ATTACHMENT D.1 PRICE SCHEDULE 36C24923R0026 Home Oxygen TVHS Mt Home Memphis VAs Revised 6-30-2023.xlsx

XLSX spreadsheet 298 KB Posted

Attached to
Q999--Home Oxygen Services - Tennessee Valley Healthcare System, James H. Quillen & Memphis VA Medical Centers
Solicitation number
36C24923R0026
Issued by

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Items

Item NumberSLINDescriptionRef CLINCommentInclude Comments in DocumentContract PeriodPop BeginPop EndQuantityUnit of MeasurePackaging MultipleReceipt TypeLine Item IsUnit PriceItem Discount Type NameItem DiscountDate UpdatedAddress1Address2Address3CityStateZipZip4CountryMark ForContact NameContact PhoneContact EmailDelivery DateFOBSpecial InstructionsInclude Instructions/Comments in DocumentPRINCIPAL NAICS CODEPRODUCT/SERVICE CODEUNSPSCSIC CODEMANUFACTURER PART NUMBER (MPN)NATIONAL STOCK NUMBERLOCAL STOCK NUMBERDM DOC IDDELIVERY REF. COUNTERUNIT TEXT/DESCRIPTIONDELIVERY REFERENCEITEM MASTER FILE NUMBEREXPENDABLE/NON-EXPENDABLEQUANTITY REQUESTEDUNIT OF PURCHASE CODEUNIT OF PURCHASE TEXT/DESC.
0001Oxygen concentrator five (5) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/243800MO0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0002Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/243589MO0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0003Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/242201MO0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0004Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/2430MO0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0005Liquid oxygen system refills, pound (lb.), per pound as needed for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/24220LB0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0006Rental of liquid oxygen portable conserving devise: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/2436MO0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0007Contractor owned ventilator rental, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/246MO0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0008Government owned ventilator set-up and monthly assessment (vent patients), includes monthly purchase of supplies and respiratory therapist visit, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/2414MO0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0009H tank rental, each, rental per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/2458MO0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0010H tank refill, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/2417EA0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0011Compressors, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/2410MO0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0012Fire safety valves, purchase as needed, each, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/242058EA0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0013Rental of portable concentrator, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/24151EA0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0014Delivery of government owned property, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/243EA0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0015Rental of ultra-fill system (brand name or equal) VA owned, stationary & portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/2410MO0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0016One time delivery fee for any purchased items, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/2451EA0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0017Equipment check of ultra-filled system (brand name or equal) VA owed, each, per check of equipment, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/243EA0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0018Portable E and/or M6 tank refills, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/2413017EA0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0019Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/24225MO0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
0020Emergency patient visits, each, per visit, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoBase05/01/2304/30/2454EA0QuantityPricedPercent0As requested by service.NONEAs requested for each patient's prescription and specific patient location. Applies to all the line items in this contract.Yes621610Q999
1001Oxygen concentrator five (5) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/253800MO0QuantityPricedPercent0621610Q999
1002Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/253589MO0QuantityPricedPercent0621610Q999
1003Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/252201MO0QuantityPricedPercent0621610Q999
1004Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/2530MO0QuantityPricedPercent0621610Q999
1005Liquid oxygen system refills, pound (lb.), per pound as needed for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/25220LB0QuantityPricedPercent0621610Q999
1006Rental of liquid oxygen portable conserving devise: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/2536MO0QuantityPricedPercent0621610Q999
1007Contractor owned ventilator rental, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/256MO0QuantityPricedPercent0621610Q999
1008Government owned ventilator set-up and monthly assessment (vent patients), includes monthly purchase of supplies and respiratory therapist visit, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/2514MO0QuantityPricedPercent0621610Q999
1009H tank rental, each, rental per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/2558MO0QuantityPricedPercent0621610Q999
1010H tank refill, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/2517EA0QuantityPricedPercent0621610Q999
1011Compressors, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/2510MO0QuantityPricedPercent0621610Q999
1012Fire safety valves, purchase as needed, each, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/252058EA0QuantityPricedPercent0621610Q999
1013Rental of portable concentrator, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/25151EA0QuantityPricedPercent0621610Q999
1014Delivery of government owned property, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/253EA0QuantityPricedPercent0621610Q999
1015Rental of ultra-fill system (brand name or equal) VA owned, stationary & portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/2510MO0QuantityPricedPercent0621610Q999
1016One time delivery fee for any purchased items, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/2551EA0QuantityPricedPercent0621610Q999
1017Equipment check of ultra-filled system (brand name or equal) VA owed, each, per check of equipment, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/253EA0QuantityPricedPercent0621610Q999
1018Portable E and/or M6 tank refills, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/2513017EA0QuantityPricedPercent0621610Q999
1019Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/25225MO0QuantityPricedPercent0621610Q999
1020Emergency patient visits, each, per visit, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 105/01/2404/30/2554EA0QuantityPricedPercent0621610Q999
2001Oxygen concentrator five (5) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/263800MO0QuantityPricedPercent0621610Q999
2002Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/263589MO0QuantityPricedPercent0621610Q999
2003Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/262201MO0QuantityPricedPercent0621610Q999
2004Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/2630MO0QuantityPricedPercent0621610Q999
2005Liquid oxygen system refills, pound (lb.), per pound as needed for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/26220LB0QuantityPricedPercent0621610Q999
2006Rental of liquid oxygen portable conserving devise: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/2636MO0QuantityPricedPercent0621610Q999
2007Contractor owned ventilator rental, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/266MO0QuantityPricedPercent0621610Q999
2008Government owned ventilator set-up and monthly assessment (vent patients), includes monthly purchase of supplies and respiratory therapist visit, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/2614MO0QuantityPricedPercent0621610Q999
2009H tank rental, each, rental per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/2658MO0QuantityPricedPercent0621610Q999
2010H tank refill, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/2617EA0QuantityPricedPercent0621610Q999
2011Compressors, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/2610MO0QuantityPricedPercent0621610Q999
2012Fire safety valves, purchase as needed, each, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/262058EA0QuantityPricedPercent0621610Q999
2013Rental of portable concentrator, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/26151EA0QuantityPricedPercent0621610Q999
2014Delivery of government owned property, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/263EA0QuantityPricedPercent0621610Q999
2015Rental of ultra-fill system (brand name or equal) VA owned, stationary & portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/2610MO0QuantityPricedPercent0621610Q999
2016One time delivery fee for any purchased items, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/2651EA0QuantityPricedPercent0621610Q999
2017Equipment check of ultra-filled system (brand name or equal) VA owed, each, per check of equipment, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/263EA0QuantityPricedPercent0621610Q999
2018Portable E and/or M6 tank refills, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/2613017EA0QuantityPricedPercent0621610Q999
2019Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/26225MO0QuantityPricedPercent0621610Q999
2020Emergency patient visits, each, per visit, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 205/01/2504/30/2654EA0QuantityPricedPercent0621610Q999
3001Oxygen concentrator five (5) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/273800MO0QuantityPricedPercent0621610Q999
3002Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/273589MO0QuantityPricedPercent0621610Q999
3003Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/272201MO0QuantityPricedPercent0621610Q999
3004Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/2730MO0QuantityPricedPercent0621610Q999
3005Liquid oxygen system refills, pound (lb.), per pound as needed for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/27220LB0QuantityPricedPercent0621610Q999
3006Rental of liquid oxygen portable conserving devise: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/2736MO0QuantityPricedPercent0621610Q999
3007Contractor owned ventilator rental, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/276MO0QuantityPricedPercent0621610Q999
3008Government owned ventilator set-up and monthly assessment (vent patients), includes monthly purchase of supplies and respiratory therapist visit, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/2714MO0QuantityPricedPercent0621610Q999
3009H tank rental, each, rental per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/2758MO0QuantityPricedPercent0621610Q999
3010H tank refill, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/2717EA0QuantityPricedPercent0621610Q999
3011Compressors, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/2710MO0QuantityPricedPercent0621610Q999
3012Fire safety valves, purchase as needed, each, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/272058EA0QuantityPricedPercent0621610Q999
3013Rental of portable concentrator, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/27151EA0QuantityPricedPercent0621610Q999
3014Delivery of government owned property, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/273EA0QuantityPricedPercent0621610Q999
3015Rental of ultra-fill system (brand name or equal) VA owned, stationary & portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/2710MO0QuantityPricedPercent0621610Q999
3016One time delivery fee for any purchased items, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/2751EA0QuantityPricedPercent0621610Q999
3017Equipment check of ultra-filled system (brand name or equal) VA owed, each, per check of equipment, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/273EA0QuantityPricedPercent0621610Q999
3018Portable E and/or M6 tank refills, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/2713017EA0QuantityPricedPercent0621610Q999
3019Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/27225MO0QuantityPricedPercent0621610Q999
3020Emergency patient visits, each, per visit, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 305/01/2604/30/2754EA0QuantityPricedPercent0621610Q999
4001Oxygen concentrator five (5) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/283800MO0QuantityPricedPercent0621610Q999
4002Rental of portable "E" system and/or M-6 system, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/283589MO0QuantityPricedPercent0621610Q999
4003Rental of oxygen conserving device: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/282201MO0QuantityPricedPercent0621610Q999
4004Rental of liquid oxygen system, stationary and portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/2830MO0QuantityPricedPercent0621610Q999
4005Liquid oxygen system refills, pound (lb.), per pound as needed for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/28220LB0QuantityPricedPercent0621610Q999
4006Rental of liquid oxygen portable conserving devise: including demand valve, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/2836MO0QuantityPricedPercent0621610Q999
4007Contractor owned ventilator rental, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/286MO0QuantityPricedPercent0621610Q999
4008Government owned ventilator set-up and monthly assessment (vent patients), includes monthly purchase of supplies and respiratory therapist visit, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/2814MO0QuantityPricedPercent0621610Q999
4009H tank rental, each, rental per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/2858MO0QuantityPricedPercent0621610Q999
4010H tank refill, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/2817EA0QuantityPricedPercent0621610Q999
4011Compressors, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/2810MO0QuantityPricedPercent0621610Q999
4012Fire safety valves, purchase as needed, each, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/282058EA0QuantityPricedPercent0621610Q999
4013Rental of portable concentrator, portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/28151EA0QuantityPricedPercent0621610Q999
4014Delivery of government owned property, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/283EA0QuantityPricedPercent0621610Q999
4015Rental of ultra-fill system (brand name or equal) VA owned, stationary & portable, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/2810MO0QuantityPricedPercent0621610Q999
4016One time delivery fee for any purchased items, each, per delivery, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/2851EA0QuantityPricedPercent0621610Q999
4017Equipment check of ultra-filled system (brand name or equal) VA owed, each, per check of equipment, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/283EA0QuantityPricedPercent0621610Q999
4018Portable E and/or M6 tank refills, each, per refill, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/2813017EA0QuantityPricedPercent0621610Q999
4019Rental of oxygen concentrator ten (10) liter, stationary, each, per month, per unit for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/28225MO0QuantityPricedPercent0621610Q999
4020Emergency patient visits, each, per visit, per patient for patients of the TVHS, Mt Home and Memphis VAs.NoOption 405/01/2704/30/2854EA0QuantityPricedPercent0621610Q999

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