36C10B18R2676-005.xlsx
XLSX spreadsheet 300 KB Posted
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- FSC Healthcare Clearinghouse Services
- Solicitation number
- 36C10B18R2676
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36C10B18R2676 A4- Price Worksheet.xlsx
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| 36C10B18R2676-A0004000.docx | DOCX document | |
| 36C10B18R2676-A0004001.docx | DOCX document | |
| 36C10B18R2676-A0003001.docx | DOCX document | |
| 36C10B18R2676-A0003002.docx | DOCX document | |
| 36C10B18R2676-A0003000.docx | DOCX document | |
| 36C10B18R2676-A0002000.docx | DOCX document | |
| 36C10B18R2676-009.pdf | ||
| 36C10B18R2676-001.docx | DOCX document | |
| 36C10B18R2676-002.doc | DOC document | |
| 36C10B18R2676-004.xls | XLS spreadsheet | |
| 36C10B18R2676-008.doc | DOC document | |
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| 36C10B18R2676-006.xlsx | XLSX spreadsheet | |
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Text version
Instructions Instructions Tab
Evaluated Price Summary Tab Instructions -
(1) Offeror shall make no inputs in this tab. Evaluated Price Summary tab automatically calculates the total evaluated price.
FFP Priced CLINs Tab Instructions -
(1) The Offeror shall enter unit prices (in yellow shaded cells) for the Firm Fixed Price CLINs. Unit prices shall be entered with no more than two decimal places. If unit prices are entered with more than two decimal places, cells are formatted to be flagged and will be color shaded. Ensure all unit price cells are corrected so no color shading is remaining before submitting proposal.
Evaluated Price Summary
| Evaluated Price Summary Tab | |||||
| Category | Base Year | Option Year 1 | Option Year 2 | Option Year 3 | Total Evaluated Price |
| Base | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |
| Optional Task 1 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |
| Optional Task 2 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |
| Optional Task 3 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | |
| Optional Task 4 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
Total Evaluated Price $ - 0 $ - 0 $ - 0 $ - 0 $ - 0
FFP PRICED CLINs
| LINE ITEM | Unit | Price | CLIN 002 | Unit | Price | Unit | Price | Unit | Price | Unit | Price | Unit | Price | CLIN 0002AF | Unit | Price | Totals | |||||
| CMS-1500 Claims | CMS-1450 Claims | 837 Healthcare Claims | 835 Healthcare Claims | 270/271/275/276/277/278 Claims | Pharmacy Claims | Rendered Images |
SLIN 0002AA - Base 0 - 2,000,000 Transactions $ - 0 SLIN 0002AB - Base 0 - 2,000,000 Transactions $ - 0 SLIN 0002AC - Base 0 - 2,000,000 Transactions $ - 0 SLIN 0002AD - Base 0 - 2,000,000 Transactions $ - 0 SLIN 0002AE - Base 0 - 2,000,000 Transactions $ - 0 500 $ - 0 $ - 0
SLIN 0002AG - Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 0002AH - Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 0002AJ - Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 0002AK - Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 0002AL - Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 0002AM - Optional Task 1 0 – 5,000,000 Transactions $ - 0 $ - 0
SLIN 0002AN - Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 0002AP - Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 0002AQ - Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 0002AR - Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 0002AS - Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 0002AT - Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 $ - 0
SLIN 0002AU - Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 0002AV - Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 0002AW - Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 0002AX - Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 0002AY - Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 0002AZ - Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 $ - 0
SLIN 0002BA - Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 0002BB - Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 0002BC - Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 0002BD - Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 0002BE - Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 0002BF - Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 $ - 0
| LINE ITEM | Unit | Price | Unit | Price | Unit | Price | Unit | Price | Unit | Price | Unit | Price | CLIN 1002AG | Unit | Price | $ - 0 | ||||||
| Transaction Type | CMS-1500 Claims | CMS-1450 Claims | 837 Healthcare Claims | 835 Healthcare Claims | 270/271/275/276/277/278 Claims | Pharmacy Claims | Rendered Images | Base Year Grand Total |
SLIN 1002AA - Optional Year 1 Base 0 - 2,000,000 Transactions $ - 0 SLIN 1002AB - Optional Year 1 Base 0 - 2,000,000 Transactions $ - 0 SLIN 1002AC - Optional Year 1 Base 0 - 2,000,000 Transactions $ - 0 SLIN 1002AD - Optional Year 1 Base 0 - 2,000,000 Transactions $ - 0 SLIN 1002AE - Optional Year 1 Base 0 - 2,000,000 Transactions $ - 0 500 $ - 0 $ - 0
SLIN 1002AG - OY1 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 1002AH - OY1 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 1002AJ - OY1 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 1002AK - OY1 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 1002AL - OY1 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 1002AM - OY1 Optional Task 1 0 – 5,000,000 Transactions $ - 0 $ - 0
SLIN 1002AN - OY1 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 1002AP - OY1 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 1002AQ - OY1 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 1002AR - OY1 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 1002AS - OY1 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 1002AT - OY1 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 $ - 0
SLIN 1002AU - OY1 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 1002AV - OY1 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 1002AW - OY1 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 1002AX - OY1 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 1002AY - OY1 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 1002AZ - OY1 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 $ - 0
SLIN 1002BA - OY1 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 1002BB - OY1 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 1002BC - OY1 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 1002BD - OY1 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 1002BE - OY1 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 1002BF - OY1 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 $ - 0
| LINE ITEM | CLIN 2001 | Unit | Price | CLIN 2002 | Unit | Price | CLIN 2003 | Unit | Price | CLIN 2004 | Unit | Price | CLIN 2005 | Unit | Price | CLIN 2006 | Unit | Price | CLIN 2002AG | Unit | Price | $ - 0 |
| Transaction Type | CMS-1500 Claims | CMS-1450 Claims | 837 Healthcare Claims | 835 Healthcare Claims | 270/271/275/276/277/278 Claims | Pharmacy Claims | Rendered Images | Option Year 1 Grand Total |
SLIN 2002AA - Optional Year 2 Base 0 - 2,000,000 Transactions $ - 0 SLIN 2002AB - Optional Year 2 Base 0 - 2,000,000 Transactions $ - 0 SLIN 2002AC - Optional Year 2 Base 0 - 2,000,000 Transactions $ - 0 SLIN 2002AD - Optional Year 2 Base 0 - 2,000,000 Transactions $ - 0 SLIN 2002AE - Optional Year 2 Base 0 - 2,000,000 Transactions $ - 0 500 $ - 0 $ - 0
SLIN 2002AG - OY2 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 2002AH - OY2 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 2002AJ - OY2 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 2002AK - OY2 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 2002AL - OY2 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 2002AM - OY2 Optional Task 1 0 – 5,000,000 Transactions $ - 0 $ - 0
SLIN 2002AN - OY2 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 2002AP - OY2 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 2002AQ - OY2 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 2002AR - OY2 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 2002AS - OY2 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 2002AT - OY2 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 $ - 0
SLIN 2002AU - OY2 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 2002AV - OY2 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 2002AW - OY2 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 2002AX - OY2 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 2002AY - OY2 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 2002AZ - OY2 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 $ - 0
SLIN 2002BA - OY2 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 2002BB - OY2 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 2002BC - OY2 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 2002BD - OY2 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 2002BE - OY2 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 2002BF - OY2 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 $ - 0
| LINE ITEM | CLIN 3001 | Unit | Price | CLIN 3002 | Unit | Price | CLIN 3003 | Unit | Price | CLIN 3004 | Unit | Price | CLIN 3005 | Unit | Price | CLIN 3006 | Unit | Price | CLIN 3002AG | Unit | Price | $ - 0 |
| Transaction Type | CMS-1500 Claims | CMS-1450 Claims | 837 Healthcare Claims | 835 Healthcare Claims | 270/271/275/276/277/278 Claims | Pharmacy Claims | Rendered Images | Option Year 2 Grand Total |
SLIN 3002AA - Optional Year 3 Base 0 - 2,000,000 Transactions $ - 0 SLIN 3002AB - Optional Year 3 Base 0 - 2,000,000 Transactions $ - 0 SLIN 3002AC - Optional Year 3 Base 0 - 2,000,000 Transactions $ - 0 SLIN 3002AD - Optional Year 3 Base 0 - 2,000,000 Transactions $ - 0 SLIN 3002AE - Optional Year 3 Base 0 - 2,000,000 Transactions $ - 0 500 $ - 0 $ - 0
SLIN 3002AG - OY3 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 3002AH - OY3 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 3002AJ - OY3 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 3002AK - OY3 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 3002AL - OY3 Optional Task 1 2,000,000 – 5,000,000 Transactions $ - 0 SLIN 3002AM - OY3 Optional Task 1 0 – 5,000,000 Transactions $ - 0 $ - 0
SLIN 3002AN - OY3 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 3002AP - OY3 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 3002AQ - OY3 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 3002AR - OY3 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 3002AS - OY3 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 SLIN 3002AT - OY3 Optional Task 2 5,000,000 – 10,000,000 Transactions $ - 0 $ - 0
SLIN 3002AU - OY3 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 3002AV - OY3 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 3002AW - OY3 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 3002AX - OY3 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 3002AY - OY3 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 SLIN 3002AZ - OY3 Optional Task 3 10,000,000 – 20,000,000 Transactions $ - 0 $ - 0
SLIN 3002BA - OY3 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 3002BB - OY3 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 3002BC - OY3 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 3002BD - OY3 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 3002BE - OY3 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 SLIN 3002BF - OY3 Optional Task 4 20,000,000 – 30,000,000 Transactions $ - 0 $ - 0
| $ - 0 |
| Option Year 3 Grand Total |
BASE PLUS OPTIONS GRAND TOTAL
$ - 0
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