HomeMy WebLinkAbout201383 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 254452 Page 1 of 1
i ONE CIVIC SQUARE PURDUE UNIVERSITY
CARMEL, INDIANA 46032 LYNN HALL OF VETERINARY MEDICINE CHECK AMOUNT: $1,290.65
625 HARRISON STREET CHECK NUMBER: 201383
WEST LAFAYETTE IN 47907 -2026
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4357600 S- 753613 -1 1,290.65 ANIMAL SERVICES
PURDUE
U N 1 V E R$ I T Y VETERINARY TEACHING HOSPITAL
Invoice Visit: S- 753613 -1
Carmel Police Department Patient Name: Ben
3 Civic Square Patient ID: 753613
Carmel, IN 46032 Admission Date: 9/7/2011 8:39:29 AM
Discharge Date: 9/7/2011 4:24:00 PM
Reason: oval w MRI -hind quarter weakness
Administrative Fee U ni ts Charge Credit Sub -Total
09/07/20.11 Bio- Security Fee 1.00 $4.00 $0.00 $4.00
0970712011 Records Fee 1.00 $17.00 $0.00 $17.00
Sub Totals: $21.00 $0.00 $21. 00
Anesthesia Units Charge Credit Sub -Total
.09/0712011 Anesth Iso 2+ Hr 0.70 $25.20 $0.00 $25.20
09/07/2011 Anesth Blood Pressure Indirect 1.00 $20.00 $0.00 $20.00
09/07/2011 Anesth Ventilator 1.00 $3.00 $0.00 $3.00
09/07/2011 Anesth Insert Periph. Catheter 1.00 $17.00 $0.00 $17.00
09/07/2011 Anesth Injection Fee 1.00 $16.00 $0.00 $16.00
09/07/2011 Anesth Iso I st Hr 1.00 $65.00 $0.00 $65.00
09/07/2011 Anesth Pulse Oximetry Monitor 1.00 $16.00 $0,00 $16.00
Sub Totals: $16220 $0.00 $162.20
Diagnostic Imaging Units Charge Credit Sub -Total
09/0712011 Radiographs- diagnostic 4.00 $120.00 $0.00 $120,00
.09/07/2011 MRI Pre and Post Contrast 1.00 $847.00 $0.00 $847.00
Sub Totals: $967.00 $0.00 $967.00
Pharmacy Unit Charge Credit Sub -Total
09/07/2011 OC: Hydromorphone 2mg /ml Injectable 2.00 $6.00 $0.00 $6.00
09/07/2011 OC: Antisedan (Atipatnezole) 5mg /ntl Injectable 1.00 $12.00 $0.00 $12.00
09/07/2011 OC: 1-lydromorphone 2mg /ml Injectable (Credit) -1.00 ($3.00) $0.00 -$3.00
09/07/2011 Cabapentin 300mg Oral Capsule, Amneal 12.00 $11.60 $0.00 $11,60
NDC:53746- 1.02 -05 1
09/07/2011 Plasmalyte A I000ml Injectable 1.00 $6.00 $0.00 56.00
Sub Totals: 532.60 $0.00 532.60
Professional Services Un Charge Credit Sub -Total
09/07/2011 Office visit, referral 1.00 $93.00 $0.00 $93.00
Sub Totals: $93.00 S0.00 $93.00
School of Vcrerinw)
Lynn. Hall of Veterinary Medicine 625 Harrison Street West Lafayette, IN 47907 -2026 Printed: 09i07/2011 04:24 PM
Small Animal Hospital (765) 494-1107 I_.arge Animal Hospital (765) 494 -3548 Page I of 2
P URDUE
U N 'I V E R S I T .Y VETERINARY TEACHING HOSPITAL
Invoice Visit: S- 753613 -1
Supplies Units Charge Credit Sub -Total
09/07/2011 IV SET, BASIC SOLUTION, 10 DROP/ML 1.00 $4.35 $0.00 $4.35
09/07/2011 Invivo Standard Quatrode electrodes 1.00 $10.50 $0.00 S10.50
Sub Totals: $14.85 $0.00 514.85
Charged Credits Sub -Total
Total: $1290.65 $0.00 $1290.65
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School of Veterinary A4edicine
Lynn Hall of Veterinary Medicine 625 Harrison Street West Lafayette, IN 47907 -2026 Printed: 09/07/201104:24 PM
Small Animal l (765) 494 -1 107 Large Animal Hospital (765) 494 -8548 Page 2 of
VOUCHER NO. WARRANT NO.
ALLOWED 20
Purdue University
Lynn Hall of Veterinary Medicine
IN SUM OF
625 Harrison Street
West Lafayette, IN 47907 -2026
$1,290.65
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1110 S- 753613 -1 I 43- 576.00 I $1,290.65 1 hereby certify that the attached invoice(s), or
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
Monday, September 12, 2011
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
09/07/11 S- 753613 -1 payment for MRI on K9 Ben $1,290.65
1 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
Clerk- Treasurer