp.AdamC. Comprehens've Ph s' I Exam $117.07 $117.07
Respirator/Medical Review $19.11 $19.11
OnMed Program $0.00 $0.00
Health Risk Appraisal Medikee er 0.00 0.00
Body Fat Test-BIA Bio-Eiec Imp Anal 16:73 $16.73
TreadmiN-Submax $182.69 $182.69
CMP C mQ Metabolic Panel 22.86 $22.86
CBC Com Blood Count 20.70 $20.70
Li •d Panel BI 24.30 1 124.30
Ven' uncture $3.00 $3:60
PSA-Prostate S ecife A Blood 41.8 1:81
Vital SI -HT WT BP P R $0.00
Vision-Acuity $31.06 $31.
PFT=Pulmonary Function Test $n.42 : $39.42
Audlometry $16.73 16.73
EKG W/Interp $23.89 $23.89
Urinalysis-Di stick 3.60 Et
Med O inion-Wellness 0.00 Med O Inion-Res irator 0.00
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Please write invoice number on-payment check. Our Federal Employer identification number is 35-2079797.
We greatly appreciate the opportunity to serve you. If you have any questions regarding this invoice, please contact
Michelle McClure at 317-964-2364.
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 00350364 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
PUBLIC SAFETY MEDICAL SERVICES IN SUM OF$ 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
$6,174.72
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
100944 00-32770 43-407.01 $858.51 1 hereby certify that the attached invoice(s),or 4/26/18 00-32770 officer physicals $858.51
1110 101 1110 101
100944 00-32827 43-407.01 $5,316.21 bill(s)is(are)true and correct and that the 5/4/18 00-32827 officer physicals $5,316.21
1110 101 materials or services itemized thereon for 1110 101
which charge is made were ordered and
received except
Monday, May 7,2018
jBp ' kap.•A.cw
Jim Barlow
Chief
I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have
audited same in accordance with IC 5-11-10-1.6
20
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Public Safety Medical - INVOICE ....
!i-T Public Safety Medical Invoice Date: 04/26/2018
' �°$
:, 6612 E.75th Street Invoice# 00-32770
•L'Ei! Floor 2 Terms:
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JN Indianapolis,IN 46250
Carmel Police Department I CARMEPD
R-Eja Pyoung@carmel.In.Gov (W)
5 ,+::�:
Exclusively Serving Public Safety Professionals Since 9990.
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Respirator Gearance-SS $26.65
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26.
Chart Review/Completion $97.22 18.4
6Indana PERF Exam 18.46
Drua Screen 9 +O sates&Oxycodone 48.02 $48.02
Venipuncture $3.62 $3.62
AwAcant Blood Panel-PERF $137-82 $137.82
QuaAferon-Tb 1 $60.01
Ton Glaucoma T .21 $43,21
Urinalysis.Diostick $3.62 $3.62
EKG WUnterp $24,014.01
Agdlo16.81
tion Test $44,132 .$44.6
Vision-Color Ishihara1.21 $31.21
Vision-Acuity 31.21 1 $31.21
Vital Sans-HT WT BP P R $0.0000
Chest X-Ray-PAILAT(Digital) 72.02 2
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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
Michelle McClure at 317-964-2364.
Public Safety Medical - INVOICE ,
Public Safety Medical Invoice Date: 05/0212018
iF
Nrs 6612 E.75th Street Invoice# 00-32827
� - Floor 2 Terms:
IN
Indianapolis,IN 46250
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1.CCarmel Police Department/CARMEPD
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;` Pyoung@carme61n.Gov (VI)
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T»"�s3i`Zi R
Exclusively-Serving Public Safety Professionals Since 9990.
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04123118 L%tic.Zachary un re
!J id Panel Blood $24.42 $24.42
CBC(COMD Blood Count 20.80 $20.80
CMP(Comp Metabolic Panel .97 $22.97
Cra r William D. HIV-Ah Gen Rapid Test Blood 26.58 $26.68
Venipuncture $3.62 $3.62
Li td Panel Blood) 924-42 $24.42
CBC LQ=Blood Count 0.80 $20.00
CMP(Comp.Mewbolic Panel) 7
A-Prostate,ftecffia A B ood 2
Dunlar).C dsto n Ragid T (Blood) 26.58 $26.58
Veni u
Li id P 24.42 $24.42
CBC Comp Blood Count $20. $20.8
CMP(Comp Metabolic Panel 22.97 $22.97
PSA-Prostate Specific A (Blood) 2.01 $42.01.
Foster.Johnathan A. HIV-.4th Gen Rapid Test(Blood) 26.58 $26.5d
Ve nature $3,02 $3.621
Li id Panel 24.42 $24.41
Blood Count) _$20.80 $20.8d
P lic Panel 22.97 22.9
PSA-Pmatate Sm
i Aq Moodl $42.01 1
Foost Dmdqht D. -4th Gen Ra id Test 2 26.5
Venlaynature $3.62
Unid Panel Blood 24.4
CBC(Comp Blood Count $20.80 $20.80
CMP(Comy Metabolic Panel 22.97 $22.97
PSA-Prostate S edfic Blood 2.01 $42.01
Ms Matthew W. Med'O i 'on-Post Offs -PERF 90.00 $0.00
Res lml r Clearance-SS $26.65 $26.651
Chart w Com letion $97.22 $97.221
Indiana PERF $218
Drug Green 9 +Opiates 48.0
Veni •§2
AwIloant Blood Panel-P5RF $137.82 E137.82 .
Tb •t'vQuestion n 0.00
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Public Safety Medical - INVOICE
Public Safety Medical Invoice Date: 05/0212018
s, 6612 E.75th Street Invoice# 00-32827
i Floor 2 Terms:
LIndianapolis,IN 46250
11. Carmel Police Department 1 CARMEPD
Pyoung@carmel.ln.Gov (NI)
Exclusively Serving Public Safety Professionals Since' 9990.
iw. fit•! a.ti-'•lvtl_ f1F ILt. - tai{i
_wii �I ire K'"`.:Q� RIPrh-��ry:�r rpt. s4 '66 `BaTI4' �
I is- 2
EKG W/Int $24.01 $24.01
Audiometry 16.81 $16.B1
PFT-Pulmonary Function Test $44.62
Vision-Color(Ishihara) 1.21 $31.21
vision-Acui $31-21 $31.21
Vital SI -HT WT BP P R $0.0o 0.0
st X-R -PAILAT(Digital) 2.02 $72.0
Mable.Michael Ven[Duncture 93.62 S3.621
U id Pa d $24.42 $24AA
CBC(Qqrnp Blood nt 20.80 $20.80
Metabolic
PS -Prostate 2.0 $42-01
Pelzel Charles R. Med Opinion-Post Offer-PERF $0.00 $0.00
Respirator Clearance-SS $26.65
Chart Review/Completion $97.22 $97.22
Indiana PERF Exam $218.46 21B.46
Venipuncture 3.62 $3.62
Armficant Blood Panel-P 7.82 $137.82
antiferon-Tb I 60.01 60.01
Drug +Opiates codons $48.02 .02
Tonorna Test 21 $43,21
Urinalysis-En tick $3.62 $3.62
EKG 1 $24,01
d' me
PFT-Pulmonary Function Test $44.62S".621
Vision-Color Ishihara 1.21 $31.211
Vision-Aculty $31.21 $31.21
Vital Signs-HT WT BP P R $0.00 0.00
Chest X-Ray-PAILAT(Dinitall $72.02 7202
Rogowsid.J2Mh H. Venlyunclure 93.62 •62
Li id Pa I 42 42
CBC(Comn Blood 0.80 20.80
CMP Acolm Metabolic Panell .97 $22.97
aghgeff Jh ald D. HIV-4th Gen Rapid Test(Blondl $26.58 $26.
Vank)uncture S3.62
Upid Panel(Bloodl $24,42
Public Safety Medical - INVOICE
'' Invoice Date: 0510212018
Public Safety Medical
6612 E.75th Street Invoice# 00.32827
Floor 2 Terms:
Indianapolis,IN 46250
Carmel Police Department/CARMEPD
`� Pyoung@carmel.In.Gov (W)
115
Exclusively Serving Public Safety. Professionals Since 1990.
�' 2B +„ii f •F.W ' ..R C-13C(camp elo2g Count)
0.60
CMP mp Metabolic Panel 22.97 $22.9
PSA-Prostate g2edficA Blood 2.01 42.01
SmithTro D. HIV-4th Gen Rapid Test Blood 6.58 $26,581
- Veni ncture $3.62
LI .62
i Panel(Blood) 24.42 24 42
2.01
CBC Blood Coot) 20.80
MP Com Metabolic Panel) .97 22.9
P -Prostate iflc d
N Shane HIV- Ra id Blood 26.58
YAniouncture 3.62
' id Pa 24.4
CBQ(Comp BI nt 20.80
CMP(Comp Metabolic Panel 22.97 $22.97
PSA-Prostate S22cific Blood 2.01 2.01
04/24118 Bickel ScottMI. HIV-4th Gen Rapid Test Blood 26.58 26.5
Venipuncture $3.62 .6
Lipid Panel(Blood) 24. 2 24A
CBQ(Comp Blood unt) 20.80 $72n.Rn
CMP(Comp Mobolic Panel 22.97 22.
PSA-Prostate Smcffic d .0 $42.01
Die K. HIV-4th Gen Radd Test B! 2
Vent 2
Lipjd Panel 4.42 $24.421
COO(C
Blood 2
CMP Co Metabolic Panel $22.97 $22.9
PSA-Prostate Specific A Blood 2.01 $42.01
Flamin Anna G. HIV-4th Gen Rapid Test Blood 26.58 $26•
58
Ve[Liouncture- .62 $3.62
U id Panel Blood 24.4 24.4
CBC Blood Count) .80 0.8
MP(Comp Motgbolic Panel 22.97
Gilmore M. HIV-4h Gen Ravid T Blood $26.68 S26.5d
Ventunctu .62 $i.62
UrAd (Blood) 24.
CSQ m BI 0
Public Safety Medical - INVOICE
-�as Public Safety Medical Invoice Date: 0510212018
11 6612 E.75th Street Invoice# 00-32827
Floor 2 Terms:
Indianapolis,IN 46250
Carmel Police Department 1 CARMEPD
Pyoung@carmel.In.Gov (IN)
Exclusively Serving Public Safety Professionals Since 1990.
som
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Y arles Y. VenipunctuM $3.62 S3.62
i.l Id Panel Blood 24.42 24.42
CBC(Comp Blood Count 0.80 $20.
CMP(comy Metabolic Panel 22.97 $22.97
PSA-Prostate Specific A Blood 2.01 $42.01.
Hood BMan L HIV-4th Gen Ra id Test Blood 26.58 26.58
Vent ncture $3.62 3.62
U id Pan Blood $24,42 $24.42
C CamD Bigad Count) 20• $20,
C MetaboPanel) 7 $22.97
SA-Prostte Spectfic $42.01
tt p Gen Rjp1d Test S26,5 $26.58
Venly-uncture- 2
LI id Panel Blood 24.42 $24.42
CBC mp Blood Count 20.80 .80
CMP(Comp Metabolic Panel 2.97 .9
PSA-Prostate Speoffic A (Blood) 42.01 $42.011
Malloy,Katherine E. HIV-4th Gen Rapid Test Blood 26.58 $26.5d
Venipuncture $3.62 3.62
LI id Panel Blood 24.42 $24.4
CBC(Comp BloW Count) 20.80 $20.80
CMP(Comp Metabolic Pana 22 $22,97
Pitman,Michael A. n Ra id (Blood) 26 $26.58
Venipuncture $3.62 $3.62
Upid Panel
CBC(Comp Blood Count 20.80 $20.6
CMP(Conm Metabolic Panel 22.97 $22.97.
PSA-Prostate Specific A Blood $42.01 $42.01
Renforth.Trevor M. HIV-4th Gen Rapid Test Blood) $26.58 $26.5d
Venipuncture 93.62 $3.62
Upid Panel Blood 442
CBC(Comp Blood Count .80 $20.80
C MetaboPanel)- 22.9
PSA-PostSpecific A 1 $42,01
SemesAer.James S. HIV- Gen Rapid Test(Blood) $26,58' 26,5
V-enipuncture2 2.
Upid IB
Public Safety Medical - INVOICE .�
Public Safety Medical Invoice Date: 05/02/2018
I
6612 E.7511h Street Invoice# 00-32827
Aim P Floor 2 Terms:
Indianapolis,IN 46250
6L:r
INT
iE Carmel Police Department!CARMEPD
'�- Pyoung@carmel.in.Gov (W)
Exclusively Serving Public Safety Professionals Since 1990.
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CMP mp Metabolic Panel $22.97 $22.97
PSA-Prostate Specific A (Blood) 2.01 2.01
Tilson Travis C. OnMed Proaram $0.00 $0.00
- iratorlMedicat Review $19.21 $19.211
Health Fisk A ralsa{ edike r 0.0 $0.00
Comorehenseve Physical Exam 117. 4 $117.6
MedO nion-Wellness .00
Med QpInion-Respirator $0.00 $0.00
Waist! 3.62
BWv Fat Test- Bio-Elec Imp AnaW- 16.8 1
6.81
Treadmill- max 1183,5 .59
musmilar-Mngth Endurance Test $31.
Flexibility Test $12.01 $12.01
Urin sis-Di do $3.62 $3.62
EKG W/inte 24.01 V4.01
Audiometry $16.81 $16.81
PET-eulmonary Function Test .62 $44.62
VI -Acuity 3 21 $31.21
Vital Signs-FIT WT BP P R $0.00 $0.00
04/25118 Jent.Danny N. HIV-4th Gen Rapid T (Blood) 2 6 5
Venlpuncture* U.62 .62
l i id Pa 24.42
CBC QgMo Blo 20 $20.8
CMP tabolic P 922.97
PSA-Prostate S eclfic A Blood 2.01 $42.01
Kim Christopher J. HIV-Ah Gen Rapid Test Blood $26.58 $26.5
Ven' uncture $3.62 $3.621
U id Panel Blood 2442124A
CBC m BloodCount 0
CMP Com Metabolic Panel 22.97
Marti Brian A. H - Gen Rapid Test(Blood) 26.58Vent uncture Unid nel Blood $24 42
CBC C Count)
(CompCMP M e 2
Public Safety Medical - INVOICE
W •
�'•wX Public Safety Medical Invoice Date: 05102/2018
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6612 E.75th Street Invoice#' 00-32827
.I Floor 2 Terms:
Indianapolis,IN 46250
Carmel Police Department 1 CARMEPD
irr Pyoung@carmel.In.Gov (W)
Exclusively Serving Public Safety Professionals Since 1990.
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l( ' $24.42 $24.42
CBC(Comp Blood Count 20.80 $20.80
CMP(Comp MetaboUc Panel $22.97 22.9
Paris Marie J. Veni uncture $3.62 $3.62
1 i ld Panel Blood 24.42 $24.421
BC(Como Blood Count 20.80 2
CMP CMetabolic Panel) !922.9Z $22.9
PSA-Prostate S lood 1 2.01
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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
Michelle McClure at 317-964-2364.