UPDATED 36C25025R0061 LineItems 10 22 25.xlsx
XLSX spreadsheet 584 KB Posted
- Attached to
- W065--VISN10 Home 02 Services (IN & MI)
- Solicitation number
- 36C25025R0061
About this file
This document is a detailed Line Item Information spreadsheet for VA VISN 10 Home Oxygen Services contract (Solicitation Number 36C25025R0061), covering home oxygen and respiratory equipment rental services for Veterans in Indiana and Michigan. The comprehensive spreadsheet outlines multiple line items for medical equipment rentals across six VA Medical Centers: Ann Arbor, Battle Creek, Detroit, Indianapolis, NIHCS Fort Wayne/Marion, and Aleda E. Lutz Saginaw.
Key equipment categories include oxygen concentrators (with various flow rates), portable oxygen systems, oxygen cylinders, respiratory equipment like ventilators, suction machines, nebulizers, and supplementary items such as masks, batteries, and medical accessories. The contract spans two five-year periods (2026-2030), with line items detailing specific equipment types, quantities, and rental terms. Each medical center has unique equipment requirements, with quantities varying by location. The contract emphasizes providing comprehensive respiratory support for Veterans, including backup systems, portable options, and specialized medical equipment for patients with complex respiratory needs.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 36C25025R0061 0005.docx | DOCX document | |
| UPDATED 36C25025R0061 LineItems 12 12 25.xlsx | XLSX spreadsheet | |
| 36C25025R0061 0004.docx | DOCX document | |
| UPDATED 36C25025R0061 LineItems 11 18 25.xlsx | XLSX spreadsheet | |
| 36C25025R0061 0003.docx | DOCX document | |
| 36C25025R0061 0002.docx | DOCX document | |
| 36C25025R0061 0001.docx | DOCX document | |
| 36C25025R0061 LineItems 9 30 25.xlsx | XLSX spreadsheet | |
| SCHEDULE.xlsx | XLSX spreadsheet | |
| 36C25025R0061.docx | DOCX document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Action Line Item Information
| Action Type Name | Primary ID | Secondary ID | Mod Number | Title | Order Discount Type Name | Order Discount Type | Order Discount | |
| RFP | 36C25024R0147 | VISN10 Home 02 Services | ||||||
| (IN & MI) | Percent | 0 |
KB Version: FY24.09A
Items
| Item Number | SLIN | Description | Ref CLIN | Comment | Include Comments in Document | Contract Period | Pop Begin | Pop End | Quantity | Unit of Measure | Packaging Multiple | Receipt Type | Line Item Is | Unit Price | Item Discount Type Name | Item Discount | Date Updated | Address1 | Address2 | Address3 | City | State | HCPC | Zip4 | Country | Mark For | Contact Name | Contact Phone | Contact Email | Delivery Date | FOB | Special Instructions | Include Instructions/Comments in Document | Include Data Values in Document | PRINCIPAL NAICS CODE | PRODUCT/SERVICE CODE | UNSPSC | SIC CODE | MANUFACTURER PART NUMBER (MPN) | NATIONAL STOCK NUMBER | LOCAL STOCK NUMBER | DM DOC ID | DELIVERY REF. COUNTER | UNIT TEXT/DESCRIPTION | DELIVERY REFERENCE | ITEM MASTER FILE NUMBER | EXPENDABLE/NON-EXPENDABLE | QUANTITY REQUESTED | |
| 0001 | VA Ann Arbor Healthcare System - 2215 Fuller Road, Ann Arbor, MI 48105 | None | No | 0 | Quantity | NSP | 0 | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||||||
| 0001 | AA | Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified). Concentrator will have flow rate capacity up to 5LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 160 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | AB | Rental concentrator with backup system consisting of compressed gas source, regulator, stand (nasal cannula or mask and humidifier when specified). Concentrator must have flow rate capacity up to 10 LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 50 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | AC | Rental Concentrator with Portable Gaseous Oxygen System, home compressor used to fill portable oxygen cylinders- (2) self-filling -type oxygen cylinders, integrated oxygen conserving device, regulator, flow meter, humidifier, cannula or mask, tubing, cylinder carrier. Concentrator will have flow rate capacity up to 5 LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 200 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | AD | Rental Concentrator with Portable Gaseous Oxygen System, home compressor used to fill portable oxygen cylinders- (2) self-filling -type oxygen cylinders, integrated oxygen conserving device, regulator, flow meter, humidifier, cannula or mask, tubing, cylinder carrier. Concentrator will have flow rate capacity up to 10 LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 75 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | AE | Refillable – type oxygen cylinder- Rental of additional re-fillable cylinders for patients who are assessed to have an extended need for oxygen portability due to high liter flow and/or increased patient activity outside of the home. E0443 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 500 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | B | Cylinder, size M or H set-up consisting of regulator, flow meter, safety stand, humidifier and disposable supplies (emergency backup system or as primary) NOTICE: This shall be invoiced per cylinder provided to the patient. This is NOT a recurring rental PRICE, charges will only incur when an empty cylinder is refilled or replaced with a full cylinder (reference CLIN C regarding refills or replacements). SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment; backup system is provided at no cost | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0424 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | C | Cylinder, size M or H refill/replacement (Backup/Primary) E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment; backup system is provided at no cost | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0424 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | D | Portable system ONLY: prescription does not include concentrator consists of “E”, “D”, “B” (M6), or “C” (M9) size aluminum (or equivalent weight metal) cylinder with regulator, flow meter, handcart, pouch and disposable supplies. NOTICE: This shall be | |||||||||||||||||||||||||||||||||||||||||||||||
| invoiced per cylinder provided to the patient. This is NOT a recurring rental PRICE, charges will only incur when an empty cylinder is refilled or replaced (reference clins E-H regarding refills). SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 50 | EA | 0 | Quantity | Priced | Percent | 0 | E0431 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||||
| 0001 | E | Cylinder, size “E” refill/replacement for CLIN D above; Aluminum (or metal of equivalent weight or less) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 40 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | F | Cylinder, size “D” (M15) refill/replacement for CLIN D; Aluminum (or metal of equivalent weight or less) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 30 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | G | Cylinder, size “B” (M6) refill/replacement for CLIN D; Aluminum (or metal of equivalent weight or less) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 20 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | H | Cylinder, size “C” refill/replacement for CLIN D; Aluminum (or metal of equivalent weight) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | I | Demand Nasal Cannula (e.g. Oximeter) Reservoir or pendant/equivalent. VA111 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | VA111 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | J | Removed | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 0 | EA | 0 | Quantity | Priced | Percent | 0 | VA111 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | K | Rental liquid oxygen system (90 –100 lbs.) stationary reservoir per patient. E0439; AND Rental portable liquid oxygen system per patient E0434 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0439 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | L | Liquid oxygen per pound for portable liquid oxygen system under Item K. E0444 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0444 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | M | Delivery for re-supply and/or relocation of equipment due to change in patient’s residence | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||
| 0001 | NA | Portable Concentrator- Rental portable oxygen concentrator E1392 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 230 | EA | 0 | Quantity | Priced | Percent | 0 | E1392 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | NB | Extra Battery for Portable Oxygen Concentrator – Temporary rental to be used only during patient travel, when extended time away from a permanent power source is expected. E1356 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 100 | EA | 0 | Quantity | Priced | Percent | 0 | E1356 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | O | Overnight Oximeter- Rental oximeter for overnight oximetry testing E0445 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | E0445 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | P | Suction Machine- Rental suction machine E0600 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 50 | EA | 0 | Quantity | Priced | Percent | 0 | E0600 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | Q | Compressor 50 psi - Rental 50 psi air compressor E0565 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 20 | EA | 0 | Quantity | Priced | Percent | 0 | E0565 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | R | Ventilator Negative Pressure ventilator; portable or stationary; Rental negative pressure ventilator E0465 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0465 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | S | Pressure support ventilator with volume control mode; may include pressure control mode; Rental pressure support ventilator | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 50 | EA | 0 | Quantity | Priced | Percent | 0 | E0465 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | T | Oxygen Thermal Fuse (Fire Safe Cannula)- fuse to isolate oxygen supply in case of fire | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 50 | EA | 0 | Quantity | Priced | Percent | 0 | VA186 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | U | Closed Suction Catheters – Contractor shall provide closed suction catheters to each ventilator patient each month, Catheters shall be replaced as needed during monthly visit by contractor RT. A4605 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | A4605 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | V | Heated Humidifier- The contractor shall provide a heated humidifier to Veterans receiving mechanical ventilation to provide optimal levels of heat and moisture to the patient’s airway. | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 35 | EA | 0 | Quantity | Priced | Percent | 0 | E0562 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | W | Portable Suction Machine- The contractor shall provide a portable suction machine equipped with an internal battery for use during transport to Veterans receiving mechanical ventilation only E0600 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 50 | EA | 0 | Quantity | Priced | Percent | 0 | E0600 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | X | Nebulizer with Compressor- The contractor will provide a nebulizer with compressor to ventilator patients only, as ordered by the VA. MONTHLY PRICE shall include spring loaded T-adapter, neb cups, tubing, masks, trach masks. E0570 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0570 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | Y | Tracheostomy care supplies – The contractor shall provide supplies needed to properly clean and maintain trach and stoma to ventilator patients only. These supplies shall include, tracheostomy drain sponges A6402, basic tracheostomy care kits A4629, 3ml UNIT dose normal saline A4649, cuffed and uncuffed tracheostomy tubes A7521, A7520, tracheostomy inner cannulas A4623 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||
| 0001 | Z | Inline HME- The contractor shall provide an inline heated moisture exchanger (HME) to Veterans receiving noninvasive mechanical ventilation in order to provide optimal levels of heat and moisture to the patient’s airway. A4483 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | A4483 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | Z1 | PAP Pressure Valve- Contractor shall furnish a Positive Airway Pressure (PAP) Valve to each Veteran on nocturnal oxygen bled into a Positive Airway Pressure (PAP) Device when ordered by the VAMC. E1399 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E1399 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | Z2 | Variable concentration mask, (such as oxytrach mask, oxymask, or like mask) - The contractor shall provide a variable concentration mask to Veterans, as ordered by VA Medical Center Staff. This shall include the mask and all mask components | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 15 | EA | 0 | Quantity | Priced | Percent | 0 | A4620 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | Z3 | Rental Mouthpiece Ventilation (e.g., sip n puff, easyspeak) to include all disposable accessories required | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 15 | EA | 0 | Quantity | Priced | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||
| 0001 | Z4 | Combination Oral/Nasal Mask to Veterans receiving non-invasive mechanical ventilation. This item is to be provided to ventilator patients only. | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | A7027 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | Z5 | Full Face PAP Mask - The contractor shall provide a full face mask to Veterans receiving non-invasive mechanical ventilation. This item is to be provided to ventilator patients only. | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | A7030 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0001 | Z6 | Cough Stimulating Device - Notice this MONTHLY PRICE shall include all components required for operation of the device, both disposable and non-disposable components. | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | E0482 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | Battle Creek VA Medical Center - 5500 Armstrong Rd. Battle Creek, MI 49037 | No | 0 | Quantity | NSP | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||||||||
| 0002 | AA | Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified). Concentrator will have flow rate capacity up to 5LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 200 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | AB | Rental concentrator with backup system consisting of compressed gas source, regulator, stand (nasal cannula or mask and humidifier when specified). Concentrator must have flow rate capacity up to 10 LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 50 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | AC | Rental Concentrator with Portable Gaseous Oxygen System, home compressor used to fill portable oxygen cylinders- (2) self-filling -type oxygen cylinders, integrated oxygen conserving device, regulator, flow meter, humidifier, cannula or mask, tubing, cylinder carrier. Concentrator will have flow rate capacity up to 5 LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 200 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | AD | Rental Concentrator with Portable Gaseous Oxygen System, home compressor used to fill portable oxygen cylinders- (2) self-filling -type oxygen cylinders, integrated oxygen conserving device, regulator, flow meter, humidifier, cannula or mask, tubing, cylinder carrier. Concentrator will have flow rate capacity up to 10 LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 150 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | AE | Refillable – type oxygen cylinder- Rental of additional re-fillable cylinders for patients who are assessed to have an extended need for oxygen portability due to high liter flow and/or increased patient activity outside of the home. E0443 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 700 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | B | Cylinder, size M or H set-up consisting of regulator, flow meter, safety stand, humidifier and disposable supplies (emergency backup system or as primary) NOTICE: This shall be invoiced per cylinder provided to the patient. This is NOT a recurring rental PRICE, charges will only incur when an empty cylinder is refilled or replaced with a full cylinder (reference CLIN C regarding refills or replacements). SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment; backup system is provided at no cost | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | E0424 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | C | Cylinder, size M or H refill/replacement (Backup/Primary) E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment; backup system is provided at no cost | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0424 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | D | Portable system ONLY: prescription does not include concentrator consists of “E”, “D”, “B” (M6), or “C” (M9) size aluminum (or equivalent weight metal) cylinder with regulator, flow meter, handcart, pouch and disposable supplies. NOTICE: This shall be | |||||||||||||||||||||||||||||||||||||||||||||||
| invoiced per cylinder provided to the patient. This is NOT a recurring rental PRICE, charges will only incur when an empty cylinder is refilled or replaced (reference clins E-H regarding refills). SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 15 | EA | 0 | Quantity | Priced | Percent | 0 | E0431 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||||
| 0002 | E | Cylinder, size “E” refill/replacement for Item D above; Aluminum (or metal of equivalent weight or less) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 40 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | F | Cylinder, size “D” (M15) refill/replacement for Item D above. Aluminum (or metal of equivalent weight or less) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 30 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | G | Cylinder, size “B” (M6) refill/replacement for Item D above; Aluminum (or metal of equivalent weight or less) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 20 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | H | Cylinder, size “C” refill/replacement for Item D above; Aluminum (or metal of equivalent weight) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | I | Demand Nasal Cannula (e.g. Oximeter) Reservoir or pendant/equivalent. VA111 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | VA111 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | J | Removed | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 0 | EA | 0 | Quantity | Priced | Percent | 0 | VA111 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | K | Rental liquid oxygen system (90 –100 lbs.) stationary reservoir per patient. E0439; AND Rental portable liquid oxygen system per patient E0434 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0439 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | L | Liquid oxygen per pound for portable liquid oxygen system under Item K. E0444 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0444 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | M | Delivery for re-supply and/or relocation of equipment due to change in patient’s residence | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||
| 0002 | NA | Portable Concentrator- Rental portable oxygen concentrator E1392 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 250 | EA | 0 | Quantity | Priced | Percent | 0 | E1392 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | NB | Extra Battery for Portable Oxygen Concentrator – Temporary rental to be used only during patient travel, when extended time away from a permanent power source is expected. E1356 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 80 | EA | 0 | Quantity | Priced | Percent | 0 | E1356 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | O | Overnight Oximeter- Rental oximeter for overnight oximetry testing E0445 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 15 | EA | 0 | Quantity | Priced | Percent | 0 | E0445 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | P | Suction Machine- Rental suction machine E0600 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 20 | EA | 0 | Quantity | Priced | Percent | 0 | E0600 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | Q | Compressor 50 psi - Rental 50 psi air compressor E0565 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 20 | EA | 0 | Quantity | Priced | Percent | 0 | E0565 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | R | Ventilator Negative Pressure ventilator; portable or stationary; Rental negative pressure ventilator E0465 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0465 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | S | Pressure support ventilator with volume control mode; may include pressure control mode; Rental pressure support ventilator | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 15 | EA | 0 | Quantity | Priced | Percent | 0 | E0465 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | T | Oxygen Thermal Fuse (Fire Safe Cannula)- fuse to isolate oxygen supply in case of fire | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 60 | EA | 0 | Quantity | Priced | Percent | 0 | VA186 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | U | Closed Suction Catheters – Contractor shall provide closed suction catheters to each ventilator patient each month, Catheters shall be replaced as needed during monthly visit by contractor RT. A4605 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | A4605 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | V | Heated Humidifier- The contractor shall provide a heated humidifier to Veterans receiving mechanical ventilation to provide optimal levels of heat and moisture to the patient’s airway. | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | E0562 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | W | Portable Suction Machine- The contractor shall provide a portable suction machine equipped with an internal battery for use during transport. E0600 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | E0600 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | X | Nebulizer with Compressor- The contractor will provide a nebulizer with compressor to ventilator patients only, as ordered by the VA. MONTHLY PRICE shall include spring loaded T-adapter, neb cups, tubing, masks, trach masks. E0570 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0570 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | Y | Tracheostomy care supplies – The contractor shall provide supplies needed to properly clean and maintain trach and stoma to ventilator patients only. These supplies shall include, tracheostomy drain sponges A6402, basic tracheostomy care kits A4629, 3ml UNIT dose normal saline A4649, cuffed and uncuffed tracheostomy tubes A7521, A7520, tracheostomy inner cannulas A4623 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||
| 0002 | Z | Inline HME- The contractor shall provide an inline heated moisture exchanger (HME) to Veterans receiving noninvasive mechanical ventilation in order to provide optimal levels of heat and moisture to the patient’s airway. A4483 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | A4483 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | Z1 | PAP Pressure Valve- Contractor shall furnish a Positive Airway Pressure (PAP) Valve to each Veteran on nocturnal oxygen bled into a Positive Airway Pressure (PAP) Device when ordered by the VAMC. E1399 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E1399 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | Z2 | Variable Concentration Trach Mask - The contractor shall provide a variable concentration trach mask to Veterans, as ordered by VA Medical Center Staff. This shall include the mask and all mask components | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | A4620 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | Z3 | Rental Mouthpiece Ventilation (e.g., sip n puff, easyspeak) to include all disposable accessories required | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||
| 0002 | Z4 | Combination Oral/Nasal Mask to Veterans receiving non-invasive mechanical ventilation. This item is to be provided to ventilator patients only. | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | A7027 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | Z5 | Full Face PAP Mask - The contractor shall provide a full face mask to Veterans receiving non-invasive mechanical ventilation. This item is to be provided to ventilator patients only. | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | A7030 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0002 | Z6 | Cough Stimulating Device - Notice this MONTHLY PRICE shall include all components required for operation of the device, both disposable and non-disposable components. | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | E0482 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | Detroit VAMC 4646 John R. St. Detroit, MI 48201 | No | 0 | Quantity | NSP | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||||||||
| 0003 | AA | Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified). Concentrator will have flow rate capacity up to 5LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 165 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | AB | Rental concentrator with backup system consisting of compressed gas source, regulator, stand (nasal cannula or mask and humidifier when specified). Concentrator must have flow rate capacity up to 10 LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 40 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | AC | Rental Concentrator with Portable Gaseous Oxygen System, home compressor used to fill portable oxygen cylinders- (2) self-filling -type oxygen cylinders, integrated oxygen conserving device, regulator, flow meter, humidifier, cannula or mask, tubing, cylinder carrier. Concentrator will have flow rate capacity up to 5 LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 180 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | AD | Rental Concentrator with Portable Gaseous Oxygen System, home compressor used to fill portable oxygen cylinders- (2) self-filling -type oxygen cylinders, integrated oxygen conserving device, regulator, flow meter, humidifier, cannula or mask, tubing, cylinder carrier. Concentrator will have flow rate capacity up to 10 LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 80 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | AE | Refillable – type oxygen cylinder- Rental of additional re-fillable cylinders for patients who are assessed to have an extended need for oxygen portability due to high liter flow and/or increased patient activity outside of the home. E0443 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 410 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | B | Cylinder, size M or H set-up consisting of regulator, flow meter, safety stand, humidifier and disposable supplies (emergency backup system or as primary) NOTICE: This shall be invoiced per cylinder provided to the patient. This is NOT a recurring rental PRICE, charges will only incur when an empty cylinder is refilled or replaced with a full cylinder (reference CLIN C regarding refills or replacements). SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment; backup system is provided at no cost | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0424 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | C | Cylinder, size M or H refill/replacement (Backup/Primary) E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment; backup system is provided at no cost | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0424 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | D | Portable system ONLY: prescription does not include concentrator consists of “E”, “D”, “B” (M6), or “C” (M9) size aluminum (or equivalent weight metal) cylinder with regulator, flow meter, handcart, pouch and disposable supplies. NOTICE: This shall be | |||||||||||||||||||||||||||||||||||||||||||||||
| invoiced per cylinder provided to the patient. This is NOT a recurring rental PRICE, charges will only incur when an empty cylinder is refilled or replaced (reference clins E-H regarding refills). SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 30 | EA | 0 | Quantity | Priced | Percent | 0 | E0431 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||||
| 0003 | E | Cylinder, size “E” refill/replacement for Item D above; Aluminum (or metal of equivalent weight or less) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 40 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | F | Cylinder, size “D” (M15) refill/replacement for Item D above. Aluminum (or metal of equivalent weight or less) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 30 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | G | Cylinder, size “B” (M6) refill/replacement for Item D above; Aluminum (or metal of equivalent weight or less) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 20 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | H | Cylinder, size “C” refill/replacement for Item D above; Aluminum (or metal of equivalent weight) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | I | Demand Nasal Cannula (e.g. Oximeter) Reservoir or pendant/equivalent. VA111 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | VA111 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | J | Removed | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 0 | EA | 0 | Quantity | Priced | Percent | 0 | VA111 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | K | Rental liquid oxygen system (90 –100 lbs.) stationary reservoir per patient. E0439; AND Rental portable liquid oxygen system per patient E0434 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0439 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | L | Liquid oxygen per pound for portable liquid oxygen system under Item K. E0444 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0444 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | M | Delivery for re-supply and/or relocation of equipment due to change in patient’s residence | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||
| 0003 | NA | Portable Concentrator- Rental portable oxygen concentrator E1392 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 250 | EA | 0 | Quantity | Priced | Percent | 0 | E1392 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | NB | Extra Battery for Portable Oxygen Concentrator – Temporary rental to be used only during patient travel, when extended time away from a permanent power source is expected. E1356 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 60 | EA | 0 | Quantity | Priced | Percent | 0 | E1356 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | O | Overnight Oximeter- Rental oximeter for overnight oximetry testing E0445 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 15 | EA | 0 | Quantity | Priced | Percent | 0 | E0445 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | P | Suction Machine- Rental suction machine E0600 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | E0600 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | Q | Compressor 50 psi - Rental 50 psi air compressor E0565 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | E0565 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | R | Ventilator Negative Pressure ventilator; portable or stationary; Rental negative pressure ventilator E0465 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0465 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | S | Pressure support ventilator with volume control mode; may include pressure control mode; Rental pressure support ventilator | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 40 | EA | 0 | Quantity | Priced | Percent | 0 | E0465 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | T | Oxygen Thermal Fuse (Fire Safe Cannula)- fuse to isolate oxygen supply in case of fire | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 60 | EA | 0 | Quantity | Priced | Percent | 0 | VA186 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | U | Closed Suction Catheters – Contractor shall provide closed suction catheters to each ventilator patient each month, Catheters shall be replaced as needed during monthly visit by contractor RT. A4605 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | A4605 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | V | Heated Humidifier- The contractor shall provide a heated humidifier to Veterans receiving mechanical ventilation to provide optimal levels of heat and moisture to the patient’s airway. | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | E0562 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | W | Portable Suction Machine- The contractor shall provide a portable suction machine equipped with an internal battery for use during transport to Veterans receiving mechanical ventilation only E0600 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | E0600 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | X | Nebulizer with Compressor- The contractor will provide a nebulizer with compressor to ventilator patients only, as ordered by the VA. MONTHLY PRICE shall include spring loaded T-adapter, neb cups, tubing, masks, trach masks. E0570 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0570 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | Y | Tracheostomy care supplies – The contractor shall provide supplies needed to properly clean and maintain trach and stoma to ventilator patients only. These supplies shall include, tracheostomy drain sponges A6402, basic tracheostomy care kits A4629, 3ml UNIT dose normal saline A4649, cuffed and uncuffed tracheostomy tubes A7521, A7520, tracheostomy inner cannulas A4623 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||
| 0003 | Z | Inline HME- The contractor shall provide an inline heated moisture exchanger (HME) to Veterans receiving noninvasive mechanical ventilation in order to provide optimal levels of heat and moisture to the patient’s airway. A4483 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | A4483 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | Z1 | PAP Pressure Valve- Contractor shall furnish a Positive Airway Pressure (PAP) Valve to each Veteran on nocturnal oxygen bled into a Positive Airway Pressure (PAP) Device when ordered by the VAMC. E1399 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E1399 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | Z2 | Variable Concentration Trach Mask - The contractor shall provide a variable concentration trach mask to Veterans, as ordered by VA Medical Center Staff. This shall include the mask and all mask components | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | A4620 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | Z3 | Rental Mouthpiece Ventilation (e.g., sip n puff, easyspeak) to include all disposable accessories required | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||
| 0003 | Z4 | Combination Oral/Nasal Mask to Veterans receiving non-invasive mechanical ventilation. This item is to be provided to ventilator patients only. | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | A7027 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0003 | Z5 | Full Face PAP Mask - The contractor shall provide a full face mask to Veterans receiving non-invasive mechanical ventilation. This item is to be provided to vetnilator patients only. | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | A7030 | |||||||||||||||||||||||||||||||||||
| 0003 | Z6 | Cough Stimulating Device - Notice this MONTHLY PRICE shall include all components required for operation of the device, both disposable and non-disposable components. | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | E0482 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | Indianapolis VAMC 1481 W. 10th St. Indianapolis, IN 46202 | No | 0 | Quantity | NSP | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||||||||
| 0004 | AA | Rental concentrator with backup system consisting of compressed gas source, regulator, stand, (nasal cannula or mask and humidifier when specified). Concentrator will have flow rate capacity up to 5LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 95 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | AB | Rental concentrator with backup system consisting of compressed gas source, regulator, stand (nasal cannula or mask and humidifier when specified). Concentrator must have flow rate capacity up to 10 LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 40 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | AC | Rental Concentrator with Portable Gaseous Oxygen System, home compressor used to fill portable oxygen cylinders- (2) self-filling -type oxygen cylinders, integrated oxygen conserving device, regulator, flow meter, humidifier, cannula or mask, tubing, cylinder carrier. Concentrator will have flow rate capacity up to 5 LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 100 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | AD | Rental Concentrator with Portable Gaseous Oxygen System, home compressor used to fill portable oxygen cylinders- (2) self-filling -type oxygen cylinders, integrated oxygen conserving device, regulator, flow meter, humidifier, cannula or mask, tubing, cylinder carrier. Concentrator will have flow rate capacity up to 10 LPM. E1390 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 65 | EA | 0 | Quantity | Priced | Percent | 0 | E1390 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | AE | Refillable – type oxygen cylinder- Rental of additional re-fillable cylinders for patients who are assessed to have an extended need for oxygen portability due to high liter flow and/or increased patient activity outside of the home. E0443 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 280 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | B | Cylinder, size M or H set-up consisting of regulator, flow meter, safety stand, humidifier and disposable supplies (emergency backup system or as primary) NOTICE: This shall be invoiced per cylinder provided to the patient. This is NOT a recurring rental PRICE, charges will only incur when an empty cylinder is refilled or replaced with a full cylinder (reference CLIN C regarding refills or replacements). SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment; backup system is provided at no cost | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | E0424 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | C | Cylinder, size M or H refill/replacement (Backup/Primary) E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment; backup system is provided at no cost | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0424 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | D | Portable system ONLY: prescription does not include concentrator consists of “E”, “D”, “B” (M6), or “C” (M9) size aluminum (or equivalent weight metal) cylinder with regulator, flow meter, handcart, pouch and disposable supplies. NOTICE: This shall be | |||||||||||||||||||||||||||||||||||||||||||||||
| invoiced per cylinder provided to the patient. This is NOT a recurring rental PRICE, charges will only incur when an empty cylinder is refilled or replaced (reference clins E-H regarding refills). SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 35 | EA | 0 | Quantity | Priced | Percent | 0 | E0431 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||||
| 0004 | E | Cylinder, size “E” refill/replacement for Item D above; Aluminum (or metal of equivalent weight or less) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 40 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | F | Cylinder, size “D” (M15) refill/replacement for Item D above. Aluminum (or metal of equivalent weight or less) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 30 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | G | Cylinder, size “B” (M6) refill/replacement for Item D above; Aluminum (or metal of equivalent weight or less) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 20 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | H | Cylinder, size “C” refill/replacement for Item D above; Aluminum (or metal of equivalent weight) tanks required E0443 SPECIAL NOTE: Regulators and Conserving devices shall be included in the monthly rental price for all applicable equipment | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | E0443 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | I | Demand Nasal Cannula (e.g. Oximeter) Reservoir or pendant/equivalent. VA111 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 10 | EA | 0 | Quantity | Priced | Percent | 0 | VA111 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | J | Removed | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 0 | EA | 0 | Quantity | Priced | Percent | 0 | VA111 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | K | Rental liquid oxygen system (90 –100 lbs.) stationary reservoir per patient. E0439; AND Rental portable liquid oxygen system per patient E0434 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0439 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | L | Liquid oxygen per pound for portable liquid oxygen system under Item K. E0444 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0444 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | M | Delivery for re-supply and/or relocation of equipment due to change in patient’s residence | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | NONE | No | No | 621610 | W065 | |||||||||||||||||||||||||||||||
| 0004 | NA | Portable Concentrator- Rental portable oxygen concentrator E1392 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 140 | EA | 0 | Quantity | Priced | Percent | 0 | E1392 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | NB | Extra Battery for Portable Oxygen Concentrator – Temporary rental to be used only during patient travel, when extended time away from a permanent power source is expected. E1356 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 40 | EA | 0 | Quantity | Priced | Percent | 0 | E1356 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | O | Overnight Oximeter- Rental oximeter for overnight oximetry testing E0445 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 20 | EA | 0 | Quantity | Priced | Percent | 0 | E0445 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | P | Suction Machine- Rental suction machine E0600 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 15 | EA | 0 | Quantity | Priced | Percent | 0 | E0600 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | Q | Compressor 50 psi - Rental 50 psi air compressor E0565 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 15 | EA | 0 | Quantity | Priced | Percent | 0 | E0565 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | R | Ventilator Negative Pressure ventilator; portable or stationary; Rental negative pressure ventilator E0465 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0465 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | S | Pressure support ventilator with volume control mode; may include pressure control mode; Rental pressure support ventilator | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 35 | EA | 0 | Quantity | Priced | Percent | 0 | E0465 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | T | Oxygen Thermal Fuse (Fire Safe Cannula)- fuse to isolate oxygen supply in case of fire | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 50 | EA | 0 | Quantity | Priced | Percent | 0 | VA186 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | U | Closed Suction Catheters – Contractor shall provide closed suction catheters to each ventilator patient each month, Catheters shall be replaced as needed during monthly visit by contractor RT. A4605 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | A4605 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | V | Heated Humidifier- The contractor shall provide a heated humidifier to Veterans receiving mechanical ventilation to provide optimal levels of heat and moisture to the patient’s airway. | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 30 | EA | 0 | Quantity | Priced | Percent | 0 | E0562 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | W | Portable Suction Machine- The contractor shall provide a portable suction machine equipped with an internal battery for use during transport to Veterans receiving mechanical ventilation only E0600 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 20 | EA | 0 | Quantity | Priced | Percent | 0 | E0600 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | X | Nebulizer with Compressor- The contractor will provide a nebulizer with compressor to ventilator patients only, as ordered by the VA. MONTHLY PRICE shall include spring loaded T-adapter, neb cups, tubing, masks, trach masks. E0570 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | E0570 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | Y | Tracheostomy care supplies – The contractor shall provide supplies needed to properly clean and maintain trach and stoma to ventilator patients only. These supplies shall include, tracheostomy drain sponges A6402, basic tracheostomy care kits A4629, 3ml UNIT dose normal saline A4649, cuffed and uncuffed tracheostomy tubes A7521, A7520, tracheostomy inner cannulas A4623 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | E1399 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | Z | Inline HME- The contractor shall provide an inline heated moisture exchanger (HME) to Veterans receiving noninvasive mechanical ventilation in order to provide optimal levels of heat and moisture to the patient’s airway. A4483 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | A4483 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | Z1 | PAP Pressure Valve- Contractor shall furnish a Positive Airway Pressure (PAP) Valve to each Veteran on nocturnal oxygen bled into a Positive Airway Pressure (PAP) Device when ordered by the VAMC. E1399 | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 5 | EA | 0 | Quantity | Priced | Percent | 0 | E1399 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | Z2 | Variable Concentration Trach Mask - The contractor shall provide a variable concentration trach mask to Veterans, as ordered by VA Medical Center Staff. This shall include the mask and all mask components | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 15 | EA | 0 | Quantity | Priced | Percent | 0 | A4620 | NONE | No | No | 621610 | W065 | ||||||||||||||||||||||||||||||
| 0004 | Z3 | Rental Mouthpiece Ventilation (e.g., sip n puff, easyspeak) to include all disposable accessories required | No | Ordering Period 1 | 1/1/26 | 12/31/26 | 1 | EA | 0 | Quantity | Priced | Percent | 0 | NONE | No | No | 621610 | W065 |
This is the start of the file's text. The full file is on GovTribe.
File details come from the government source that posted it. Updated .