36C24918Q0291-002.xlsx
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- Radiopharmaceuticals
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- 36C24918Q0291
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36C24918Q0291 626 RADIOPHARMACEUTICALS 1.xlsx
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| 36C24918Q0291-00001000.docx | DOCX document | |
| 36C24918Q0291-000.docx | DOCX document | |
| 36C24918Q0291-001.docx | DOCX document |
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Base Year
| Option Year Four Period of Performance: Oct 01, 2021 to Sept. 30, 2022 | ||||
| Base Year Period of Performance: Oct 01, 2018 to Sept. 30, 2019 | ||||
| CLIN | CLIN Supplies | EST QTY | UNIT COST | TOTAL COST |
| 0001 | Technetium LEU-99m MDP patient dose, 15-30mCi | 455 | ||
| 0002 | Technetium LEU 99m-DTPA, patient dose 30-45mCi | 87 | ||
| 0003 | Technetium LEU-99m Pertechnetate patient dose, 12 to 40 mCi | 267 | ||
| 0004 | Technetium LEU-99m MAA patient dose, 4 to 5 mCi | 108 | ||
| 0005 | Technetium LEU-99mTc Sulfur Colloid patient dose, 5-12 mCi | 72 | ||
| 0006 | Technetium LEU- 99m Mebrofenin patient dose, 4 to 6 mCi | 112 | ||
| 0007 | Technetium LEU 99m Pertechnetate 200mCi, dose cal linearity | 4 | ||
| 0008 | Technetium LEU -99m MAG3 patient dose, 5 to 10 mCi | 61 | ||
| 0009 | WBC Label (indium 111 OXINE) | 1 | ||
| 0010 | WBC label (LEU ) 99mTc - HMPAO | 0 | ||
| 0011 | Technetium LEU -99m Tetrofosmin unit-dose | 7975 | ||
| 0012 | Technetium LEU-99m, pertechnetate, patient dose, 1 to 11 mCi | 16 | ||
| 0013 | Technetium LEU 99m Sulfur Colloid, 200 to 1000 uCi | 78 | ||
| 0014 | Technetium LEU 99mTc- Sestamibi, patient dose, 8 to 30 mCi | 60 | ||
| 0015 | Thallium-201 per mCi | 168 | ||
| 0016 | Gallium-67 patient dose, per mCi | 0 | ||
| 0017 | I-131 radioactive Uptake Capsule, patient dose 15 to 30 uCi | 15 | ||
| 0018 | I-131 Capsule patient dose 1-6mCi | 10 | ||
| 0019 | I-131 Therapy capsule, per mCi, ea addn mCi above 6 mCi, | 10 | ||
| 0020 | 111-Indium DTPA 1.5mCi vial | 2 | ||
| 0021 | In111 Octreoscan | 10 | ||
| 0022 | I-123 Whole Body Scan 4 mCi | 1 | ||
| 0023 | I-123 capsule, 100uCi | 153 | ||
| 0024 | I-123 Dx capsule 200 uCi | 152 | ||
| 0025 | I-123 MIBG per dose 10 mCi | 2 | ||
| 0026 | Biodose dose management system, (York) Annual maintenance | 1 | ||
| 0027 | Biodose dose management system, (Nashville) Annual maintenance | 1 | ||
| 0028 | Leuckocyte prep kit | 1 | ||
| 0029 | Emergency Call Out (after hours) | 7 | ||
| ESTIMATED FOR BASE YEAR |
Op YR 1
| Option Year Four Period of Performance: Oct 01, 2021 to Sept. 30, 2022 | ||||
| Option Year One Period of Performance: Oct 01, 2019 to Sept. 30, 2020 | ||||
| CLIN | CLIN Supplies | EST QTY | UNIT COST | TOTAL COST |
| 1001 | Technetium LEU-99m MDP patient dose, 15-30mCi | 455 | ||
| 1002 | Technetium LEU 99m-DTPA, patient dose 30-45mCi | 87 | ||
| 1003 | Technetium LEU-99m Pertechnetate patient dose, 12 to 40 mCi | 267 | ||
| 1004 | Technetium LEU-99m MAA patient dose, 4 to 5 mCi | 108 | ||
| 1005 | Technetium LEU-99mTc Sulfur Colloid patient dose, 5-12 mCi | 72 | ||
| 1006 | Technetium LEU- 99m Mebrofenin patient dose, 4 to 6 mCi | 112 | ||
| 1007 | Technetium LEU 99m Pertechnetate 200mCi, dose cal linearity | 4 | ||
| 1008 | Technetium LEU -99m MAG3 patient dose, 5 to 10 mCi | 61 | ||
| 1009 | WBC Label (indium 111 OXINE) | 1 | ||
| 1010 | WBC label (LEU ) 99mTc - HMPAO | 0 | ||
| 1011 | Technetium LEU -99m Tetrofosmin unit-dose | 7975 | ||
| 1012 | Technetium LEU-99m, pertechnetate, patient dose, 1 to 11 mCi | 16 | ||
| 1013 | Technetium LEU 99m Sulfur Colloid, 200 to 1000 uCi | 78 | ||
| 1014 | Technetium LEU 99mTc- Sestamibi, patient dose, 8 to 30 mCi | 60 | ||
| 1015 | Thallium-201 per mCi | 168 | ||
| 1016 | Gallium-67 patient dose, per mCi | 0 | ||
| 1017 | I-131 radioactive Uptake Capsule, patient dose 15 to 30 uCi | 15 | ||
| 1018 | I-131 Capsule patient dose 1-6mCi | 10 | ||
| 1019 | I-131 Therapy capsule, per mCi, ea addn mCi above 6 mCi, | 10 | ||
| 1020 | 111-Indium DTPA 1.5mCi vial | 2 | ||
| 1021 | In111 Octreoscan | 10 | ||
| 1022 | I-123 Whole Body Scan 4 mCi | 1 | ||
| 1023 | I-123 capsule, 100uCi | 153 | ||
| 1024 | I-123 Dx capsule 200 uCi | 152 | ||
| 1025 | I-123 MIBG per dose 10 mCi | 2 | ||
| 1026 | Biodose dose management system, (York) Annual maintenance | 1 | ||
| 1027 | Biodose dose management system, (Nashville) Annual maintenance | 1 | ||
| 1028 | Leuckocyte prep kit | 1 | ||
| 1029 | Emergency Call Out (after hours) | 7 | ||
| ESTIMATED TOTAL OPTION YEAR 1 |
OP YT 2
| Option Year Four Period of Performance: Oct 01, 2021 to Sept. 30, 2022 | ||||
| Option Year Two Period of Performance: Oct 01, 2020 to Sept. 30, 2021 | ||||
| CLIN | CLIN Supplies | EST QTY | UNIT COST | TOTAL COST |
| 2001 | Technetium LEU-99m MDP patient dose, 15-30mCi | 455 | ||
| 2002 | Technetium LEU 99m-DTPA, patient dose 30-45mCi | 87 | ||
| 2003 | Technetium LEU-99m Pertechnetate patient dose, 12 to 40 mCi | 267 | ||
| 2004 | Technetium LEU-99m MAA patient dose, 4 to 5 mCi | 108 | ||
| 2005 | Technetium LEU-99mTc Sulfur Colloid patient dose, 5-12 mCi | 72 | ||
| 2006 | Technetium LEU- 99m Mebrofenin patient dose, 4 to 6 mCi | 112 | ||
| 2007 | Technetium LEU 99m Pertechnetate 200mCi, dose cal linearity | 4 | ||
| 2008 | Technetium LEU -99m MAG3 patient dose, 5 to 10 mCi | 61 | ||
| 2009 | WBC Label (indium 111 OXINE) | 1 | ||
| 2010 | WBC label (LEU ) 99mTc - HMPAO | 0 | ||
| 2011 | Technetium LEU -99m Tetrofosmin unit-dose | 7975 | ||
| 2012 | Technetium LEU-99m, pertechnetate, patient dose, 1 to 11 mCi | 16 | ||
| 2013 | Technetium LEU 99m Sulfur Colloid, 200 to 1000 uCi | 78 | ||
| 2014 | Technetium LEU 99mTc- Sestamibi, patient dose, 8 to 30 mCi | 60 | ||
| 2015 | Thallium-201 per mCi | 168 | ||
| 2016 | Gallium-67 patient dose, per mCi | 0 | ||
| 2017 | I-131 radioactive Uptake Capsule, patient dose 15 to 30 uCi | 15 | ||
| 2018 | I-131 Capsule patient dose 1-6mCi | 10 | ||
| 2019 | I-131 Therapy capsule, per mCi, ea addn mCi above 6 mCi, | 10 | ||
| 2020 | 111-Indium DTPA 1.5mCi vial | 2 | ||
| 2021 | In111 Octreoscan | 10 | ||
| 2022 | I-123 Whole Body Scan 4 mCi | 1 | ||
| 2023 | I-123 capsule, 100uCi | 153 | ||
| 2024 | I-123 Dx capsule 200 uCi | 152 | ||
| 2025 | I-123 MIBG per dose 10 mCi | 2 | ||
| 2026 | Biodose dose management system, (York) Annual maintenance | 1 | ||
| 2027 | Biodose dose management system, (Nashville) Annual maintenance | 1 | ||
| 2028 | Leuckocyte prep kit | 1 | ||
| 2029 | Emergency Call Out (after hours) | 7 | ||
| ESTIMATED TOTAL OPTION YEAR 2 |
OP YR 3
| Option Year Four Period of Performance: Oct 01, 2021 to Sept. 30, 2022 | ||||
| Option Year Three Period of Performance: Oct 01, 2021 to Sept. 30, 2022 | ||||
| CLIN | CLIN Supplies | EST QTY | UNIT COST | TOTAL COST |
| 3001 | Technetium LEU-99m MDP patient dose, 15-30mCi | 455 | ||
| 3002 | Technetium LEU 99m-DTPA, patient dose 30-45mCi | 87 | ||
| 3003 | Technetium LEU-99m Pertechnetate patient dose, 12 to 40 mCi | 267 | ||
| 3004 | Technetium LEU-99m MAA patient dose, 4 to 5 mCi | 108 | ||
| 3005 | Technetium LEU-99mTc Sulfur Colloid patient dose, 5-12 mCi | 72 | ||
| 3006 | Technetium LEU- 99m Mebrofenin patient dose, 4 to 6 mCi | 112 | ||
| 3007 | Technetium LEU 99m Pertechnetate 200mCi, dose cal linearity | 4 | ||
| 3008 | Technetium LEU -99m MAG3 patient dose, 5 to 10 mCi | 61 | ||
| 3009 | WBC Label (indium 111 OXINE) | 1 | ||
| 3010 | WBC label (LEU ) 99mTc - HMPAO | 0 | ||
| 3011 | Technetium LEU -99m Tetrofosmin unit-dose | 7975 | ||
| 3012 | Technetium LEU-99m, pertechnetate, patient dose, 1 to 11 mCi | 16 | ||
| 3013 | Technetium LEU 99m Sulfur Colloid, 200 to 1000 uCi | 78 | ||
| 3014 | Technetium LEU 99mTc- Sestamibi, patient dose, 8 to 30 mCi | 60 | ||
| 3015 | Thallium-201 per mCi | 168 | ||
| 3016 | Gallium-67 patient dose, per mCi | 0 | ||
| 3017 | I-131 radioactive Uptake Capsule, patient dose 15 to 30 uCi | 15 | ||
| 3018 | I-131 Capsule patient dose 1-6mCi | 10 | ||
| 3019 | I-131 Therapy capsule, per mCi, ea addn mCi above 6 mCi, | 10 | ||
| 3020 | 111-Indium DTPA 1.5mCi vial | 2 | ||
| 3021 | In111 Octreoscan | 10 | ||
| 3022 | I-123 Whole Body Scan 4 mCi | 1 | ||
| 3023 | I-123 capsule, 100uCi | 153 | ||
| 3024 | I-123 Dx capsule 200 uCi | 152 | ||
| 3025 | I-123 MIBG per dose 10 mCi | 2 | ||
| 3026 | Biodose dose management system, (York) Annual maintenance | 1 | ||
| 3027 | Biodose dose management system, (Nashville) Annual maintenance | 1 | ||
| 3028 | Leuckocyte prep kit | 1 | ||
| 3029 | Emergency Call Out (after hours) | 7 | ||
| ESTIMATED TOTAL OPTION YEAR 3 |
OP YR 4
| Option Year Four Period of Performance: Oct 01, 2021 to Sept. 30, 2022 | ||||
| Option Year Four Period of Performance: Oct 01, 2022 to Sept. 30, 2023 | ||||
| CLIN | CLIN Supplies | EST QTY | UNIT COST | TOTAL COST |
| 4001 | Technetium LEU-99m MDP patient dose, 15-30mCi | 455 | ||
| 4002 | Technetium LEU 99m-DTPA, patient dose 30-45mCi | 87 | ||
| 4003 | Technetium LEU-99m Pertechnetate patient dose, 12 to 40 mCi | 267 | ||
| 4004 | Technetium LEU-99m MAA patient dose, 4 to 5 mCi | 108 | ||
| 4005 | Technetium LEU-99mTc Sulfur Colloid patient dose, 5-12 mCi | 72 | ||
| 4006 | Technetium LEU- 99m Mebrofenin patient dose, 4 to 6 mCi | 112 | ||
| 4007 | Technetium LEU 99m Pertechnetate 200mCi, dose cal linearity | 4 | ||
| 4008 | Technetium LEU -99m MAG3 patient dose, 5 to 10 mCi | 61 | ||
| 4009 | WBC Label (indium 111 OXINE) | 1 | ||
| 4010 | WBC label (LEU ) 99mTc - HMPAO | 0 | ||
| 4011 | Technetium LEU -99m Tetrofosmin unit-dose | 7975 | ||
| 4012 | Technetium LEU-99m, pertechnetate, patient dose, 1 to 11 mCi | 16 | ||
| 4013 | Technetium LEU 99m Sulfur Colloid, 200 to 1000 uCi | 78 | ||
| 4014 | Technetium LEU 99mTc- Sestamibi, patient dose, 8 to 30 mCi | 60 | ||
| 4015 | Thallium-201 per mCi | 168 | ||
| 4016 | Gallium-67 patient dose, per mCi | 0 | ||
| 4017 | I-131 radioactive Uptake Capsule, patient dose 15 to 30 uCi | 15 | ||
| 4018 | I-131 Capsule patient dose 1-6mCi | 10 | ||
| 4019 | I-131 Therapy capsule, per mCi, ea addn mCi above 6 mCi, | 10 | ||
| 4020 | 111-Indium DTPA 1.5mCi vial | 2 | ||
| 4021 | In111 Octreoscan | 10 | ||
| 4022 | I-123 Whole Body Scan 4 mCi | 1 | ||
| 4023 | I-123 capsule, 100uCi | 153 | ||
| 4024 | I-123 Dx capsule 200 uCi | 152 | ||
| 4025 | I-123 MIBG per dose 10 mCi | 2 | ||
| 4026 | Biodose dose management system, (York) Annual maintenance | 1 | ||
| 4027 | Biodose dose management system, (Nashville) Annual maintenance | 1 | ||
| 4028 | Leuckocyte prep kit | 1 | ||
| 4029 | Emergency Call Out (after hours) | 7 | ||
| ESTIMATED TOTAL OPTION YEAR 4 |
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