Mock-up Sample.xlsx

XLSX spreadsheet 23 KB Posted Jan 8, 2021

Attached to: Q522--36C25521R0002--IR/DR Radiology Physician, On-Site - Dole VAMC Wichita - Diagnostic Radiologist, Interventional Radiologist, including Fellowship Trained IR and Neuroradioloist Amendment 0007
Solicitation number: 36C25521R0002
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 15

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File	Type	Posted
36C25521R0002 Amend 0007.pdf	PDF	Jan 20, 2021
36C25521R0002 Amendment 0006.pdf	PDF	Jan 13, 2021
Conformed_RFP_36C25521R0002_to_Amendment_0006.pdf	PDF	Jan 13, 2021
36C25521R0002 Amendment 0005.pdf	PDF	Jan 8, 2021
Conformed_RFP_36C25521R0002_to_Amendment_0005.pdf	PDF	Jan 8, 2021
Conformed_RFP_36C25521R0002_to_Amend_0004.pdf	PDF	Jan 5, 2021
Correct Atch 7 Key Personnel Checklist.pdf	PDF	Jan 5, 2021
36C25521R0002 Amendment 0004.pdf	PDF	Jan 5, 2021
Conformed__Atch 1 Subcontracting Plan - Radiology.pdf	PDF	Dec 31, 2020
Conformed__Atch 3 Appendix A Contractor Conf of Int.pdf	PDF	Dec 31, 2020
Conformed__Atch 5 Information for Proposed Physicians.pdf	PDF	Dec 31, 2020
Conformed__Atch 2 Quality Assurance Surveillance Plan 21R0002.pdf	PDF	Dec 31, 2020
Conformed__Atch 4 Immigration Certification.pdf	PDF	Dec 31, 2020
Conformed__Atch 11 VHA Directive 1105.05, Magnetic Resonance (MR) Safety.pdf	PDF	Dec 31, 2020
Conformed__Atch 7 Key Personnel Checklist.pdf	PDF	Dec 31, 2020
Conformed__RFP_36C25521R0002_to_Amend_0003.pdf	PDF	Dec 31, 2020
Amend_0003_History_Summary_Page.xlsx	XLSX spreadsheet	Dec 31, 2020
Amend_0003_History_Summary_Page.pdf	PDF	Dec 31, 2020
Conformed__Atch 6 Contingency Plan - Personnel.pdf	PDF	Dec 31, 2020
Conformed__Atch 9 Wichita Critical Test Value Notification 2019.pdf	PDF	Dec 31, 2020
Amend_0003_to_RFP_36C25521R0002.pdf	PDF	Dec 31, 2020
Conformed__Atch 10 Fluoroscopy_Safety_VHA_1105.04_June_2018.pdf	PDF	Dec 31, 2020
Conformed__Atch 8 Appendix D Rules of Behavior.pdf	PDF	Dec 31, 2020
36C25521R0002 Amendment 0002.pdf	PDF	Dec 10, 2020
36C25521R0002 0001.pdf	PDF	Dec 2, 2020
Atch 6 Contingency Plan - Personnel.docx	DOCX document	Nov 27, 2020
Atch 11 VHA Directive 1105.05, Magnetic Resonance (MR) Safety.docx	DOCX document	Nov 27, 2020
Atch 7 Key Personnel Checklist.docx	DOCX document	Nov 27, 2020
Atch 4 Immigration Certification.docx	DOCX document	Nov 27, 2020
Atch 1 Subcontracting Plan - Radiology.docx	DOCX document	Nov 27, 2020
Atch 2 Quality Assurance Surveillance Plan 21R0002.docx	DOCX document	Nov 27, 2020
Atch 9 Wichita Critical Test Value Notification 2019.pdf	PDF	Nov 27, 2020
Request for Proposal 36C25521R0002.docx	DOCX document	Nov 27, 2020
Atch 5 Information for Proposed Physicians.docx	DOCX document	Nov 27, 2020
Atch 10 Fluoroscopy_Safety_VHA_1105.04_June_2018.docx	DOCX document	Nov 27, 2020
Atch 3 Appendix A Contractor Conf of Int.docx	DOCX document	Nov 27, 2020
Atch 8 Appendix D Rules of Behavior.docx	DOCX document	Nov 27, 2020

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Radiologist A

IMAGING PHYSICIAN wRVU SUMMARY
Run Date: Jan 08, 2021			Page: 1
Facility: ROBERT J DOLE VAMC	Date Range: December 1, 2020 - December 31, 2020
RADIOLOGIST A			Total #	Total
CPT CODE	DESCRIP	wRVU	of exams	wRVU
EC9G3	CT LUMBAR SPINE W/O CONT	0.00	1.00	0.00
71450	SPINE LUMBOSACRAL MIN 6 VIEWS	0.00	8.00	0.00
4344C	WRIST (RIGHT) 3 OR MORE VIEWS	0.00	5.00	0.00
C9115	ORBIT MIN 4 VIEWS	0.13	1.00	0.13
X5114	HIP 1 VIEW (LEFT) W/PELVIS IF REQUE	0.16	1.00	0.16
AC250	MRI CERVICAL SPINE W&W/O CONT	0.16	1.00	0.16
941CB	MRI THORACIC SPINE W&W/O CONT	0.16	1.00	0.16
X5141	HIP,BILAT,2 VIEW,W/PELVIS IF REQUES	0.17	1.00	0.17
X5148	INTRO AV FISTULA NEEDLE/CATH W/FLUO	0.17	1.00	0.17
5HW89	MRI LUMBAR SPINE W&W/0 CONT	0.17	1.00	0.17
5X9XH	MRI LUMBAR SPINE W/O	0.17	1.00	0.17
X5125	HIP 1 VIEW (RIGHT) W/PELVIS IF REQU	0.18	1.00	0.18
X5131	HIP 2-3 VIEW (LEFT) W/PELVIS IF REQ	0.18	1.00	0.18
36F32	KNEE (RIGHT) 4 OR MORE VIEWS	0.18	1.00	0.18
EC922	CT CHEST/THORAX W/O CONTRAST	0.22	1.00	0.22
EC923	CT GUIDANCE FOR NEEDLE PLACEMENT	0.22	1.00	0.22
X515X	KNEE (LEFT) 2 VIEWS	0.22	1.00	0.22
361ZX	KNEE (RIGHT) 2 VIEWS	0.22	1.00	0.22
44890	REMOVE NEPH TUBE W/FLUORO GUIDANCE	0.23	1.00	0.23
L3L25	CT NECK SOFT TISSUE W/CONTRAST	0.27	1.00	0.27
MC450	CT SINUSES CORONAL	0.30	1.00	0.30
MC491	DEEP BONE, BIOPSY	0.30	1.00	0.30
3AD91	LIVER ULTRASOUND	0.16	2.00	0.32
AC045	LUMBAR PUNCT. DIAGNOSTIC W/IMA GUID	0.16	2.00	0.32
AC160	MRI BRAIN W/O	0.16	2.00	0.32
AC260	MRI CERVICAL SPINE W/O CONTRAST	0.17	2.00	0.34
AC2X9	MRI LUMBAR SPINE W	0.17	2.00	0.34
X5132	HIP 2-3 VIEW (RIGHT) W/PELVIS IF RE	0.18	2.00	0.36
2P1A6	KNEE (LEFT) 4 OR MORE VIEWS	0.22	2.00	0.44
P1148	US GUIDANCE FNA EA ADDL	0.25	2.00	0.50
4315X	VENOGRAM EXTREMITY BILAT S&I	0.50	1.00	0.50
MC486	CTA CHEST W/ CONT (NONCORONARY)	0.26	2.00	0.52
449G3	SPINE CERVICAL 4 OR 5 VIEWS	0.53	1.00	0.53
X5156	IVC FILTER INSERTION	0.18	3.00	0.54
44880	POSITRON EMMISION TOMOGRAPHY W/ CT,	0.18	3.00	0.54
3Q260	CHEST 1 VIEW	0.28	2.00	0.56
P1052	US ANKLE/BRACHIAL INDICES	0.58	1.00	0.58
71491	TIBIA & FIBULA (LEFT) 2 OR MORE VIE	0.59	1.00	0.59
71553	TOE(S) OF RIGHT FOOT (2 OR MORE VIE	0.59	1.00	0.59
P1100	US ARTERIAL SHUNT EVAL	0.64	1.00	0.64
449Y9	SHOULDER (RIGHT) AP, AXIL & Y	0.70	1.00	0.70
P1P3P	US ABD AORTA LIMITED	0.74	1.00	0.74
5X9X9	CT ABD & PELV W/CONTRAST	0.85	1.00	0.85
X5149	INTRO AV FISTULA W/BALLOON ANGIOPLA	0.18	5.00	0.90
P1110	US BLOOD FLOW ABD/RENAL (LTD)	0.30	3.00	0.90
P1156	US RENAL COMPLETE	0.45	2.00	0.90
K3328	CT MUSCLE BIOPSY,PERCUTANEOUS NEEDL	0.16	6.00	0.96
36G32	ANGIO-+VESSEL POST EXAM	0.99	1.00	0.99
369ZX	ABD 2 VIEWS	1.00	1.00	1.00
K3324	SPINE LUMBOSACRAL MIN 2 VIEWS	1.01	1.00	1.01
L3L23	SPINE LUMBOSACRAL MIN 4 VIEWS	1.06	1.00	1.06
3Q160	CAROTID DOPPLER	1.10	1.00	1.10
AC046	MODIFIED BARIUM SWALLOW	0.22	5.00	1.10
AC150	MRI BRAIN W&W/O CONT	0.22	5.00	1.10
X9P1P	ULTRASOUND GUIDANCE FOR VASCULAR AC	0.59	2.00	1.18
X9P1P	FLUORINE-18 FDG	1.22	1.00	1.22
MC4MC	CTA ABDOMEN & PELVIS	0.22	6.00	1.32
P1132	US GALLBLADDER	0.80	2.00	1.60
P1P2P	US AAA SCREENING ONLY	0.55	3.00	1.65
71486	SPINE SINGLE VIEW	0.56	3.00	1.68
3Q250	CERVICAL SPINE W/ FLEX & EXT	1.73	1.00	1.73
X5050	FOOT (LEFT) 3 OR MORE VIEWS	1.78	1.00	1.78
P1149	US KIDNEYS	0.45	4.00	1.80
EC9Y9	CT LUMBAR SPINE W/CONT	1.82	1.00	1.82
C9116	POSITRON EMISSION TOMOGRAPHY CT, WH	1.90	1.00	1.90
449X9	SHOULDER (RIGHT) 2 OR MORE VIEWS	2.01	1.00	2.01
71471	SPINE SINGLE VIEW	0.30	7.00	2.10
P1050	US ABDOMEN LTD, SINGLE ORG OR QUADR	0.74	3.00	2.22
X5052	FOOT (RIGHT) 3 OR MORE VIEWS	2.29	1.00	2.29
X5100	GALLBLADDER,LIVER,PANCREAS ULTRASOU	2.29	1.00	2.29
X5110	HAND (LEFT) 3 OR MORE VIEWS	2.29	1.00	2.29
P115X	US SCROTUM	1.16	2.00	2.32
33Q91	ANKLE (LEFT) 3 OR MORE VIEWS	2.45	1.00	2.45
P1131	US EXTREMITY VEINS UNILAT OR LTD	2.50	1.00	2.50
5PW89	CLAVICLE	1.27	2.00	2.54
2P1P6	ABD 1 VIEW	1.46	2.00	2.92
MC553	FEMUR (RIGHT) 2 VIEW MIN	1.00	3.00	3.00
P1114	US BLOOD FLOW ABD/RENAL DOPPLER (CO	1.50	2.00	3.00
3Q045	ANKLE (RIGHT) 3 OR MORE VIEW	3.36	1.00	3.36
71551	TIBIA & FIBULA (RIGHT) 2 OR MORE VI	0.59	6.00	3.54
EC9X9	CT HEAD W/O CONT	1.24	3.00	3.72
MC551	ESOPHAGUS 2 CON(HIGH DENS BA+EFFERV	1.00	4.00	4.00
P1141	US GUIDANCE FNA 1ST LESION	0.80	5.00	4.00
941C9	CT ABD & PELV W/O CONTRAST	1.38	3.00	4.14
3Q2X9	CHEST 2 VIEWS	0.85	5.00	4.25
44922	RIBS (LEFT) UNILAT 2 VIEW	2.20	2.00	4.40
X5P2P	FLUORO-60 MIN. OR LESS	1.48	3.00	4.44
3Q150	CALCANEOUS 2 VIEWS (RIGHT HEEL)	4.46	1.00	4.46
43156	US THYROID (NECK SOFT-TISSUE)	0.80	6.00	4.80
3Q046	ANKLE/BRACHIAL INDICIES	4.83	1.00	4.83
EC890	CT CHEST/THORAX W/CONT	0.22	29.00	6.38
44923	RIBS (RIGHT) UNILAT 2 VIEW	1.74	4.00	6.96
A1115	CT ABD & PELVIS W/WO CONTRAST	1.48	6.00	8.88
4444Q	SHOULDER (LEFT) AP,AXIL & Y	1.82	5.00	9.10
A1116	CT ANGIO LOWER EXTREMITY	2.29	4.00	9.16
EC880	CT CERVICAL SPINE W/O CONT	0.18	53.00	9.54
P1125	US CAROTID BILATERAL	2.44	4.00	9.76
ECECQ	CT HEAD W&W/O CONT	1.16	12.00	13.92
X5P3P	FLUORO-60 MIN. OR LESS	1.48	14.00	20.72
			322.00	219.62

Radiologist B

IMAGING PHYSICIAN wRVU SUMMARY
Run Date: Jan 08, 2021			Page: 1
Facility: ROBERT J DOLE VAMC	Date Range: December 1, 2020 - December 31, 2020
RADIOLOGIST B			Total #	Total
CPT CODE	DESCRIP	wRVU	of exams	wRVU
PN1X9	US GALLBLADDER	2.44	17.00	41.48
71553	SHOULDER (LEFT) AP,AXIL & Y	1.74	9.00	15.66
X5P2P	ESOPHAGUS	1.48	10.00	14.80
X9P1P	SHOULDER (RIGHT) 2 OR MORE VIEWS	1.82	8.00	14.56
3Q046	ANKLE/BRACHIAL INDICIES	0.85	13.00	11.05
P1050	SPINE CERVICAL 4 OR 5 VIEWS	2.20	5.00	11.00
36G32	ANKLE (LEFT) 2 VIEWS	2.00	5.00	10.00
EC880	CT CERVICAL SPINE W/O CONT	1.24	8.00	9.92
5PW89	CT ABD & PELV W/O CONTRAST	2.29	4.00	9.16
5X9X9	CT ABDOMEN W&W/O CONT	0.18	47.00	8.46
3Q160	CERVICAL SPINE W/ FLEX & EXT	1.38	6.00	8.28
3Q2X9	CT ABD & PELV W/CONTRAST	1.48	5.00	7.40
MC553	DEEP BONE, BIOPSY	1.48	5.00	7.40
A1116	CT BONE MARROW-BX AND ASPIRATION	1.16	6.00	6.96
36F32	KNEE (LEFT) 4 OR MORE VIEWS	1.35	5.00	6.75
EC890	CT CHEST/THORAX W/CONT	1.82	3.00	5.46
EC922	CT CHEST/THORAX W/O CONTRAST	1.82	3.00	5.46
X9AMP	WRIST (LEFT) 3 OR MORE VIEWS	0.80	6.00	4.80
941C9	CT ABDOMEN W/O CONT	0.22	19.00	4.18
P1P2P	SHOULDER (RIGHT) 4 VIEWS	2.01	2.00	4.02
33Q91	ANKLE (LEFT) 3 OR MORE VIEWS	4.00	1.00	4.00
MC491	CTA CHEST (NONCORONARY)	1.00	4.00	4.00
P1141	TIBIA & FIBULA (RIGHT) 2 OR MORE VI	0.59	6.00	3.54
K3K3Q	US EXTREMITY VEINS UNILAT OR LTD	1.50	2.00	3.00
X9P1P	ELBOW (RIGHT) 2 VIEWS	1.48	2.00	2.96
P1156	US ARTERIAL SHUNT EVAL	0.74	4.00	2.96
P1131	SPINE THORACIC AP&LAT&SWIM VIEWS	0.56	5.00	2.80
AA291	US SOFT TISSUE MASS, HEAD-NECK	0.70	4.00	2.80
K3324	MRI SHOULDER RIGHT W/O CONT	1.35	2.00	2.70
L3L23	MRI THORACIC SPINE W/O	1.35	2.00	2.70
2P1P6	ABD 1 VIEW	2.45	1.00	2.45
PN1Y9	US LOWER EXT ARTERIES BILAT	0.80	3.00	2.40
X5P3P	FEMUR (LEFT) 2 VIEW MIN	2.29	1.00	2.29
L3L25	CT PELVIS W/O CONT	0.22	10.00	2.20
X5100	FLUORO-60 MIN. OR LESS	2.20	1.00	2.20
71551	SHOULDER (LEFT) 2 OR MORE VIEWS	2.20	1.00	2.20
3Q260	CHEST 2 VIEWS	2.15	1.00	2.15
449Y9	MRI SHOULDER LEFT W/O CONT	2.15	1.00	2.15
P1114	SPINE SINGLE VIEW	0.30	7.00	2.10
MC4MC	CT UROGRAM	1.00	2.00	2.00
PN122	US EXTREMITY NONVASC LIMITED	0.64	3.00	1.92
4444Q	MRI LUMBAR SPINE W/O	0.17	11.00	1.87
L3L23	US PELVIS COMPLETE(NON OB)	0.45	4.00	1.80
EC923	CT CO-PERC INSERT CATH W/IMG GUIDAN	0.16	11.00	1.76
3Q250	CHEST 1 VIEW	1.75	1.00	1.75
P1149	US ANKLE/BRACHIAL INDICES	0.55	3.00	1.65
AC045	KNEE (RIGHT) 4 OR MORE VIEWS	1.62	1.00	1.62
PN1G3	US LOWER EXT ARTERIES UNILAT	0.80	2.00	1.60
AC160	MODIFIED BARIUM SWALLOW	0.22	7.00	1.54
941CB	MRI BRAIN W/O	0.22	7.00	1.54
2P1A6	HIPS,BILAT,3-4 VIEWS, W/PELVIS IF R	0.17	9.00	1.53
449X9	MRI PELVIS W & W/O	0.17	9.00	1.53
MC551	CTA CHEST W/ CONT (NONCORONARY)	1.48	1.00	1.48
P1P3P	SHOULDER (RIGHT) AP, AXIL & Y	1.46	1.00	1.46
369ZX	ABD 2 VIEWS	1.44	1.00	1.44
71491	RIBS (RIGHT) UNILAT 2 VIEW	1.40	1.00	1.40
43156	US BLOOD FLOW ABD/RENAL DOPPLER (CO	0.69	2.00	1.38
4315X	US CAROTID BILATERAL	0.69	2.00	1.38
EC9X9	CT HEAD W/O CONT	0.27	5.00	1.35
3AD91	KNEE (RIGHT) 2 VIEWS	1.35	1.00	1.35
449G3	MRI SHOULDER RIGHT W/CONT	1.35	1.00	1.35
C3151	US THYROID (NECK SOFT-TISSUE)	0.45	3.00	1.35
AC250	MRCP	0.22	6.00	1.32
71450	ORBIT MIN 4 VIEWS	0.18	7.00	1.26
X515X	HIP 2-3 VIEW (RIGHT) W/PELVIS IF RE	0.17	7.00	1.19
71486	POSITRON EMMISION TOMOGRAPHY W/ CT,	1.19	1.00	1.19
C3153	US TRANSVAGINAL	1.16	1.00	1.16
3Q150	CAROTID DOPPLER	1.13	1.00	1.13
3Q045	ANKLE (RIGHT) 3 OR MORE VIEW	0.28	4.00	1.12
C9115	MRI CERVICAL SPINE W/O	0.22	5.00	1.10
X5052	FLUORINE-18 FDG	1.09	1.00	1.09
P1100	SPINE LUMBOSACRAL MIN 2 VIEWS	0.53	2.00	1.06
MC486	CTA ABDOMEN & PELVIS	1.00	1.00	1.00
AMP2P	WRIST (RIGHT) 2 VIEWS	0.50	2.00	1.00
ECECQ	CT GUIDANCE FOR NEEDLE PLACEMENT	0.22	4.00	0.88
AA250	US RENAL COMPLETE	0.80	1.00	0.80
MC450	CT THORACIC SPINE W/O CONT	0.26	3.00	0.78
AA286	US SCROTUM	0.70	1.00	0.70
71471	PELVIS 1 VIEW	0.23	3.00	0.69
A1115	CT ANGIO NECK	0.22	3.00	0.66
5X9XH	MRI BRAIN W&W/O CONT	0.16	4.00	0.64
P1052	SPINE CERVICAL MIN 2 VIEWS	0.60	1.00	0.60
P1132	TIBIA & FIBULA (LEFT) 2 OR MORE VIE	0.59	1.00	0.59
P1148	US AAA SCREENING ONLY	0.59	1.00	0.59
AC260	MRI ABD W & W/O CONTRAST	0.29	2.00	0.58
P115X	US BLOOD FLOW ABD/RENAL (LTD)	0.58	1.00	0.58
P1125	SPINE THORACIC 2 VIEWS	0.56	1.00	0.56
X5110	FLUORO-60 MIN. OR LESS	0.18	3.00	0.54
X5125	FOOT (RIGHT) 3 OR MORE VIEWS	0.18	3.00	0.54
X5131	GALLBLADDER,LIVER,PANCREAS ULTRASOU	0.18	3.00	0.54
X5132	HAND (LEFT) 3 OR MORE VIEWS	0.18	3.00	0.54
44922	MRI KNEE RIGHT W/O CONT	0.17	3.00	0.51
44923	MRI LUMBAR SPINE W&W/O CONT	0.17	3.00	0.51
AA271	US RENAL LIMITED	0.50	1.00	0.50
PN123	US EXTREMITY VEINS BILAT	0.49	1.00	0.49
5HW89	MRI BRAIN + IAC W & W/OUT	0.16	3.00	0.48
EC9G3	CT MAXILLOFACIAL W/CONT	0.20	2.00	0.40
X5156	HIP 2-3 VIEW (LEFT) W/PELVIS IF REQ	0.17	2.00	0.34
44880	MRI FOOT LEFT W & W/O CONT	0.16	2.00	0.32
EC9Y9	CT LUMBAR SPINE W/O CONT	0.30	1.00	0.30
K3324	US PARACENTESIS W/IMAGING	0.25	1.00	0.25
K3328	CT NECK SOFT TISSUE W/CONTRAST	0.23	1.00	0.23
X5114	FOOT (LEFT) 3 OR MORE VIEWS	0.18	1.00	0.18
AC046	LIVER ULTRASOUND	0.18	1.00	0.18
AC150	LOWER EXTREM. VENOUS DOPPLER	0.18	1.00	0.18
AC2X9	MRI ANKLE LEFT W/O CONT	0.18	1.00	0.18
X5050	FINGER(S) OF RIGHT HAND 2 OR MORE V	0.17	1.00	0.17
X5149	HIP 1 VIEW (RIGHT) W/PELVIS IF REQU	0.17	1.00	0.17
X5141	HAND (RIGHT) 3 OR MORE VIEWS	0.16	1.00	0.16
X5148	HIP 1 VIEW (LEFT) W/PELVIS IF REQUE	0.16	1.00	0.16
C9116	MRI CERVICAL SPINE W/O CONTRAST	0.16	1.00	0.16
44890	MRI HIP LEFT W/O CONT	0.16	1.00	0.16
361ZX	KNEE (LEFT) 2 VIEWS	0.13	1.00	0.13
P1110	SPINE LUMBOSACRAL MIN 4 VIEWS	0.00	18.00	0.00
AMP3P	WRIST (RIGHT) 3 OR MORE VIEWS	0.00	17.00	0.00
			474.00	325.04

File details come from the government source that posted it. Updated Jan 9, 2021.