HomeMy WebLinkAbout330702 10/02/18 VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ CITY OF CARMEL
2046 RELIABLE PKWY 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.
CHICAGO, IL 60686-0020
Payee
$72,921.05
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
301 Medical Fund Terms
301 Medical Fund Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
764032 50-239.90 $165.00 1 hereby certify that the attached invoice(s),or 9/30/18 764032 Onsite Wellness UDS Sept 2018 $165.00
301 301 301 301
764068 50-239.90 $40,343.04 bill(s)is(are)true and correct and that the 9/30/18 764068 Onsite Staff Time Sept 2018 $40,343.04
301 1 1 301 materials or services itemized thereon for 301 1 301
764069 50-239.90 $1,238.20 9/30/18 764069 Onsite PEPM Sept 2018 $1,238.20
301 301 which charge is made were ordered and 301 301
764106 50-239.90 $30,340.51 received except 9/30/18 764106 Onsite Misc Sept 2018 $30,340.51
301 301 301 301
764135 50-239.90 $834.30 9/30/18 764135 Onsite Billing Sept 2018 $834.30
301 301 301 301
Tuesday, October 2,2018
Lamb, Barbara
Director
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
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
3j1 Indiana University Health Workplace Services, LLC
714 N.Senate Avenue
Suite 200
Indianapolis, IN 46202
317-963-1535
Tax ID# 20-0994452
Invoice
September 30, 2018
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Wellness UDS/Sept.2018
1 Civic Square
Carmel,IN 46032-
Invoice# 764032
Service Date Description Quantity Charge Recei Ad"US Balance
08/17/2018 Quick Read UDS/6panel
15.00
08/20/2018 Quick Read UDS/6panel includes 1.00 15.00 15.00
kit
OCT 0 2 zom
Invoice# 764032(continued)page 2
Service Date Description n i Charae Recei Adiust Balance
165.00
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Indiana University Health Workplace Services,LLC
714 N.Senate Avenue
Suite 200
Indianapolis, IN 46202
317-963-1535
Tax I D# 20-0994452
Invoice
September 30, 2018
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Staff Time/Sept.2018
1 Civic Square
Carmel,IN 46032-
Invoice# 764068
Service Date Description Quanti Charge Recei Ad"Us Balance
09/04/2018 N.P.Staff Time 5.50 638.33 638.33
Tina Nitsos
09/04/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
09/04/2018 R.N.Staff Time 9.75 622.64 622.64
Stacey Neese
09/04/2018 M.A.Staff Time 8.33 240.24 240.24
Kimberly Pride
09/05/2018 M.A.Staff Time 5.40 155.74 155.74
Elizabeth Herald
09/05/2018 Health Coach Staff Time 1.50 98.88 98.88
Kristin Hullett
09/05/2018 N.P.Staff Time 9.25 1,073.56 1073.56
Tina Nitsos
09/05/2018 MD Staff Time 2.00 360.50 360.50
Geraldine Darroca
09/05/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
09/05/2018 R.N.Staff Time 9.50 606.67 606.67
Stacey Neese
09/05/2018 M.A.Staff Time 8.15 235.05 235.05
Kimberly Pride
09/06/2018 MD Staff Time 4.00 721.00 721.00
Dr.Moody
09/06/2018 R.N.Staff Time 4.50 287.37 287.37
Stacey Neese
09/06/2018 M.A.Staff Time 4.20 121.13 121.13
Kimberly Pride
09/07/2018 Health Coach Staff Time 3.50 230.72 230.72
Kristin Hullett
09/07/2018 N.P.Staff Time 5.75 667.35 667.35
Tina Nitsos
TOP
OCT 02 2018
t
Invoice# 764068(continued)page 2
Service Date DescriptionQuant! Charge Recei Ad"Us Balance
09/07/2018 R.N.Staff Time 5.75 367.20 367.20
Stacey Neese
09/07/2018 M.A.Staff Time 5.20 149.97 149.97
Kimberly Pride
09/10/2018 Health Coach Staff Time 7.00 461.44 461.44
Kristin Hullett
09/10/2018 N.P.Staff Time 4.25 493.26 493.26
Tina Nitsos
09/10/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
09/10/2018 R.N.Staff Time 10.25 654.57 654.57
Stacey Neese
09/10/2018 M.A.Staff Time 8.05 232.16 232.16
Kimberly Pride
09/11/2018 N.P.Staff Time 5.50 638.33 638.33
Tina Nitsos
09/11/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
09/11/2018 R.N.Staff Time 9.50 606.67 606.67
Stacey Neese
09/11/2018 M.A.Staff Time 8.20 236.49 236.49
Kimberly Pride
09/12/2018 M.A.Staff Time 5.00 144.20 144.20
Maria Collins
09/12/2018 N.P.Staff Time 9.00 1,044.54 1044.54
Tina Nitsos
09/12/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
09/12/2018 R.N.Staff Time 10.00 638.60 638.60
Stacey Neese
09/12/2018 M.A.Staff Time 8.25 237.93 237.93
Kimberly Pride
09/13/2018 MD Staff Time 4.00 721.00 721.00
Dr.Moody
09/13/2018 R.N.Staff Time 4.50 287.37 287.37
Stacey Neese
09/13/2018 M.A.Staff Time 4.20 121.13 121.13
Kimberly Pride
09/14/2018 Health Coach Staff Time 5.00 329.60 329.60
Kristin Hullett
09/14/2618 N.P.Staff Time 5.50 638.33 638.33
Tina Nitsos
09/14/2018 R.N.Staff Time 5.50 351.23 351.23
Stacey Neese
09/14/2018 M.A.Staff Time 5.10 147.08 147.08
Kimberly Pride
09/17/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
Invoice# 764068(continued)page 3
Service Date Description Quanti Charae Recei Ad"Us Balance
09/17/2018 Health Coach Staff Time 7.00 461.44 461.44
Kristin Hullett
09/17/2018 N.P.Staff Time 4.50 522.27 522.27
Tina Nitsos
09/17/2018 R.N.Staff Time 10.00 638.60 638.60
Stacey Neese
09/17/2018 M.A.Staff Time 7.45 214.86 214.86
Kimberly Pride
09/18/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
09/18/2018 N.P.Staff Time 5.75 667.35 667.35
Tina Nitsos
09/18/2018 R.N.Staff Time 4.00 255.44 255.44
Stacey Neese
09/18/2018 R.N.Staff Time 2.47 157.73 157.73
Cheretha Benson
09/18/2018 M.A.Staff Time 9.50 273.98 273.98
Kimberly Pride
09/19/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
09/19/2018 N.P.Staff Time 9.25 1,073.56 1073.56
Tina Nitsos,
09/19/2018 R.N.Staff Time 9.75 622.64 622.64
Stacey Neese
09/19/2018 M.A.Staff Time 5.90 170.16 170.16
Elizabeth Herald
09/19/2018 M.A.Staff Time 7.58 218.61 218.61
Kimberly Pride
09/20/2018 MD Staff Time 4.00 721.00 721.00
Dr.Moody
09/20/2018 R.N.Staff Time 4.75 303.34 303.34
Stacey Neese
09/20/2018 M.A.Staff Time 4.20 121.13 121.13
Kimberly Pride
09/21/2018 Health Coach Staff Time 5.00 329.60 329.60
Kristin Hullett
09/21/2018 N.P.Staff Time 5.50 638.33 638.33
Tina Nitsos
09/21/2018 R.N.Staff Time 6.00 383.16 383.16
Stacey Neese
09/21/2018 M.A.Staff Time 4.20 121.13 121.13
Kimberly Pride
09/24/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
09/24/2018 Health Coach Staff Time 7.00 461.44 461.44
Kristin Hullett
09/24/2018 N.P.Staff Time 4.50 522.27 522.27
Tina Nitsos
Invoice# 764068(continued)page 4
Service Date Description Quant! Charge Recei Ad'us Balance
09/24/2018 R.N.Staff Time 9.25 590.71 590.71
Stacey Neese
09/24/2018 M.A.Staff Time 7.62 219.76 219.76
Kimberly Pride
09/25/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
09/25/2018 N.P.Staff Time 5.75 667.35 667.35
Tina Nitsos
09/25/2018 R.N.Staff Time 9.50 606.67 606.67
Stacey Neese
09/25/2018 M.A.Staff Time 8.23 237.35 237.35
Kimberly Pride
09/26/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
09/26/2018 N.P.Staff Time 8.50 986.51 986.51
Tina Nitsos
09/26/2018 R.N.Staff Time 9.50 606.67 606.67
Stacey Neese
09/26/2018 M.A.Staff Time 5.28 152.28 152.28
Elizabeth Herald
09/26/2018 M.A.Staff Time 8.15 235.05 235.05
Kimberly Pride
09/27/2018 MD Staff Time 4.00 721.00 721.00
Dr.Moody
09/27/2018 R.N.Staff Time 4.50 287.37 287.37
Stacey Neese
09/27/2018 M.A.Staff Time 4.30 124.01 124.01
Kimberly Pride
09/28/2018 Health Coach Staff Time 5.00 329.60 329.60
Kristin Hullett
09/28/2018 N.P.Staff Time 5.75 667.35 667.35
Tina Nitsos
09/28/2018 R.N.Staff Time 6.50 415.09 415.09
Stacey Neese
09/28/2018 M.A.Staff Time 5.00 144.20 144.20
Barbara Brummel
CITYCARO Invoice# 764068 Balance Due: 40343.04
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Indiana University Health Workplace Services, LLC
714 N.Senate Avenue
Suite 200
Indianapolis, IN 46202
317-963-1535
Tax I D# 20-0994452
Invoice
September 30, 2018
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite PEPM/Sept.2018
1 Civic Square
Carmel,IN 46032-
Invoice# 764069
Service Date Description Quanti Charge Receip Ad'us Balance
09/01/2018 Monthly Wellness PEPM 604.00 1,238.20 1238.20
CITYCARO Invoice# 764069 Balance Due: 1238.20
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Subrnitted
OCT 02 2018
Indiana University Health Workplace Services, LLC
714 N.Senate Avenue
Suite 200
Indianapolis, IN 46202
317-963-1535
Tax I D# 20-0994452
Invoice
September 30, 2018
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Misc.Onsite/Sept.2018
1 Civic Square
Carmel,IN 46032-
Invoice# 764106
Service Date Description anti Charge Recelp Aftal Balance
08/17/2018 AS Medical Solutions Mail-In Meds 1.00 5,971.02 5971.02
08/21/2018 AS Medical Solutions Clinic Meds 1.00 22.91 22.91
08/22/2018 AS Medical Solutions Clinic Meds 1.00 12.05 12.05
08/29/2018 AS Medical Solutions Clinic Meds 1.00 431.98 431.98
08/31/2018 Onsite Lab Charges 1.00 5,380.72 5380.72
August 2018 Labs
09/01/2018 Utility Expenses 1.00 572.59 572.59
09/01/2018 Building Expenses 1.00 1,086.87 1086.87
09/01/2018 Lease Expense 1.00 4,316.05 4316.05
09/04/2018 AS Medical Solutions Clinic Meds 1.00 1,315.45 1315.45
09/06/2018 AS Medical Solutions Mail-In Meds 1.00 2,883.64 2883.64
09/06/2018 AS Medical Solutions Clinic Meds 1.00 989.96 989.96
09/12/2018 AS Medical Solutions Clinic Meds 1.00 66.28 66.28
09/13/2018 AS Medical Solutions Mail-In Meds 1.00 6,834.67 6834.67
09/14/2018 AS Medical Solutions Clinic Meds 1.00 433.36 433.36
09/18/2018 AS Medical Solutions Clinic Meds 1.00 22.96 22.96
CITYCARO Invoice# 764106 Balance Due: 30340.51
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
S bu as1,ed T
OCT 0 2 2018
Clerk u r easku ` r
Indiana University Health Workplace Services,LLC
714 N.Senate Avenue
Suite 200
Indianapolis, IN 46202
317-963-1535
Tax I D# 20-0994452
Invoice
September 30, 2018
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite On-Site Billing/Sept.2018
1 Civic Square
Carmel,IN 46032-
Invoice# 764135
Service Date DescriptionQuant! Charge Receip Ad'us Balance
09/01/2018 Onsite Operating Supplies 1.00 465.30 465.30
September 2018 Supplies
09/01/2018 Onsite Facility Operations 1.00 369.00 369.00
September 2018 Facility Charges
CITYCARO Invoice# 764135 Balance Due: 834.30
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
OCT 02 2018