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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 We appreciate your feedback. We invite you to complete a Client Satisfaction Survey online at http: /www. vet .purdue,edu /vtll /survey.htinl. Thank you for choosing the Veterinary Teaching Hospital at the Purdue School of Veterinary Medicine. 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