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HomeMy WebLinkAbout202733 10/11/2011 CITY OF CARMEL, INDIANA VENDOR: 254452 Page 1 of 1
ONE CIVIC SQUARE PURDUE UNIVERSITY CHECK AMOUNT: $2,617.55
CARMEL, INDIANA 46032 LYNN HALL OF VETERINARY MEDICINE
625 HARRISON STREET CHECK NUMBER: 202733
WEST LAFAYETTE IN 47907 -2026
CHECK DATE: 10/11/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4357600 S- 753613 -3 2,617.55 ANIMAL SERVICES
_JT Tin 'TE
E U nDru
U N I V E R. S I T Y' VETERINARY TEACHING HOSPITAL
Invoice Visit: 5- 753613 -3
Carmel Police Department Patient Name: Ben
3 Civic Square Patient 1D: 753613
Carmel, IN 46032 Admission Date: 9/29/2011 7:30:17 AM
Discharge Date:
Reason: Decompression and stabilization sx
*ICU 10 /1*
Administrative Fee Units Charge Credit Sub -Total
09/29/20.11 Bio- Security Fee 1.00 $4.00 $0.00 $4.00
09/30/2011 Bio Security Fee -Each Additional Day, up to 30 1.00 $2.00 $0.00 $2.00
days
10/01/2011 Bio Security Fee Each Additional Day, up to 30 1.00 $2.00 $0.00 $2.00
days
Sub Totals: $8.00 $0.00 $8.00
Anesthesia U nit s C harge Credit Sub -Total
09/29/2011 Anesth Iso 1st Hr 1.00 $65.00 $0.00 $65.00
09/29/2011 Anesth ]so 2+ Hr 6.00 $216,00 $0.00 $216.00
09/29/2011 Anesth ECG Monitor 1.00 $24.00 $0.00 $24.00
09/29/2011 Anesth Pulse Oximetsy Monitor 1.00 $16.00 $0.00 $16.00
09/29/2011 Anesth Blood Pressure Direct 1.00 $56.00 $0.00 $56.00
09/29/2011 Anesth Ventilator 4.00 $12.00 $0.00 $12,00
09/29/2011 Anesth Insert Periph, Catheter 3.00 $51.00 $0.00 $51.00
Sub Totals: $440.00 $0.00 $440.00
Diagnostic Imaging Units Charge Credit Sub -Total
09/29/2011 Consultation- radiology 1.00 $37.00 $0.00 $37.00
09/29/2011 Radiographs diagnostic 2.00 $60.00 $0.00 $60.00
Sub Totals: $97.00 $0.00 $9700
Hospitalization Units Charge Credit Sub -Total
09/29/2011 ICU Level H full day 1.00 $69.00 $0.00 $69.00
09/29/201.1 Hospitalization 1.00 $36.00 $0.00 $36.00
09/30/2011 ICU Level II full day 1.00 $69.00 $0.00 $69.00
09/30/2011 Hospitalization 1.00 $36.00 $0.00 $36.00
Sub Totals: $210.00 $0.00 $210.00
Laboratory Units Charge Credit Sub -Total
09/29/2011 Hematocrit/Total.Protein 1.00 $12.00 $0.00 $12.00
School of Veterinary Medicine
Lynn Hall of Veterinary Medicine 625 Harrison Street Nest Lafayette, 1N 47907 -2026 Printed: 10/01/201109.48 AM
Small Animal I Iospital (765) 494 -1 107 Laroc Animal l lospital (765) 494 -8548 Page 1 of 4
PURDUE
U N I V E R S I T Y VETERINARY TEACHING HOSPITAL
Invoice Visit: S- 753613 -3
09/29/2011 Hematocrit/Total Protein 4.00 $48.00 $0.00 $48.00
09/29/2011 IRMA Bloodgas /Lytes 1.00 $32.00 $0.00 $32.00
09/30/2011 Hematocrit /Total Protein 1.00 $12.00 50.00 $12.00
Sub Totals: $104.00 $0.00 $104.00
Pharmacy Un Charge Credit Sub -Total
09/29/2011 OC: Dexdomitor (Dexmedetomidine) 0.5mg /ml 1.00 $17.00 $0.00 $17.00
Injectable
09/29/20.11 OC: Hydromorphone 2mg/ml Injectable 2.00 $6.00 $0.00 $6.00
09/29/2011 OC: Propoflo (Propofol) l Omg /ml Injectable, 1.00 $20.00 $0.00 $20.00
Abbott
09/29/2011 OC: Fentanyl 0.05mg/ml Injectable Solution, I0m1 1.00 $6.75 $0.00 $6.75
09/29/2011 Fentanyl 0.05mg /ml Injectable Solution, lOtnt 4.00 $27.00 $0.00 $27.00
NDC:00409- 9094 -28
09/29/2011 Rimadyl (Carprofen) 75mg:Oral Tablet 10.00 $17.00 $0.00 $17.00
09/29/2011 OC: Fentanyl 0 05mg/ml Injectable. Solution, 10m1 1.00 $6.75 $0.00 $6.75
09/29/2011 OC: Fentanyl 0.05mg/ml Injectable Solution, 10ml 1.00 $6.75 $0.00 $6.75
09/29/2011 Cefazolin Igm Injectable Hospira NDC :00409- 2.00 $12.50 $0.00 $12.50
0805 -01]
09/29/2011 Cefazolin Igm Injectable, Hospira NDC:00409- 3.00 $18.75 $0.00 $18.75
0805 -01]
09/29/2011 Gelfoam 12 -7 mm (Absorbable Gelatin Sponge) 1.00 $12.40 $0.00 $12.40
Topica NDC:00009- 03 1 5 -08
09/29/2011 Plasmalyte A 1000ml Injectable 3.00 $18.00 $0.00. $18.00
09/2912011 OC: Fentanyl 0.05mg /ml Injectable Solution, 10ml 3.00 $20.25 $0.00 $20.25
09/29/2011 Rimadyl (Carprofen) 50mg/ml Injectable 3.20 $20.40 $0.00 $20.40
09/29/2011 OC: Plasmalyte A 1 OOOml Injectable 1.00 $6.00 $0.00 $6.00
09130/2011 OC: Plasmalyte A IOOOmlInjectable 2.00 $12.00 $0.00 $12.00
09730120; I Tramadoi 50mg Tablet NDC:65162- 0627 -1 1 75.00 $38.75 $0.00 $38.75
09/30/2011 Cephalexin 500mg Oral, aurobindo NDC:65862- 48.00 $21.80 $0.00 $21.80
019-051
10/01/2011 OC: Plasmalyte A 1000m1 Injectable 1.00 $6.00 $0.00 $6.00
10/01/2011 OC: Fentanyl 0.05mg /ml Injectable Solution, 10ml -1.00 ($5.75) $0.00 -$5.75
(Credit)
Sub- Totals: $288.35 $0.00 $2$8.35
Professional Services Units Charge Cred Sub -Total
09/29/2011 ICU urine sample collection 1.00 $4.00 $0.00 $4.00
09/29/2011 Office visit, brief 1.00 $33.00 $0.00 533.00
09/29/2011 Sas C- Arm Fee 1.00 $93.00 $0.00 $93.00
09/29/2011 Hosp /doctor Charge 1.00 $22.00 $0.00 $22.00'
Schocl of Veterinary Medicine
Lynn Hall of Veterinary Medicine 625 Harrison Street West Lafayette, IN 47907 -2026 Printed: 10101/2011 09:48 AM
Small Animal Hospital (765) 494 -1107 Large Animal Hospital (765) 494 -8548 Page 2 of 4
rURDUE
U N l V E R. S I T Y VETERINARY TEACHING HOSPITAL
Invoice Visit: S- 753613 -3
09/30/2011 Hosp /doctor Charge 1.00 $22.00 $0.00 $22.00
Sub Totals: $174.00 $0.00 $174.00
Supplies Units Cha C redit Sub T o tal
09/29/2011 Dressing Sponge IOpk sterile 1.00 $1.00 50.00 $1.00
09/29/2011 CATHETER, ORANGE RUBBER, 8FR X 22 IN 1.00 $1.90 $0.00 $1.90
09/29/2011 SUCTION BUCKETS WITH LIDS 3.00 $7.50 $0.00 $7.50
09/29/2011 Drill /Saw (All power equip) 2.00 $28.00 $0.00 $28.00
09/29/2011 Synthes burr (e -pen) charge 1.00 $52,50 $0.00 $52.50
09/29/2011 Steam double pouch charge 4.00 516.00 $0.00 $16.00
09/29/2011 Steam, single pouch 1.00 $3,00 $0.00 $3.00
09/29/2011 Steam blue wrap charge 1.00 $6.00 $0.00 $6.00
09/29/2011 SPONGE, X -RAY, STERILE 8.00 $27.60 50.00 $27.60
09/29/2011 Dressing Sponge IOpk sterile 1.00 $1.00 $0.00 $1.00
09/29/2011 Suture, 2 -0 PDS'SH (Z317H) 1.00 $7.95 $0.00 $7.95
09/29/2011 SUTURE, 3 -0 MONOCRYI, RB -1, Y305H 1.00 $7.35 $0.00 $7.35
09/29/2011 Syringe, 60CC Catheter Tip 2.00 $5.90 $0.00 $5.90
09/29/2011 DISPOSABLE MIXING BOWL, STERILE 1.00 $23.25 $0.00 $23.25
09/29/20.1.1 Sterile Skin Marker 1.00 $1.00 $0.00 $1.00
09/29/2011 SUTURE, 0 PDS CT -1 Z3401I 4.00 $31.60 $0.00 $31.60
09/29/2011 C -arm drape, large 1.00 $25.00 $0.00 $25.00
09/29/20.11 DRAPE, IOBAN 11, 13" X 13" 6640EZ 1,00 $7.60 $0.00 $7.60
09/29/2011 BONE CEMENT, WHOLE DOSE 2.00 $302.00 $0.00 $302.00
09/29/2011 SUTURE, 3-0 PROLENE, SH, 8832H 1.00 $8.95 $0.00 $8.95
09/29/2011 Tegaderm dressing, 8 "x6'" 1.00 $2.65 $0.00 $2,65
09/2.9/2011 SPOOL WIRE, 20GA. 1.0 OZ. 1.00 $16.20 $0.00 $16.20
09/29/2011 K -WIRE, .062 X 9 IN 2.00 $8.80 $0.00 $8.80
0912912011 GLOVES, SURGICAL, 7 2.00 $2.00 $0.00 $2.00
09/29/2011 Fluid, Pourable Saline, 1000ml 1.00 $2.00 $0.00 $2.00
09/29/2011 DRAPE, 1' /2 Drape, 40 "X58" 1.00 $2.55 $0.00 $2.55
09/2972011 PIN PACK 1.00 $6.00 $0.00 $6.00
09/29/2011 Wire Kit. 1.00 $6.00 $0.00 $6.00
09/29/2011 Imex SK External Fixator Pack 1.00 $30.00 $0.00 $30,00
09/29/2011 IV SET, EXTENSION SET, 301N 1.00 $3.45 $0.00 53.45
09/29/2011 Mini -bore Extension.Set 1,00 $1.95 $0.00 $1.95
09/29/2011 ABBOTT PLUM SET 1.00 $6.55 $0.00 $6.55
09/29/2011 Terumo IV CATHETER 20ga X 1 1/4" 3.00 $4.50 $0.00 $4.50
09/29/2011 INJECTION CAPS, PRN ADAPTER 1.00 $0.50 $0.00 $0.50
09/29/2011 OC: THERMOMETER, RECTAL, DIGITAL 1.00 $4.65 $0.00 $4.65
09/29/2011 SMALL PLUS INTERFACE HALF -PIN 7/64 6.00 $70.20 $0.00 $70.20
School of Veterinary Medicine
Lynn Hall of Veterinary Medicine 625 Harrison Street West Lafayette, W 47907 -2026 Printed; 10/01/2011 09.48 AM
Small Animal Hospilal (765) 494 -1107 Large Animal Hospital (765) 494 -8548 Page 3 of 4
PURDUE
U ICI I V E R S I T Y VETERINARY TEACHING HOSPITAL
Invoice Visit: S- 753613-3
09/29/2011 OC: Stopcock, 3 -way 1.00 $5.25 $0.00 $5.25
09/29/2011 OC: CATHETER ADAPTER LARGE 1.00 $5.25 $0.00 $5.25
09/30/2011 OC: THERMOMETER, RECTAL, DIGITAL 1.00 $4.65 $0.00 $4.65
09130/2011 OC: Mini -bore Extension Set 1.00 $1.95 $0.00 $1.95
Sub Totals: $750.20 $0.00 $75020
Surgery Units Charge Credit Sub -Tota
09/29/2011 Other Surgery fee complex 2.00 $338.00 $0.00 $338.00
09/29/2011 Surgery room 1.00 $208.00 $0.00 $208.00
Sub- Totals: $546.00 $0.00 $546.00
Charged Credits Sub -Total
Total: $26.17.55 $0.00 $2617.55
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School of VelerinaryMedicine
Lynn Hall of Veterinary Medicine 625 Harrison Street West Lafayette, IN 47907 -2026 Printed. 10/01/2011.09`.48 AM
Small Animal Hospital (765)494-1107 Large Animal Hospital (765) 494 -8548 Page 4 of 4
VOUCHER NO. WARRANT N
ALLOWED 20
Purdue University
Lynn Hall of Veterinary Medicine
IN SUM OF
625 Harrison Street
West Lafayette, IN 47907 -2026
$2,617.55
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1110 5- 753613 -3 43- 576.00 $2,617.55
I hereby certify that the attached invoice(s), or
I f
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
Wednesday, October 05, 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))
09/29/11 S- 753613 -3 surgery for K9 Ben $2,617.55
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