333769 12/21/18 CITY OF CARMEL, INDIANA VENDOR: 372939
4® � ONE CIVIC SQUARE ASCENSION ST VINCENT PUBLIC SAFEI%4ECK AMOUNT: $****13,585.39*
r CARMEL, INDIANA 46032 6612 E 75TH STREET CHECK NUMBER: 333769
SUITE 200„*oN�• CHECK DATE: 12/21/18
INDIANAPOLIS IN 46250
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4340701 20-34235 98.39 MEDICAL EXAM FEES
1110 4340701 20-34236 858.51 MEDICAL EXAM FEES
1110 4340701 20-34291 12,628.49 MEDICAL EXAM FEES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 372939 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
ASCENSION ST VINCENT PUBLIC SAFETY IN SUM OF$ CITY OF CARMEL
6612 E 75TH STREET An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
SUITE 200 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
INDIANAPOLIS, IN 46250
Payee
$13,585.39
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
20-34235 43-407.01 $98.39 1 hereby certify that the attached invoice(s),or 12/12/18 20-34235 officer physicals $98.39
1110 101 1110 101
20-34236 43-407.01 $858.51 bill(s)is(are)true and correct and that the 12/12/18 20-34236 officer physicals $858.51
1110 101 materials or services itemized thereon for 1110 101
20-34291 I 43-407.01 I $12,628.49 12/19/18 20-34291 officer physicals $12,628.49
1110 101 which charge is made were ordered and 1110 101
received except
Wednesday, December 19,2018
&'.. ? IE-:N.A.w
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
Ascension St. Vincent Public Safety Medical -I IVOICE'
o` Ascension St Vincent Invoice Date: 12/1212018 .8
~' Public Safety Medical
' - Invoice# 20-34235
+'
6612 E.75th Street,Suite 200 Terms:
Indianapolis N46250
f o Carmel Police Department/CARMEPD
fC F- Pyoung@carmel.In:G.ov(W),
Exclusively Serving Public.Safety Professionals Since 9990.
Amount_Y, Aalance"P&,
12 o /18 Zellers timothy An_d 'A. HIV -4th Gen Ra id lest 63f 26.58 26:5
Veni uncture $162 $3.62
Li id Pand, Blood $24.42 $24.42
CBC Com 'Blood Count 20.80 208o
.
Cmp.(Cbmp Metabolic Panel $22'.§r $22.971
4,
otahCharges,, $9.839a <=
i
tf Total
Payment's,&Balancebue >
i
i
Please make check payable to=.Ascension St Vincent Public Safety Medical and write invoice number on payment
check Our Federal Employer identification number is 46-1227:327.
We.greatly appreciate the opportunity to serve you. If you have any questions regarding this invoice, please contact
Michelle McClure at 31T.964-2304.
I
Ascension St. Vincent Public Safety Medical - INVOICE
I -
6 Ascension St Vincent
Invoice Date: 1 2/1 212 61 8
Public Safety Medical Invoice# 20-34236
6612E 75th Street,Suite 20.0
Indianapolis IN -46260 Terms:
c , Carmel Police Department-/CARMEPD
t- Pyoung@carmel.In:Gov(W)
!
!
Exclusively Serving Public Safety Professionals Since 1990.
!
I
Desnption Amount Balance.:Due
2/0718 Meier.Jeremvl Indiana E txam18:�i6 21
Med 0 inion=Past Offer PERF 'A0. $t).00
Chart Review/Com lesion $97:2297:2
Res irator Clearance-SSS
..26.66 26x6
'Applicant Blood Panel $131AZ. 137.82
.Veni uncture 3:62 3.62
Quantiferon=Tb Biood 6'U 60:0:1
Dru Screen'9 +O fates&Ox codons 8:02 `t302
Chest.X-RaPkLATfbtdita6
Vital Si ns-HT WT B '0 R
0.00
Vision:-Acufty tm `7 31:24
Visi n i I 31;2. 1
FT: i .t 62
Audiome" $:96;81 $16c81
EKG WI Irate 24:07 24.01
Urinal`sis-'Di"stick 3.62 3.62
T6hoifibtrV JGI6Uqbjp&T6§q 43 21 21
roial Charges-> s $858 5i
Please make.check payable to"Ascension St.Vincent Public Safety Medical"and write invoice number on payment
check. Our Federal Employer identification number is 46-1227327.
We greatly appreciate.the opportunity to serve you. If you have any questions regarding this invoice, please contact
Michelle McClure at 317-964-2364.
Ascension St. Vincent Public Safety Medical - INVOICE
o Ascension St.Vincent Invoice Date: 12/18/2018
Public Safety Medical
Invoice# 20-34291
E 6612 E.75th Street,Suite 200
Terms:
Indianapolis IN 46256
Carmel Police Department 1 CARMEPD
Py' oung' @car'm' bl.ln.Gpv(W)
Exclusively Serving Public. Safety Professionals Since 1990.
Date Employee Description Amount Balance Due
Med Oninion-Wellness $0-00 $0.00
Med Opinion-Respirator $0.00 $0.00
WaMfflip Ratio $9.62 $3.62
Bddy,Fat Test-BIA(Bio-E ed ft Anal16.81 $16.81
Treadmill-Sbbrnax $183.59 $183.59
Muscular Str66gqth Endurance Test -$31.21 131.21
FlklbilftV Test $12.01 $12.6-1
-Chest X-Ray-PAILAT(Di-git6l) $72.02 :$72.0
Urinalvsis--Di stick $3.62 $3.62
EKG WI.Inteirp $24.01 24.01
Audbrnetry- .$16.91 $16.81
PFT-NlrnonaN.Function Test $44.62 '$44.6
VW on-Acuity $81.21 $91.21
Vital Si"nsm HT WT BP P R. 0.00 $0.00
Kinkade,Matthew P. OnMed Program $0.00 $0;00
Respirator/Medical REM&W- $19.21 119.21
Health'Risk Appfaisal(Medikeeper) $0.00 $0.0
Comprehensive PhVsical Exam $117.64 $117.6
Med Opinion-Wellness $0.00 $0.0
Med Obinion-Respirator $0.00 $0.00
Waist/Hip'Ratio $3.62 1 $3.62
Body Fat Test-BIA(Bio-Eleb IMP Anal y) $16.81 116.81
Treadmill-Submax $183.59 $183.59
Muscular Strenath Endurance Test $31.21 $91.21
83,
3
21
Flexibilitv Test V 2.01 $12.01
Chest X-Ray-PA/LAT(Digital) $72.02 $72.02
Urinalysis-Dipstick $3.62 $3.62
EKG Wi Inter p $24.01 $24.01
Audiornetry 1 6.81 '$16.81
44.62
PFT-Pulmonary Function Test _M $44.621
Vision-Acuity $31.21 $31.21
Vital Signs-HT Vff BP P R $0.00 $0.0
Myers,Brady R. OnMed Pro ram $0.00 $0.0
1 Respirator/Medical Review $19.21 $19.21
Health Risk Appraisal(Medikeeper) $0.00 $6.00
Com prehensive Physical Exam $117.64 $11L764
Med QUihion-"Wellness tn nn $0.00
Ascension St. Vincent Public-Safety Medical - INVOICE
Ascension St.Vincent Invoice Date.- 12/18/2018
Public Safety Medical Invoice# 20=34291
6612E 75th'Street,Suite 200 Terms:
Indianapolis IN 46250
•..
c Carmel Police Department/CARMEPD
H Pyoung@carmel.In.Gov(W)
•m '
Exclusively Serving Public aSafety Professionals Since 1990
Date _ Employeei DescriptionAmount, Balance Due
12112/18 Wady.:Sean P OnMed Pro 'W.00 :00
Respirator/Medical Review $5921 $19.21
:Health Risk Appraisal Medikee er $0.00 $0.00
Com rehensive:Ph sical Exam $117.64 $117.64
'Med O inion-Wellness to.00 $0.00
Med`O' inion:-
Respirator $0.00 $0.00
Waist/Hi :Ratio 3.62 $3.62
Bod Fai.Test-MA Bio=Flee imp Anal' 16:81 1116.81
Treadmill Submax 183.59 183.59
Muscular'Stren th Endurance Test $31.21 1 .$31.21
Flexibility Test 12.01 112.01
Chest X=Ra -_P L a 72.02
Urinal`sis-'DWstick 3:62 M62
EKG W/Interp, $24.01 $24.01
-Audiomet $16;81 °$16.81
_PFT-Pulmona :Function Test $44:62 1 144:62
Vision:Acui 31:21 31.21
Vital Signs-:HT WT BP P R $0.00 $0.00
GilbertWilliam J. OnMed Program 0.00 0.00
Res irator/MedicalReview 419.2Jl 19:21
Health Risk A raisal Medikee er 0:00 $0.00
'Comprehensive Physical Exam 117.64 $117.64
Med'O.inion �ellness . 0.00 1 0.00
Med Opinion-SWAT $0.00 $0.0
Med O ` ion-Respirator $0.00 $0.00
Waist/Hi Ratio $3.62 $3.62
Body Fat Test-.81 Bio-Elec imp Anal 16.81 $96:81
Treadmill-Submax $183.59 $183.59
Muscular Stren th Endurance Test 31.21 31.21
FlexibilityTest 1261 12.01
Chest X-Ra -PA/IAT(Digital) 72.02 72.0
Urinalysis-Dipstick 3.62 $3.62
EKG.Wi Interp $24.01 $24.01
Audlometry $16.81 $16.81
PFT-P&nona Function Test 44.62 44.62
Vision-Acuit. 431.21 31.21
Vital Signs-H 0 0
Ascension St. Vincent Public Safety Medical - INVOICE
o Ascension St.Vincent Invoice Date: 12/1812018
Public,Sdety Medical IhV6ice# 20.;34291
S 6612 E.45th'Street,Suite 200
Indianapolis IN 46250 Terms:
Carmel,Police Department I CARMEIRD
.12 Pyoung@ rmeLIp.Gbv
CA (W-)
Im
ExclusIvely Serving Public Seifetv Professionals Since 1990.
Date Employee Description. Amount! Balance Due
ue
1_6ach,Abr6jj M. _0bMed Pro!jrLarh $0.60 $6.0
ResOirttor/Medlcall Review $19.21 119.91
Health Risk Appraisal(Medik6epdr) $0.00 $0.0
Com preh6h§ive Phsisal Exam $117.64 $117.6
Mad'00inion:-.Wellness $0.00 $0.00
Med Opinion-Resnir6t& $0.00 $0.00
Waist/Hi'Rati6 $3.62 $3.62
BodVFat Test-BIA'(13io-Eled Inib Anal Y $16.81 ;$16.81.
Treadmill r Subrnak $183.59 $183.59
Muscular Strength EndurarideTett- $31.21 31.21
FldxibilitV Test $12.01 $1101
Chas X-RaV-PA/LAT(Didital) S72.62 '$72.0
Urih'alysi Diostick' $3.62 t3.62
EKG W/Inter p -t24.01 $24.01
Audiornetry "$16.51 116.81
PFT'-PulmonaNfunction Test 44.62 '$44.6
Vision-Abuity $31.21 131.21
Vital Signs-HT WT BP P R moo $0.00
MrAllister,John W. OnMed Pro gram $0.00 $0.00
Resbirat(jeNddical Review 19.21 1 :$19.21
Health Risk Anpraisal(Medikeeper) 0.00 $0.00,
Com ijrehen§lve Ph sisal Exarn $117.64 $117.6
Med Opinion-Wellness $0.00 $0.0
Med Obinion,Resbirator $0.00 $0.0
Waist/Hip'Ratio $3.62 $3.62
Body Fat Test-BIA(Bio7EIec Imp Analy) $16.81 $16.81
Treadmill-Submax $183.59 $183.59
Chest X-Ray-PA/LAT(Digital) $72.02 $72.02
Urinalysis-Dipstick $3.62 $3:62
EKG W/Inter p $24.01 $24.01
Audiometry $16.81 $16.81
Vision-Acuity $31.21 331.21
Vital Signs-HT WT BP P R $0.00 $0.0
Miller,Adam C. OhMed Pro'ram $0.00 $0.0
Resoiratde/Medimil Review $19.21 $19.21
Health Risk Ap6raiMsal(Medikeeper) $0.00 $0.010
0]
Cornbrehensive sical Uarn $117.64 $117.64
Ascension St. Vincent'Public Safety Medical - INVOICE
0' A§cen$Idri.St.Viricent Invoice Date: 1211912616
Public Safety.Medical Invoice 4 `2044201
;E .6612 E.75th Street,;0 - t,SuRd 200
I .�Ir-
of Indianapolis IN 46250 Terms:
�Oarmel Police Department I CAKMEPD
P*pung@carmeI.In' .G,o.v(W)
Exclusively Serving Public Safety,Professionals Since 1990,
ljaii6 Employee Description Affiduht Balance Due'
Med Opinion Wei Iness $0.00
sodo
Med 0 pinion-Res-pireitor $0.00 $0.00
WaIsYHO Ratio, 0.62 $3.62
Body Fat Test-BIA(BlowEliac.Imp Anal 16.81I
Treadmill=Submax 9183.59 $163.59
M Mukular,Strendh Endurance1. 1-ance Test :$3 .231.21
Flkibf*Test 12.61. $12.61
Chesf:XmRay m PA/LATIbigital) 72.02 72.02
Urinal ysl,s,Di stick $162' $.3:62
EK6 Wl Interp I $24.of s24.01
Audiometry
16.8t,, 16.81
PFT-Pulmonary Fun6fion,Test $44M 4.62
Vision�Acuity 331.21
Vital Sighs'-HT WT BPP R. $q1.00 $0.00
Rice,Jonathbn D. OnMed Pro ram 9A
-$0.00 1 $6.00
RespiratodMddical.Revlew $19.21 $10.2i
Health Risk ApiJimisal(M-edlkeeperY $6.00 $0.00
Comprehibrisive Physical Exam 3117.54 4111.64
Med Opinion-Wellness -moo $0.60
0.00
Med 00616n-Riiispirator' Lt $0:00
WaiWHIO Ratio -$3.62 $3.62
Body Fat Test-BIA(Bio-Elee Imp Anal $16.81 $16-61
Treadmill-Submax $193.59 $183.69
Mdsdulai St rendth Endurance Test t31.21 1 $31,21
Flexibilify Test $12.01 sl2.01
Chest X-Ray-PA/LAT(Digital) '$72.02 $72.0
UrihaWis-Di stick $3.62 $3.'62
EKG W/Inte $24.01 $24.01
AudiometN $16.81 $16.81
PFT-Pulmonary Function Test $44.62 1 $44.62
Vision-Acuity 31.21 $31.21
Vital Sins-HT WT BP P R 0.00 $0 0:00
Zellers.Timothy And A. OnM6d Program 0.00 $6.00
Resolrator/Medical Review $19.21 t19.21
Health Risk Appraisal(M edikeeoeri 0-.00 0.00
I
Com mehensive Physical Exam $117.64 1117.64
Med Opinioss On nn
Ascension St. Vincent Public Safety Medical INVOICE
Ascension St.Vincent Invoice Date: 12118/20.18
Public Safety Medical Invoice# 20-34291
E 6612 E.75th Street,Suite 200
Terms:
IY Indianapolis IN 46250
c Carmel Police Department/CARMEPI]
F- Py oyrig@cafinel.In.Gov(W)
m
Exclusively Serving Public Safety Professionals.Since 1990.
Date Employee Description Amount 'Balance Due,
Co ehensive Physical Exam $117.64 117A
Med Opinion'-Wellness $0.00 $0:00
Med O"inion-Res Oirator $0.00 $0.00
Waist/Hip Ratio $3.62 $3.62
Body Fat Test-BIA'Bio-Elec Imb Anal 16.81 1, $16.61
Treadmill-Submax 183.59 $183.59
Muscular Stren ith Endurance Test 31.21 31.21
FlexibilitV Test 12.01 :$12.01
Cheg X-Ra -PA/LAT Di ital 72.02 72.02
Urinalysis-Di stick $.62 $3.62
EKG'-W/16terp $24.01 S24.01
Auaiornetry 316.81 3101
PUlmonary Function Test $44.62 44.62
Vision-Acuity $31.21 $31.21
Vital Signs-HT.WT BP P R $0.00` $0.00
Howard,Lana M. OnWd Program 0:00 0:00
Respirator/Medical Review $19.21 $19.21
Health Risk ApptaisW Medikee er 0.00 $0.00
Com rehensive Physical Exam $117.64 $117.64
Med Opinion'-Wellness' 0.00 $0.00
Med O inion-Res irator $0.00 $0.001
Waist/Hi Ratio $3.62 $3.62
Body Fat Test-BIA Bio-ElecImp.Anal 16.81 $16.81
Treadmill-Subrnax. 183.59 $183.59
Muscular Strenoth Endu`a ce Test $31.21 331.21
Flexibility Test $12.01 $12.01
Chest X-Ray-PA/LAT(Digital) $72.02 $72.02
Urinalysis-Di stick $3.62 $3.62
EKG W/Interp $24.01 24.01
Audiometry 16.81 $16.81
PFT-Pulmonary.Function Test $44.62 44.62
Vision,Acuity 31.21' $31.21
Vital Signs-HT WT BP P R $0.00 $0.001
Keith Brett A. OnMed Program $0.00 A
Res irator edical Review 19.21 1He lth is A aisal Medikee er 0.00 117.64 1Co re a sive Ph si aI Exam
Ascension. St. Vincent Public.Safety Medical INVOICE:
Ascehsl6fi St.vincent Invoice Date: 12/18/201,8
Pulbllc.Sdety Medical Invoice# 20-34291
-E 6612E 75th Street,S01te 200 Terms:
rr Indianapolis IN 46250
0, Carmel Police Department I CARIVIE131)
11- Pyoung@carrneI.ln.Gov,(W)
Exclusively Serving Public Safety Professionals Since 1990.
Date Employee Description Am6unt Balance Due,
Med Opinion .Resdrator $0,00 $0.00
Waistli-lip R6U6 $3.62 $3.62
Body F6t.Test_BIA(Bio-"Elep imp AnaiYj $16;61 $16.81
Treadmill-Submax $183:59 $183.59
Muscular Strength Endurance.Test $31.21 I t31.21
Flexibility Test' 12.'011 $12.01
d h bst-X-Ray-PA/LAT Di
igital) 72.02: $72:0
Urinal
!Xsis=b!PAck 3.62 $3.62
EKG'VVJ Intery 24.61 $24.011
Audiomeiry $16..81 $16.81
OFT-Pulmonary Function Test "4M 1 t414.62
Vision-Acuity $ 121 $3L.21
Vital'Sions m HT AT BP'-P R $0.00 $0.00
12/1'3/18 BdfloW,CodV J. OhMed Pro'ram $0:60 OO
_q M
Respir6t6diviedibal Review $19.21 $10.21,
Health RIA sisal flVledlk6eper) $0.00 $0.60
Compr6hendve PhvsicalExam $117.64 117.6
Med�Opini6n.-Wellness $0.60 $0.60
Med:Oi)lnion-SWAT $0.,06 $0.0
Med Ophicin-Resoirafor 0.00 tb-.-oo
Waist/Hi p Ratio $3.62 t3.62
Body Fat Test-BIA(Bio--Elec Imp Analy! $M61 $16.81
Treadmill-Submax $183.59 $183.59
Muscular
uscular 8trength Endurance Test $31.21 01.21
Flexibility
Test $12.01 $12.01
.-
Chest X-Rav-PAIAT(Digital) $72'.02 $72.0
1 2'01
E72 2
'0
UrinalVsis-Dip�§tick :$3.62 $3.62
1
EKG W/Int6rp $24.01 $24.01
Audidinetty 1 6.81 $16.81
PFT-PuIrnonary Function Test 44.62 $44.62
1
Vision-Acuity $31.�l 1 $31.21
Vital Signs-HT WT BP P R $0.00 $0.0
Barlow,James C. OnMed Pro ram $0.60 $0.00
Res irator/Medical Review $19.21 $19.21
Health Risk Aovraisal Wedikeeper) $.0.0-0 $0.0
Comprehensive Physical Exam $117,64 $1 17.64
Med oginion-Wellness $6,00 1 $0.00
Ascension :
St. Vincent Public Safety Medical - INVOICE
0 Ascension St.Vincent Involde Dater 12/18/2018
Public Safety Medical Invoice# 20-34291
.6612 E.75th Street,Suite 200
Terms:
Indianapolis IN 462.50
0 Carmel Police Department/GARMEPD
I-- 10young6parmel.1n.Gov(W
Exclusively Serving Public Safety Pro,fessionals Since 1990
Date, -Erno.l6yee Description Amount Balance Due
Med-03inion-Respirator 0.00 $0-0
Wais.t/H.1p Ratio $3;62 -t3.62
Bodyfdt Test-BIA(Bio-Eled Imp An11V) $16.81 $16.81
Treadmill-,Submax $183.59 $183.59
muscul'arS,trermth Endurance Test $31.21 U $31.21
Flexibility Test $12.01 $12.01
Chest X-Ray-PA/LAT(Digital) -t72;02 72.02
Urinalysis-Di stick $3.62 $3.62
EKG'W/Interr) '$24.01 :$24V
Audibryietry $16.81 $16.81
PFT-Pulmonary Fundfidn Test $44.62 $44.62
Vision:-Acuity $31.21 -$31,21
Vital Si n§-HT WT BP P R. $0.0
Bickel,Josep E. OnMed,Orograrn $0.00. $0.00
Respirator/Medical Review 419.21 $19.211
Health Mik.Apprajsaf j4edikeeperi t0.60 $U0
0
Com pr6hensive Physical Exam $117.64 1-17.64
Med Opinion=Wellness $0.00 0.00
Med Opinion-Respirator moo 0.00
Waist/kin Ratio 3.62 $3:62
Body Fat Test-BIA(Bio-Elec ImpAnaly) $16.81 :$16.81
Treadmill-Submax .$183.59 $183.5
Muscular Strength Endurance Test $31.21 $31.21
Flexibility Test $12.01 $12.01
UrInalysis-Dipstick '$3.62 $3.6
EKG W/Iriterp $24.01 .$24.01
Audiornetry $16.81 $16.81
PFT-Pulmonary Function Test. $44.62 $44.6
Vision-Acuity $31.21 $31.21
MW Signs-HT VVFT BO P'R $0.00 $0.00
Chest X X-Ra -PA/LAT(Digital) $72.02 $72.02
Horner Jeffrey J. OnMed.Program $0.00 $0.0
Respirator/Medical-Review $19.21 $19.21
Health Risk Appraisal Weidikeeper) $0.00 $0.0
Com orehensive Physical Exam $117:64 $117A
Med Opinion-Wellness 0.00, $0.001
Med Opinion-Respirator $0,00 $0.001
Ascension St. Vincent Public Safety Medical .- INVOICE
0 Ascension St.Vince]nt Invoice bate: 12/18/2018
R041i.6 Stifety MqdicqI Invoice# 20-34291
E 6612 E.75th Str6et,SuIte200
Indianapolis IN 46250 Terms:
0 Carmel Police Departrh,eht. I CARMEPD
P.y0Ungg;qrmel.In.G.dv(W)
W
Exclusivelv Serving Public Safety Professionals.Since.-1990.
Date, Employee Dewflption Arnbunt' 'Balance Due
W I aist/Hir)Ratio $162 3.6
Body Fat Test-BIA-(Bi6-Elec hp Maly) $16.81 .$16:81
Treadmill-,Subniaz. $183:59 $10.89
Muscular*Str6nQW EndUrance.Test 01.21-, :W.21
ReAbilify Test $12.01 $12.01
Chest kRby-PA/LAT DOW) $12.02 $79.0
Urinal M§-Di stick $3.62 $3.62
E KG'W/hit&p 24.01 s24.01
-Audi6m6tr-V $16'.81 !$16.81
-PFT-Pulmo6ary Fundflon Test 44.82 V44.62
Vision-AWN $31.21- $31.21
Vital Si ns-HT WT BP P R! $d,'00 so.bo
Wyer.Ryan J. GnMed Pro ram $0100 $0:00
Rebpirator/Medidal Review $19.21 $19;21
Health RlskAppraisal(Md61Wjper) $0.00 $0.00
Com prehehsim Ph'sicaUE)(arm $117:64 .$117.64
Med Opinion-Wellness, $0.00 ,$0.0
Med Opinion-Resplratbr 10.00 $0.00
Waist/Hip'Ratio !$8.62 $3.6
96dy Fat Test-BIA(Bio-Eled lmr)Anal16.81 $16.81
Treadmill-Submax $193.59 $183.59
Muscular Strenath Endurance Test 31'.21 $31.21
Flezibllh Test 92.01 $12.01
Chest X-Ray-PA/LAT(Digital) $72M' $72.0
UrihaWsis'-Dinstick 99.62 $3.62
EKG W1.Interp $24.01 $24.01
AudiornetN $16.81 $16.81
PFT-Pulmonary Function Test $44.62 $44.62
Vision-Acuity $31.21 $31.21
Vital Signs-HT WT BP P R $0.00 $0.00
Smiley,Lbhdry D. OnMed Pro ram $0-.00 $0.00
Resj)irator/Medical Review $19.21 $16.21
Health Risk-Anpraisal Wedikeeoer)' 0.00 0.00
Commehensive Physical Exam $117.64 1117,6
Med Opinion-Wellness $0.00 '$0.00
:IMed Opinion-Resoirator 00 0.00
I
Waist/Hi 12 Ratio -$3.62 -$3,621
Ascension St. Vincent Public Safety Medical - INVOICE
Fo_ Ascension St.Vincent Invoice Date: 12/18/2018 i
Public.Safety Medical Invoice# 20-34291
66:12 E.75tti'Street,Suite 200 Terms:
w Indianapolis IN 46250
c Carmel Police Department/CARMEPD
►- Pyoung@carmel.In.Gov(W)
m '
Exclusively Serving Public Safety Professionals Since 1990.
Date Employee Description Amount Balance Due
BodV at-Test-B (Big- c Imb Anal 16.81 $18.81
Treadmill-Submax $183.59 $1'83.59
Musciilar Strength Endurance Test $31.2:1 31:21
flexibili "Test'. $12.01 12:01
Urina(si's-Dipstick $3.62 $3.62
EKG W/Interp $24.01 $24.01
Audiornetry $16.81 $16.81
PFT-PulmonarV Function Test $44.62
Vision-Acuity,' $31.21
Vital Si ns-HT-WT BP-P R $0.00 $0.00
Chest X-Ra PA/LAT Di ital) $72.02
Zoultz,.Megan D: OnMed Pro-ram 00 0.00
Res rator Medical i 1 .2 S19.21
Health Risk A raisai Medikee er $0.00 $0.00
Compehensive Ph sical Exam 9 17.64
MedO inion°-Wellness $0.00
$0.00
Med Opinion-SWAT $0.00 $0.00
Med Opinion-Respirator $0.00 $0.00
Waist/Hi Ratio .3.62 $3.62
Body Fat Test-BIA Bio-Elec Im`Anal 16:81 16:81
Treadmill-Submax $183.59 $183.59
Muscular Stren th Endurance Test 31.21 $31.21
Flexibili ty Test $12.01 $12.01
ChestPA/LAT Di 72.02 72.02
Urinalysis-Di stick $3.62 $3.62
EKG Wt. nte .$24.01 $24.01
Audiomet $16.81 $16.81
PFT-Pulmonary Function Test $44.62 $44.62
Vision-Acuity 31.21 $31.211
Vital Signs-HT WT BP P R 0.00 $0.00
HIV-4th Gen Rapid Test Blood 26.58 $26.58
Veni uncture 3.62 $3.62
Li id Panel Blood 24.42 $24.42
CBC(Comp Blood Count 20.80 S20.80
CMP(Como Metabolic Panel 22:97 $22.97
Str .a Nicho as.W. OnMed Program $0.00 $0.00
Resr)irator/Medicol Review $19.21 $19.21
.Ascension St. Vincent Public Safety Medical - INVOICE
o Ascension St.Vincent Invoice Date: 12118/2018
E-
+. Public Safety Medical Invoice# 20-34291
E 6612 E.75th Street,Suite 200
XIndTerms:
Indianapolis IN 46250
c Catmel.Police'DepartmentI CARMEPD
H Pyoung@cafinel.ln.Gov(W)
c0 '
Exclusively Serving Public Safety Professionals Since 1990.
Date Employee Description Amount Balance Due
Health Risk Apgrais6l Medikee er 6.00 $0,00
Com e'hensive Physical Exam $117.64 $1-17.64
Med Opinion'-Wellness $0.00 $0.00
Med 001nibn-Respirator $0.00 $0.00
Waistl `Ratio $3.62 $3.92
Body Fat Test-BIA Bio-Elec Imb Anal 16:81 16:81
Treadrriill-Submax 183.59 $183.69
Muscular Strep th Endurance Test 31.21 31.21
Flexibilit Test 12.01 12.01
Chest`X-Ra PA/tAT Di ital 72.02 72.02
Urinalysis-Di stick3.62 $3.62
EKG W/Interp 24.01 24.01
Audiomet 16.81 6.81
PFT-PulmonaryFunction Test $44.62 $44.62
Vision-Acuity31.21 131.21
Vital Sins-HT WT BP'P R $0.00 $0.00
12/14/18 Cash II Steven H. OnMed Pro ram $0.00 $0.00
Respirator/Medical Review $19.21 $19.24
Health Risk A raisal Medikee"er 0.00 $0.00
Com rehensive Physical Exam $117.64 $117.641
Med Minion-Wellness $0.00 $0.00
Med O"inion-Res irator $0.00 $0.00
Waist/Hi Ratio $3.62 $3.62
Body Fat Test-BIA Bio-Elec Imb Anal $16,81 16.81
Treadmill-Submax t$72:02
$183.59
Muscular Strength Endurance Test $31.21
FlexibilityTest $12.01
Chest X-Ray-PA/LAT Di ital $72.02
Urinal sis-Di stick $3.62
EKG W/InteW.$24.01 $24.01
Audiomet 16.81
PFT-Pulmona Function Test 44.6Vision-Acuit $31.21
Vital Si ns-HT WT BP P R O.DO
Clark Sr. Todd C. OnMed Pro ram . 0 $0.00
Res irator/Medical Review 19.21 19.21
Health Risk Appraisal Medikee er) I so-00 1 mool
Ascension St. Vincent Public Safety Medical - INVOICE
12 Ascension St.Vincent Invoice Date: 12/18/2018 t
Public Safety Medical Invoice# 20-34291
6612 E.75th Street,Suite 200
w Indianapolis IN 46250 Terms:
c Carmel Police Department/CARMEPD
H Pyoung@carmel.ln.Gov(W)
m '
Exclusively Serving Public Safety Professionals Since 1990.
Date Employee. Description Amount Balance.Due
-Med Owniori-SWAT
U0 Wop
Med Oinion-Respirator $0.00. 0.00
Waist/Hi Ratio 3x62 3.62
BodyFat Tasl-81A Bio-Elec Imp Anal 16.81 $16.81
Treadmill .'Submax $183.59 $183.59
Flexibility Test 12:01 12:01
Chest-X=Ra -PAILAT Di itai 72:0272.02
Urinal bis.-Di stick $3.62 $3:62
EKG W/Intery
$24.011 24:01
Audiomet ;$16.81 16.81
PFT-Pulmonary Functio Test 4.62 $44.621
Vision-Acuity31.21
Vi -HT WT BPP R 30.00 10ind
Zellers,Nan L. On Med,Program $0:o0 $0.00
Respirator/Med! dl Review $`1921 $19.21
Health Risk Appraisal Medikee er 0:00 > 0:00
Com rehensive Physical Exam 117.64 1.17:64
Med Opinion-Wellness o:00' 0.00
Med Opinion-Respirator 0:00 0:00
WaisUHi 'RaG° 3:62 3.62
'BodyFat.Test.=BIA Bio-Elec ImpAnal16.81 16.81
readmill-Submax 183.59 183.59
Flexibility Test 12.01 12.01
Ches!:X Ra -PA/LAT Di ital 2 72.0
Urinalysis-Di stick 3 3.62
EKG W/Inte $24.0'1 $24.61
Audiomet. $16.81 $16.81
PFT-PulmonaryFunction Test $44.62 $44.62
Vision-Acuff 31.27 $31.21
Vital Signs-HT WT BP P R 0.00 0:00
Total Charges-> $12,628.49
Total Payments&Balance Due-> $0.00 $12,628.49
I