HomeMy WebLinkAbout332960 12/06/18 CITY OF CARMEL, INDIANA VENDOR: 367222
�)• ONE CIVIC SQUARE IU HEALTH WORKPLACE SERVICES LLCCHECK AMOUNT: $*""'66,956.16* ,
: a CARMEL, INDIANA 46032 2046 RELIABLE PKWY , CHECK NUMBER: 332960
CHICAGO IL 60686-000 CHECK DATE: 12/06/18
ITON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 764332 24,297.55 OTHER EXPENSES
301 5023990 764355 40,466.82 OTHER EXPENSES
301 5023990 764387 1,227.95 OTHER EXPENSES
301 5023990 764419 963.84 OTHER EXPENSES
VOUCHER NO. WARRANT NO. Prescribed by State Hoard of Accounts City Form No.201(Rev.1995)
Vendor# 367222 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
IU HEALTH WORKPLACE SERVICES LLC IN SUM OF$ 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
$66,956.16
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
764332 50-239.90 $24,297.55 1 hereby certify that the attached invoice(s),or 11/30/18 764332 Nov 2018 Misc $24,297.55
301 301 301 301
764355 50-239.90 $40,466.82 bill(s)is(are)true and correct and that the 11/30/18 764355 Nov 2018 Staff Time $40,466.82
301 301 materials or services itemized thereon for 301 301
764387 50-239.90 $1,227.95 11/30/18 764387 Nov 2018PEPM $1,227.95
301 301 which charge is made were ordered and 301 301
764419 50-239.90 $963.84 received except 11/30/18 764419 Nov 2018 Onsite Billing $963.84
301 301 301 301
Tuesday, December 4,2018
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
Indiana University Health Workplace Services, LLC
714 N.Senate Avenue
Suite 200 �1
Indianapolis, IN 46202
317-963-1535
Tax I D# 20-0994452
Invoice
November 30, 2018
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Misc.Onsite/Nov.2018
1 Civic Square
Carmel,IN 46032-
Invoice# 764332
Service Date Description Quant! Charae Recelp Adjust Balance
10/01/2018 Onsite Lab Charges 1.00 4,101.82 4101.82
October 2018 Labs
10/25/2018 AS Medical Solutions Clinic Meds 1.00 197.51 197.51
10/29/2018 AS Medical Solutions Mail-In Meds 1.00 3,148.48 3148.48
10/30/2018 AS Medical Solutions Clinic Meds 1.00 1,046.90 1046.90
11/01/2018 Utility Expenses 1.00 493.76 493.76
11/01/2018 Building Expenses 1.00 1,086.87 1086.87
11/01/2018 Lease Expense 1.00 4,316.05 4316.05
11/01/2018 Enhanced Care-Urgent Care Visits 1.00 2,697.00 2697.00
22 Visits
11/07/2018 AS Medical Solutions Clinic Meds 1.00 1,264.06 1264.06
11/08/2018 AS Medical Solutions Mail-In Meds 1.00 2,547.19 2547.19
11/12/2018 AS Medical Solutions Mail-In Meds 1.00 3,307.13 3307.13
11/12/2018 AS Medical Solutions Clinic Meds 1.00 70.79 70.79
11/15/2018 AS Medical Solutions Clinic Meds 1.00 19.99 19.99
CITYCARO Invoice# 764332 Balance Due: 24297.55
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
I
DEC 0 2018
U rp,r JC
Indiana University Health Workplace Services, LLC
714 N.Senate Avenue ��)
Suite 200
Indianapolis, IN 46202
317-963-1535
Tax I D# 20-0994452
Invoice
November 30, 2018
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite Staff Time/Nov.2018
1 Civic Square
Carmel,IN 46032-
Invoice# 764355
Service Date Description Quanti Charae Recei Ad"Us Balance
11/01/2018 M.A.Staff Time 3.90 112.48 112.48
Maria Collins
11/01/2018 MD Staff Time 4.00 721.00 721.00
Dr.Moody
11/01/2018 R.N.Staff Time 5.00 319.30 319.30
Stacey Neese
11/02/2018 M.A.Staff Time 5.00 144.20 144.20
Gena Hughes
11/02/2018 N.P.Staff Time 5.50 638.33 638.33
Tina Nitsos
11/02/2018 R.N.Staff Time 6.25 399.13 399.13
Stacey Neese
11/02/2018 Health Coach Staff Time 4.50 296.64 296.64
Kristin Hullett
11/05/2018 M.A.Staff Time 8.00 230.72 230.72
Roslynn Coleman
11/05/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
11/05/2018 N.P.Staff Time 4.50 522.27 522.27
Tina Nitsos
11/05/2018 R.N.Staff Time 9.75 622.64 622.64
Stacey Neese
11/05/2018 Health Coach Staff Time 7.00 461.44 461.44
Kristin Hullett
11/06/2018 M.A.Staff Time 5.73 165.25 165.25
Maria Collins
11/06/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
11/06/2018 N.P.Staff Time 5.75 667.35 667.35
Tina Nitsos
11/06/2018 R.N.Staff Time 9.50 606.67 606.67
Stacey Neese
To
DEC 0 5 zm
Invoice# 764355 (continued)page 2
Service Date Description Quanti Charae Recei Ad"Us Balance
11/07/2018 M.A.Staff Time 8.48 244.56 244.56
Elizabeth Herald
11/07/2018 M.A.Staff Time 5.30 152.85 152.85
Maria Collins
11/07/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
11/07/2018 N.P.Staff Time 8.75 1,015.53 1015.53
Tina Nitsos
11/07/2018 R.N.Staff Time 10.00 638.60 638.60
Stacey Neese
11/08/2018 M.A.Staff Time 4.00 115.36 115.36
Maria Collins
11/08/2018 MD Staff Time 4.00 721.00 721.00
Dr.Moody
11/08/2018 R.N.Staff Time 5.00 319.30 319.30
Stacey Neese
11/09/2018 M.A.Staff Time 5.20 149.97 149.97
Maria Collins
11/09/2018 N.P.Staff Time 6.00 696.36 696.36
Tina Nitsos
11/09/2018 R.N.Staff Time 6.00 383.16 383.16
Stacey Neese
11/09/2018 Health Coach Staff Time 5.00 329.60 329.60
Kristin Hullett
11/13/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
11/13/2018 N.P.Staff Time 5.50 638.33 638.33
Tina Nitsos
11/13/2018 R.N.Staff Time 10.00 638.60 638.60
Roslynn Coleman
11/13/2018 M.A.Staff Time 8.90 256.68 256.68
Maria Collins
11/14/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
11/14/2018 N.P.Staff Time 9.00 1,044.54 1044.54
Tina Nitsos
11/14/2018 M.A.Staff Time 5.30 152.85 152.85
Roslynn Coleman
11/14/2018 R.N.Staff Time 9.50 606.67 606.67
Stacey Neese
11/14/2018 M.A.Staff Time 9.40 271.10 271.10
Elizabeth Herald
11/15/2018 MD Staff Time 4.00 721.00 721.00
Dr.Moody
11/15/2018 M.A.Staff Time 4.40 126.90 126.90
Roslynn Coleman
11/15/2018 R.N.Staff Time 5.50 351.23 351.23
Stacey Neese
Invoice# 764355(continued)page 3
Service Date Description Quant! Charae Recelp AMAUSI Balance
11/16/2018 N.P.Staff Time 6.00 696.36 696.36
Tina Nitsos
11/16/2018 Health Coach Staff Time 5.00 329.60 329.60
Kristin Hullett
11/16/2018 R.N.Staff Time 6.25 399.13 399.13
Stacey Neese
11/16/2018 M.A.Staff Time 5.20 149.97 149.97
Maria Collins
11/19/2018 M.A.Staff Time 8.22 237.06 237.06
Maria Collins
11/19/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
11/19/2018 N.P.Staff Time 4.50 522.27 522.27
Tina Nitsos
11/19/2018 Health Coach Staff Time 7.00 461.44 461.44
Kristin Hullett
11/19/2018 R.N.Staff Time 10.00 638.60 638.60
Stacey Neese
11/20/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
11/20/2018 N.P.Staff Time 5.75 667.35 667.35
Tina Nitsos
11/20/2018 M.A.Staff Time 9.50 273.98 273.98
Roslynn Coleman
11/20/2018 R.N.Staff Time 9.50 606.67 606.67
Stacey Neese
11/21/2018 R.N.Staff Time 8.60 549.20 549.20
Sherry Axline
11/21/2018 M.A.Staff Time 5.75 165.83 165.83
Stacey Neese
11/21/2018 M.A.Staff Time 9.12 263.02 263.02
Elizabeth Herald
11/21/2018 MD Staff Time 5.00 901.25 901.25
-Dr.Moody
11/21/2018 N.P.Staff Time 8.00 928.48 928.48
Sheila Abebe
11/26/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
11/26/2018 M.A.Staff Time 4.83 139.30 139.30
Elizabeth Herald
11/26/2018 M.A.Staff Time 5.00 144.20 144.20
Maria Collins
11/26/2018 N.P.Staff Time 4.50 522.27 522.27
Tina Nitsos
11/26/2018 Health Coach Staff Time 7.00 461.44 461.44
Kristin Hullett
11/26/2018 R.N.Staff Time 9.75 622.64 622.64
Stacey Neese
Invoice# 764355(continued)page 4
Service Date DescriptionQuant! Charae Recelp Adjust Balance
11/27/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
11/27/2018 M.A.Staff Time 8.63 248.89 248.89
Maria Collins
11/27/2018 N.P.Staff Time 5.50 638.33 638.33
Tina Nitsos
11/27/2018 R.N.Staff Time 9.50 606.67 606.67
Stacey Neese
11/28/2018 MD Staff Time 5.00 901.25 901.25
Dr.Moody
11/28/2018 M.A.Staff Time 8.60 248.02 248.02
Elizabeth Herald
11/28/2018 N.P.Staff Time 9.00 1,044.54 1044.54
Tina Nitsos
11/28/2018 M.A.Staff Time 5.00 144.20 144.20
Roslynn Coleman
11/28/2018 R.N.Staff Time 10.00 638.60 638.60
Stacey Neese
11/29/2018 MD Staff Time 4.00 721.00 721.00
Dr.Moody
11/29/2018 M.A.Staff Time 4.50 129.78 129.78
Roslynn Coleman
11/29/2018 R.N.Staff Time 5.00 319.30 319.30
Stacey Neese
11/30/2018 N.P.Staff Time 6.00 696.36 696.36
Tina Nitsos
11/30/2018 M.A.Staff Time 5.00 144.20 144.20
Roslynn Coleman
11/30/2018 Health Coach Staff Time 5.00 329.60 329.60
Kristin Hullett
11/30/2018 R.N.Staff Time 6.00 383.16 383.16
Stacey Neese
CITYCARO Invoice# 764355 Balance Due: 40466.82
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
November 30, 2018
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite PEPM/Nov.2018
1 Civic Square
Carmel,IN 46032-
Invoice# 764387
Service Date Description Quanti Charge Recei Awus Balance
11/01/2018 Monthly Wellness PEPM 599.00 1,227.95 1227.95
CITYCARO Invoice# 764387 Balance Due: 1227.95
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
Fr. _ 71 r of
DEC 0 5 2018
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Indiana University Health Workplace Services,LLC
714 N.Senate Avenue
Suite 200 3-1
Indianapolis, IN 46202
317-963-1535
Tax I D# 20-0994452
Invoice
November 30, 2018
Bill to: Barbara Lamb For: City of Carmel-Onsite
City of Carmel-Onsite On-Site Billing/Nov.2018
1 Civic Square
Carmel,IN 46032-
Invoice# 764419
Service Date DescriptionQuant! Charge Recei Ad'us Balance
11/01/2018 Onsite Facility Operations 1.00 588.48 588.48
November 2018 Facility Charges
11/01/2018 Onsite Operating Supplies 1.00 375.36 375.36
November 2018 Supplies
CITYCARO Invoice# 764419 Balance Due: 963.84
MAKE PAYMENT TO THE BELOW ADDRESS WITHIN 30 DAYS OF INVOICE DATE-PLEASE INCLUDE
INVOICE#ON CHECK
DE„ 0 5 2018
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