RFP Home Oxygen Schedule 11-07-2022.xlsx

XLSX spreadsheet 602 KB Posted

Attached to
VISN 15 Home Oxygen Services Federal contract opportunity
Solicitation number
36C25522R0100
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 15

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Written by GovTribe AI ·

This Excel file contains a schedule for home oxygen services to be provided under a solicitation from Veterans Integrated Service Network 15. The schedule lists monthly fees for various oxygen equipment and supplies to be provided across eight locations in Missouri, Kansas, Illinois, and Kentucky from January 2023 through December 2025. Equipment and services included are 5 LPM and 10 LPM oxygen concentrators, portable concentrators, additional batteries, cylinder refills in various sizes, liquid oxygen, compressors, and ventilators. The solicitation number is 36C25522R0100 and is for the Department of Veterans Affairs VISN 15 for home oxygen services to support veterans within its network. Pricing will be evaluated for the listed equipment and locations over the three year period.

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Other files for this federal contract opportunity

Other files attached to VISN 15 Home Oxygen Services, newest first.
File Type Posted
36C25522R0100 0005.pdf PDF
RFP Home Oxygen Schedule 1-11-2023.xlsx XLSX spreadsheet
36C25522R0100 0004 Signed.pdf PDF
36C25522R0100 0003 Signed.pdf PDF
RFP Home Oxygen Schedule 11-09-2022.xlsx XLSX spreadsheet
36C25522R0100 0002 Signed.pdf PDF
36C25522R0100 0001 Signed.pdf PDF
RFP Home Oxygen Schedule 10-24-2022.xlsx XLSX spreadsheet
PWS Supplement - Counties.pdf PDF
36C25522R0100 10-13-2022.pdf PDF
RFP Home Oxygen Schedule 10-13-2022.xlsx XLSX spreadsheet
Show all 11

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Action Line Item Information

Action Type NamePrimary IDSecondary IDMod NumberTitleOrder Discount Type NameOrder Discount TypeOrder Discount
VHA-SUPPLIES-FSS-ORDER-MODV797P-7323A36C24921N0003P00001Percent0

KB Version: FY21.08A

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 Zip Zip4 Country Mark For Contact Name Contact Phone Contact Email Delivery Date FOB Special Instructions Include Instructions/Comments 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 UNIT OF PURCHASE CODE UNIT OF PURCHASE TEXT/DESC. NDC FOOD GROUP CODE NIF ITEM NUMBER MINIMUM ORDER QUANTITY MAXIMUM ORDER QUANTITY REQUIRED ORDER MULTIPLE UNIT CONVERSION FACTOR SPECIAL REMARKS CLINICAL DISCIPLINE ITEM PRICE ON BPA BASE OR OPTION PERIOD ITEM CONTROLLED SUBSTANCE BASE LINE ITEM NUMBER ENVIRONMENTAL ATTRIBUTE CODE ESTIMATED QUANTITY ITEM PRICE ON FSS/BOA ITEM PRICE ON FSS ITEM PRICE ON FSS (1-500 UNITS) ITEM PRICE ON FSS (501-1000 UNITS) ITEM PRICE ON FSS (1001-1500 UNITS) ITEM PRICE ON FSS (1500+ UNITS) EVALUATED ITEM PRICE ON FSS GPC ACCEPTED GREEN PRODUCT HAZARDOUS MATERIAL ITEM PART NAME ITEM PART NUMBER tc={C7D4309F-80DF-4295-96C6-A068BB3BC06B}: [Threaded comment]

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Comment:

item part number = distributor. Insert OEM part number of there isn't a distributor.ITEM TYPEITEMS PER UNIT OF SALE (UOS)LATEX FREEITEM MODEL NUMBEROEM CAGE CODEOEM COUNTRY OF ORIGINOEM DUNS NUMBEROEM NAMESALE START DATESALE END DATEITEM SALE PRICESALIENT CHARACTERISTICREFERENCED CONTRACT NUMBERREFERENCED CONTRACT LINE NUMBERREFERENCED CONTRACT SUB LINE NUMBERDRAWING NUMBERSPECIFICATION NUMBERSERIAL NUMBERMANUFACTURER NAMEYEAR OF MANUFACTUREPROGRAM CODEVENDOR PART NUMBERTSP AUTHENTICATION CODETRANSPORTATION PRIORITY NUMBERMonthly Total EstimateAnnual Total Estimate
00015 LPM CONCENTRATOR WITH BACKUP SYSTEM AND PORTABLE SYSTEM MONTHLY FEE.This shall include the initial set up and all visits related to the oxygen system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), back-up system complete with cylinder, regulator, stand, tubing, cannulas, filter(s) and humidifier as needed, portable cylinders with wheeled cart and/or bag, regulator and/or demand pulse conserving device and all supplies including cannulas, masks, tubing, filters, and humidifiers. Includes all cylinder demurrage charges. E1390BaseNSP621610Q20101E01-21
0001AColumbia, MOBase01/01/2312/31/23725MOPriced621610Q20101E01-2100
0001BKansas City, MOBase01/01/2312/31/23732MOPriced621610Q20101E01-2100
0001CLeavenworth, KSBase01/01/2312/31/23271MOPriced621610Q20101E01-2100
0001DMarion, ILBase01/01/2312/31/23826MOPriced621610Q20101E06-2100
0001EPoplar Bluff, MOBase01/01/2312/31/23587MOPriced621610Q20101E06-2100
0001FSt. Louis, MOBase01/01/2312/31/23731MOPriced621610Q20101E06-2100
0001GTopeka, KSBase01/01/2312/31/23307MOPriced621610Q20101E06-2100
0001HWichita, KSBase01/01/2312/31/23499MOPriced621610Q20101E01-2100
Sub-Total00
000210 LPM CONCENTRATOR WITH BACKUP SYSTEM AND PORTABLE SYSTEM MONTHLY FEE.
This shall include the initial set up and all visits related to the oxygen system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), back-up system complete with cylinder, regulator, stand, tubing, cannulas, filter(s) and humidifier as needed, portable cylinders with wheeled cart and/or bag, regulator and/or demand pulse conserving device and all supplies including cannulas, masks, tubing, filters, and humidifiers. Includes all cylinder demurrage charges. E1390BaseNSP621610Q20101E01-21
0002AColumbia, MOBase01/01/2312/31/2387MOPriced621610Q20101E01-2100
0002BKansas City, MOBase01/01/2312/31/2354MOPriced621610Q20101E01-2100
0002CLeavenworth, KSBase01/01/2312/31/2312MOPriced621610Q20101E06-2100
0002DMarion, ILBase01/01/2312/31/2327MOPriced621610Q20101E06-2100
0002EPoplar Bluff, MO01/01/2312/31/2318MOPriced621610Q20101E06-2100
0002FSt. Louis, MO01/01/2312/31/2360MOPriced621610Q20101E06-2100
0002GTopeka, KS01/01/2312/31/2310MOPriced621610Q20100
0002HWichita, KSBase01/01/2312/31/2320MOPriced621610Q20100
Sub-Total00
0003PORTABLE CONCENTRATOR SYSTEM WITH 2 BACKUP BATTERIES, DESK TOP CHARGER AND BACK UP SYSTEM MONTHLY FEE.
This shall include the initial set up and all visits related to the oxygen system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), back-up system complete with cylinder, regulator, stand, tubing, cannulas, masks, filter(s) and humidifier as needed. Includes all cylinder demurrage charges. E1392BaseNSP621610Q201
0003AColumbia, MOBase01/01/2312/31/23335MOPriced621610Q20100
0003BKansas City, MOBase01/01/2312/31/23284MOPriced621610Q20100
0003CLeavenworth, KSBase01/01/2312/31/23125MOPriced621610Q20100
0003DMarion, ILBase01/01/2312/31/23174MOPriced621610Q20100
0003EPoplar Bluff, MOBase01/01/2312/31/23142MOPriced621610Q20100
0003FSt. Louis, MOBase01/01/2312/31/23721MOPriced621610Q20100
0003GTopeka, KSBase01/01/2312/31/23146MOPriced621610Q20100
0003HWichita, KSBase01/01/2312/31/23171MOPriced621610Q20100
Sub-Total00
0004PORTABLE CONCENTRATOR BATTERIES IN EXCESS OF THE 2 PROVIDED WITH THE PORTABLE CONCENTRATOR MONTHLY FEE. (E1357)BaseNSP621610Q201
0004AColumbia, MOBase01/01/2312/31/23382MOPriced621610Q20100
0004BKansas City, MOBase01/01/2312/31/2384MOPriced621610Q20100
0004CLeavenworth, KSBase01/01/2312/31/23135MOPriced621610Q20100
0004DMarion, ILBase01/01/2312/31/2334MOPriced621610Q20100
0004EPoplar Bluff, MOBase01/01/2312/31/2335MOPriced621610Q20100
0004FSt. Louis, MOBase01/01/2312/31/23134MOPriced621610Q20100
0004GTopeka, KSBase01/01/2312/31/23157MOPriced621610Q20100
0004HWichita, KSBase01/01/2312/31/2321MOPriced621610Q20100
Sub-Total00
0005CYLINDER SIZE M or H MONTHLY CHARGE FOR STAND ALONE SYSTEM. This shall include initial set up and all visits related to the oxygen system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), the cylinder (s), regulator, flow meter, safety stand, humidifier and all disposable supplies. Includes all cylinder demurrage charges. E0424BaseNSP621610Q201
0005AColumbia, MOBase01/01/2312/31/2337MOPriced621610Q20100
0005BKansas City, MOBase01/01/2312/31/2385MOPriced621610Q20100
0005CLeavenworth, KSBase01/01/2312/31/2317MOPriced621610Q20100
0005DMarion, ILBase01/01/2312/31/237MOPriced621610Q20100
0005EPoplar Bluff, MOBase01/01/2312/31/235MOPriced621610Q20100
0005FSt. Louis, MOBase01/01/2312/31/2325MOPriced621610Q20100
0005GTopeka, KSBase01/01/2312/31/2316MOPriced621610Q20100
0005HWichita, KSBase01/01/2312/31/2350MOPriced621610Q20100
Sub-Total00
0006DEMAND PULSE CONSERVER CANNULA - Includes delivery. A4615BaseNSP621610Q201
0006AColumbia, MOBase01/01/2312/31/238EAPriced621610Q20100
0006BKansas City, MOBase01/01/2312/31/237EAPriced621610Q20100
0006CLeavenworth, KSBase01/01/2312/31/235EAPriced621610Q20100
0006DMarion, ILBase01/01/2312/31/235EAPriced621610Q20100
0006EPoplar Bluff, MOBase01/01/2312/31/235EAPriced621610Q20100
0006FSt. Louis, MOBase01/01/2312/31/235EAPriced621610Q20100
0006GTopeka, KSBase01/01/2312/31/235EAPriced621610Q20100
0006HWichita, KSBase01/01/2312/31/235EAPriced621610Q20100
Sub-Total00
0007CYLINDER SIZE H OR M REFILL. Includes all delivery and demurrage charges. E0443BaseNSP621610Q201
0007AColumbia, MOBase01/01/2312/31/237EAPriced621610Q20100
0007BKansas City, MOBase01/01/2312/31/2315EAPriced621610Q20100
0007CLeavenworth, KSBase01/01/2312/31/235EAPriced621610Q20100
0007DMarion, ILBase01/01/2312/31/235EAPriced621610Q20100
0007EPoplar Bluff, MOBase01/01/2312/31/235EAPriced621610Q20100
0007FSt. Louis, MOBase01/01/2312/31/235EAPriced621610Q20100
0007GTopeka, KSBase01/01/2312/31/235EAPriced621610Q20100
0007HWichita, KSBase01/01/2312/31/238EAPriced621610Q20100
Sub-Total00
0008CYLINDER SIZE E REFILL. Includes all delivery and demurrage charges. E0443BaseNSP621610Q201
0008AColumbia, MOBase01/01/2312/31/23697EAPriced621610Q20100
0008BKansas City, MOBase01/01/2312/31/23332EAPriced621610Q20100
0008CLeavenworth, KSBase01/01/2312/31/23147EAPriced621610Q20100
0008DMarion, ILBase01/01/2312/31/23483EAPriced621610Q20100
0008EPoplar Bluff, MOBase01/01/2312/31/23451EAPriced621610Q20100
0008FSt. Louis, MOBase01/01/2312/31/23294EAPriced621610Q20100
0008GTopeka, KSBase01/01/2312/31/23151EAPriced621610Q20100
0008HWichita, KSBase01/01/2312/31/23872EAPriced621610Q20100
Sub-Total00
0009CYLINDER SIZE D REFILL. Includes all delivery and demurrage charges. E0443BaseNSP621610Q201
0009AColumbia, MOBase01/01/2312/31/23392EAPriced621610Q20100
0009BKansas City, MOBase01/01/2312/31/23188EAPriced621610Q20100
0009CLeavenworth, KSBase01/01/2312/31/2389EAPriced621610Q20100
0009DMarion, ILBase01/01/2312/31/23415EAPriced621610Q20100
0009EPoplar Bluff, MOBase01/01/2312/31/23307EAPriced621610Q20100
0009FSt. Louis, MOBase01/01/2312/31/23212EAPriced621610Q20100
0009GTopeka, KSBase01/01/2312/31/23129EAPriced621610Q20100
0009HWichita, KSBase01/01/2312/31/23180EAPriced621610Q20100
Sub-Total00
0010CYLINDER SIZE B (M6) REFILL. Includes all delivery and demurrage charges. E0443BaseNSP621610Q201
0010AColumbia, MOBase01/01/2312/31/23367EAPriced621610Q20100
0010BKansas City, MOBase01/01/2312/31/23374EAPriced621610Q20100
0010CLeavenworth, KSBase01/01/2312/31/2351EAPriced621610Q20100
0010DMarion, ILBase01/01/2312/31/23468EAPriced621610Q20100
0010EPoplar Bluff, MOBase01/01/2312/31/23292EAPriced621610Q20100
0010FSt. Louis, MOBase01/01/2312/31/23311EAPriced621610Q20100
0010GTopeka, KSBase01/01/2312/31/2344EAPriced621610Q20100
0010HWichita, KSBase01/01/2312/31/23139EAPriced621610Q20100
Sub-Total00
0011LIQUID OXYGEN SYSTEM MONTHLY FEE. This shall include the initial set up and all visits related to the system by a Trained Certified Technican, a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), back-up system complete and all related monthly supplies. E0439b.BaseNSP621610Q201
0011AColumbia, MOBase01/01/2312/31/232MOPriced621610Q20100
0011BKansas City, MOBase01/01/2312/31/232MOPriced621610Q20100
0011CLeavenworth, KSBase01/01/2312/31/232MOPriced621610Q20100
0011DMarion, ILBase01/01/2312/31/232MOPriced621610Q20100
0011EPoplar Bluff, MOBase01/01/2312/31/232MOPriced621610Q20100
0011FSt. Louis, MOBase01/01/2312/31/232MOPriced621610Q20100
0011GTopeka, KSBase01/01/2312/31/232MOPriced621610Q20100
0011HWichita, KSBase01/01/2312/31/232MOPriced621610Q20100
Sub-Total00
0012LIQUID OXYGEN SYSTEM (PORTABLE) MONTHLY FEE. This shall include initial set up and all visits related to the system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), and all related monthly supplies. E0434BaseNSP621610Q201
0012AColumbia, MOBase01/01/2312/31/232MOPriced621610Q20100
0012BKansas City, MOBase01/01/2312/31/232MOPriced621610Q20100
0012CLeavenworth, KSBase01/01/2312/31/232MOPriced621610Q20100
0012DMarion, ILBase01/01/2312/31/232MOPriced621610Q20100
0012EPoplar Bluff, MOBase01/01/2312/31/232MOPriced621610Q20100
0012FSt. Louis, MOBase01/01/2312/31/232MOPriced621610Q20100
0012GTopeka, KSBase01/01/2312/31/232MOPriced621610Q20100
0012HWichita, KSBase01/01/2312/31/232MOPriced621610Q20100
Sub-Total00
0013LIQUID OXYGEN PER POUND. Includes all delivery charges. E0442BaseNSP621610Q201
0013AColumbia, MOBase01/01/2312/31/23300LBPriced621610Q20100
0013BKansas City, MOBase01/01/2312/31/23300LBPriced621610Q20100
0013CLeavenworth, KSBase01/01/2312/31/23300LBPriced621610Q20100
0013DMarion, ILBase01/01/2312/31/23300LBPriced621610Q20100
0013EPoplar Bluff, MOBase01/01/2312/31/23300LBPriced621610Q20100
0013FSt. Louis, MOBase01/01/2312/31/23300LBPriced621610Q20100
0013GTopeka, KSBase01/01/2312/31/23300LBPriced621610Q20100
0013HWichita, KSBase01/01/2312/31/23300LBPriced621610Q20100
Sub-Total00
0014AEROSOL COMPRESSOR MONTHLY FEE: This shall include initial set up and all visits related to the system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), and all related monthly supplies. E0565BaseNSP621610Q201
0014AColumbia, MOBase01/01/2312/31/235MOPriced621610Q20100
0014BKansas City, MOBase01/01/2312/31/235MOPriced621610Q20100
0014CLeavenworth, KSBase01/01/2312/31/235MOPriced621610Q20100
0014DMarion, ILBase01/01/2312/31/235MOPriced621610Q20100
0014EPoplar Bluff, MOBase01/01/2312/31/235MOPriced621610Q20100
0014FSt. Louis, MOBase01/01/2312/31/2314MOPriced621610Q20100
0014GTopeka, KSBase01/01/2312/31/235MOPriced621610Q20100
0014HWichita, KSBase01/01/2312/31/235MOPriced621610Q20100
Sub-Total00
0015HEATED INTEGRATED COMPRESSOR MONTHLY FEE: This shall include initial set up and all visits related to the system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), and all related monthly supplies. E0585BaseNSP621610Q201
0015AColumbia, MOBase01/01/2312/31/235MOPriced621610Q20100
0015BKansas City, MOBase01/01/2312/31/235MOPriced621610Q20100
0015CLeavenworth, KSBase01/01/2312/31/235MOPriced621610Q20100
0015DMarion, ILBase01/01/2312/31/237MOPriced621610Q20100
0015EPoplar Bluff, MOBase01/01/2312/31/235MOPriced621610Q20100
0015FSt. Louis, MOBase01/01/2312/31/235MOPriced621610Q20100
0015GTopeka, KSBase01/01/2312/31/235MOPriced621610Q20100
0015HWichita, KSBase01/01/2312/31/235MOPriced621610Q20100
Sub-Total00
0016VENTILATOR MONTHLY FEE. This shall include the initial visit, ventilator, backup ventilator, initial visit, monthly visits, set-up, and service by a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), all related monthly supplies. E0450BaseNSP621610Q201
0016AColumbia, MOBase01/01/2312/31/236MOPriced621610Q20100
0016BKansas City, MOBase01/01/2312/31/2318MOPriced621610Q20100
0016CLeavenworth, KSBase01/01/2312/31/235MOPriced621610Q20100
0016DMarion, ILBase01/01/2312/31/238MOPriced621610Q20100
0016EPoplar Bluff, MOBase01/01/2312/31/2314MOPriced621610Q20100
0016FSt. Louis, MOBase01/01/2312/31/2326MOPriced621610Q20100
0016GTopeka, KSBase01/01/2312/31/235MOPriced621610Q20100
0016HWichita, KSBase01/01/2312/31/235MOPriced621610Q20100
Sub-Total00
0017EMERGENCY SET UP FEE - Set up called in after 3PM and requires same day delivery. VA 120BaseNSP621610Q201
0017AColumbia, MOBase01/01/2312/31/235FEEPriced621610Q20100
0017BKansas City, MOBase01/01/2312/31/236FEEPriced621610Q20100
0017CLeavenworth, KSBase01/01/2312/31/235FEEPriced621610Q20100
0017DMarion, ILBase01/01/2312/31/2312FEEPriced621610Q20100
0017EPoplar Bluff, MOBase01/01/2312/31/2314FEEPriced621610Q20100
0017FSt. Louis, MOBase01/01/2312/31/235FEEPriced621610Q20100
0017GTopeka, KSBase01/01/2312/31/235FEEPriced621610Q20100
0017HWichita, KSBase01/01/2312/31/235FEEPriced621610Q20100
Sub-Total00
0018BI-DIRECTIONAL THERMAL FUSES SET UP FEE - Included in the fee of the bi-directional thermal fuse is installation and patient education of the bi-directional thermal fuses on all oxygen systems.BaseNSP621610Q201
0018AColumbia, MOBase01/01/2312/31/23115FEEPriced621610Q20100
0018BKansas City, MOBase01/01/2312/31/2393FEEPriced621610Q20100
0018CLeavenworth, KSBase01/01/2312/31/2325FEEPriced621610Q20100
0018DMarion, ILBase01/01/2312/31/23119FEEPriced621610Q20100
0018EPoplar Bluff, MOBase01/01/2312/31/23112FEEPriced621610Q20100
0018FSt. Louis, MOBase01/01/2312/31/23113FEEPriced621610Q20100
0018GTopeka, KSBase01/01/2312/31/2331FEEPriced621610Q20100
0018HWichita, KSBase01/01/2312/31/2374FEEPriced621610Q20100
Sub-Total00

Total 0 0

10015 LPM CONCENTRATOR WITH BACKUP SYSTEM AND PORTABLE SYSTEM MONTHLY FEE.This shall include the initial set up and all visits related to the oxygen system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), back-up system complete with cylinder, regulator, stand, tubing, cannulas, filter(s) and humidifier as needed, portable cylinders with wheeled cart and/or bag, regulator and/or demand pulse conserving device and all supplies including cannulas, masks, tubing, filters, and humidifiers. Includes all cylinder demurrage charges. E1390Year 2NSP621610Q201
1001AColumbia, MOYear 201/01/2412/31/24725MOPriced621610Q201
1001BKansas City, MOYear 201/01/2412/31/24732MOPriced621610Q201
1001CLeavenworth, KSYear 201/01/2412/31/24271MOPriced621610Q201
1001DMarion, ILYear 201/01/2412/31/24826MOPriced621610Q201
1001EPoplar Bluff, MOYear 201/01/2412/31/24587MOPriced621610Q201
1001FSt. Louis, MOYear 201/01/2412/31/24731MOPriced621610Q201
1001GTopeka, KSYear 201/01/2412/31/24307MOPriced621610Q201
1001HWichita, KSYear 201/01/2412/31/24499MOPriced621610Q201
Sub-Total
100210 LPM CONCENTRATOR WITH BACKUP SYSTEM AND PORTABLE SYSTEM MONTHLY FEE.
This shall include the initial set up and all visits related to the oxygen system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), back-up system complete with cylinder, regulator, stand, tubing, cannulas, filter(s) and humidifier as needed, portable cylinders with wheeled cart and/or bag, regulator and/or demand pulse conserving device and all supplies including cannulas, masks, tubing, filters, and humidifiers. Includes all cylinder demurrage charges. E1390Year 2NSP621610Q201
1002AColumbia, MOYear 201/01/2412/31/2487MOPriced621610Q201
1002BKansas City, MOYear 201/01/2412/31/2454MOPriced621610Q201
1002CLeavenworth, KSYear 201/01/2412/31/2412MOPriced621610Q201
1002DMarion, ILYear 201/01/2412/31/2427MOPriced621610Q201
1002EPoplar Bluff, MOYear 201/01/2412/31/2418MOPriced621610Q201
1002FSt. Louis, MOYear 201/01/2412/31/2460MOPriced621610Q201
1002GTopeka, KSYear 201/01/2412/31/2410MOPriced621610Q201
1002HWichita, KSYear 201/01/2412/31/2420MOPriced621610Q201
Sub-Total621610Q201
1003PORTABLE CONCENTRATOR SYSTEM WITH 2 BACKUP BATTERIES, DESK TOP CHARGER AND BACK UP SYSTEM MONTHLY FEE.
This shall include the initial set up and all visits related to the oxygen system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), back-up system complete with cylinder, regulator, stand, tubing, cannulas, masks, filter(s) and humidifier as needed. Includes all cylinder demurrage charges. E1392Year 2NSP621610Q201
1003AColumbia, MOYear 201/01/2412/31/24335MOPriced621610Q201
1003BKansas City, MOYear 201/01/2412/31/24284MOPriced621610Q201
1003CLeavenworth, KSYear 201/01/2412/31/24125MOPriced621610Q201
1003DMarion, ILYear 201/01/2412/31/24174MOPriced621610Q201
1003EPoplar Bluff, MOYear 201/01/2412/31/24142MOPriced621610Q201
1003FSt. Louis, MOYear 201/01/2412/31/24721MOPriced621610Q201
1003GTopeka, KSYear 201/01/2412/31/24146MOPriced621610Q201
1003HWichita, KSYear 201/01/2412/31/24171MOPriced621610Q201
Sub-Total
1004PORTABLE CONCENTRATOR BATTERIES IN EXCESS OF THE 2 PROVIDED WITH THE PORTABLE CONCENTRATOR MONTHLY FEE. (E1357)Year 2NSP621610Q201
1004AColumbia, MOYear 201/01/2412/31/24382MOPriced621610Q201
1004BKansas City, MOYear 201/01/2412/31/2484MOPriced621610Q201
1004CLeavenworth, KSYear 201/01/2412/31/24135MOPriced621610Q201
1004DMarion, ILYear 201/01/2412/31/2434MOPriced621610Q201
1004EPoplar Bluff, MOYear 201/01/2412/31/2435MOPriced621610Q201
1004FSt. Louis, MOYear 201/01/2412/31/24134MOPriced621610Q201
1004GTopeka, KSYear 201/01/2412/31/24157MOPriced621610Q201
1004HWichita, KSYear 201/01/2412/31/2421MOPriced621610Q20110041004100410041004100410041004100410041004100410041004100410041004100410041004100410041004100410041004100410041004100410041004100410041004
Sub-Total
1005CYLINDER SIZE M or H MONTHLY CHARGE FOR STAND ALONE SYSTEM. This shall include initial set up and all visits related to the oxygen system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), the cylinder (s), regulator, flow meter, safety stand, humidifier and all disposable supplies. Includes all cylinder demurrage charges. E0424Year 2NSP621610Q201
1005AColumbia, MOYear 201/01/2412/31/2437MOPriced621610Q201
1005BKansas City, MOYear 201/01/2412/31/2485MOPriced621610Q201
1005CLeavenworth, KSYear 201/01/2412/31/2417MOPriced621610Q201
1005DMarion, ILYear 201/01/2412/31/247MOPriced621610Q201
1005EPoplar Bluff, MOYear 201/01/2412/31/245MOPriced621610Q201
1005FSt. Louis, MOYear 201/01/2412/31/2425MOPriced621610Q201
1005GTopeka, KSYear 201/01/2412/31/2416MOPriced621610Q201
1005HWichita, KSYear 201/01/2412/31/2450MOPriced621610Q201
Sub-Total
1006DEMAND PULSE CONSERVER CANNULA - Includes delivery. A4615Year 2NSP621610Q201
1006AColumbia, MOYear 201/01/2412/31/248EAPriced621610Q201
1006BKansas City, MOYear 201/01/2412/31/247EAPriced621610Q201
1006CLeavenworth, KSYear 201/01/2412/31/245EAPriced621610Q201
1006DMarion, ILYear 201/01/2412/31/245EAPriced621610Q201
1006EPoplar Bluff, MOYear 201/01/2412/31/245EAPriced621610Q201
1006FSt. Louis, MOYear 201/01/2412/31/245EAPriced621610Q201
1006GTopeka, KSYear 201/01/2412/31/245EAPriced621610Q201
1006HWichita, KSYear 201/01/2412/31/245EAPriced621610Q201
Sub-Total
1007CYLINDER SIZE H OR M REFILL. Includes all delivery and demurrage charges. E0443Year 2NSP621610Q201
1007AColumbia, MOYear 201/01/2412/31/247EAPriced621610Q201
1007BKansas City, MOYear 201/01/2412/31/2415EAPriced621610Q201
1007CLeavenworth, KSYear 201/01/2412/31/245EAPriced621610Q201
1007DMarion, ILYear 201/01/2412/31/245EAPriced621610Q201
1007EPoplar Bluff, MOYear 201/01/2412/31/245EAPriced621610Q201
1007FSt. Louis, MOYear 201/01/2412/31/245EAPriced621610Q201
1007GTopeka, KSYear 201/01/2412/31/245EAPriced621610Q201
1007HWichita, KSYear 201/01/2412/31/248EAPriced621610Q201
Sub-Total
1008CYLINDER SIZE E REFILL. Includes all delivery and demurrage charges. E0443Year 2NSP621610Q201
1008AColumbia, MOYear 201/01/2412/31/24697EAPriced621610Q201
1008BKansas City, MOYear 201/01/2412/31/24332EAPriced621610Q201
1008CLeavenworth, KSYear 201/01/2412/31/24147EAPriced621610Q201
1008DMarion, ILYear 201/01/2412/31/24483EAPriced621610Q201
1008EPoplar Bluff, MOYear 201/01/2412/31/24451EAPriced621610Q201
1008FSt. Louis, MOYear 201/01/2412/31/24294EAPriced621610Q201
1008GTopeka, KSYear 201/01/2412/31/24151EAPriced621610Q201
1008HWichita, KSYear 201/01/2412/31/24872EAPriced621610Q201
Sub-Total
1009CYLINDER SIZE D REFILL. Includes all delivery and demurrage charges. E0443Year 2NSP621610Q201
1009AColumbia, MOYear 201/01/2412/31/24392EAPriced621610Q201
1009BKansas City, MOYear 201/01/2412/31/24188EAPriced621610Q201
1009CLeavenworth, KSYear 201/01/2412/31/2489EAPriced621610Q201
1009DMarion, ILYear 201/01/2412/31/24415EAPriced621610Q201
1009EPoplar Bluff, MOYear 201/01/2412/31/24307EAPriced621610Q201
1009FSt. Louis, MOYear 201/01/2412/31/24212EAPriced621610Q201
1009GTopeka, KSYear 201/01/2412/31/24129EAPriced621610Q201
1009HWichita, KSYear 201/01/2412/31/24180EAPriced621610Q201
Sub-Total
1010CYLINDER SIZE B (M6) REFILL. Includes all delivery and demurrage charges. E0443Year 2NSP621610Q201
1010AColumbia, MOYear 201/01/2412/31/24367EAPriced621610Q201
1010BKansas City, MOYear 201/01/2412/31/24374EAPriced621610Q201
1010CLeavenworth, KSYear 201/01/2412/31/2451EAPriced621610Q201
1010DMarion, ILYear 201/01/2412/31/24468EAPriced621610Q201
1010EPoplar Bluff, MOYear 201/01/2412/31/24292EAPriced621610Q201
1010FSt. Louis, MOYear 201/01/2412/31/24311EAPriced621610Q201
1010GTopeka, KSYear 201/01/2412/31/2444EAPriced621610Q201
1010HWichita, KSYear 201/01/2412/31/24139EAPriced621610Q201
Sub-Total
1011LIQUID OXYGEN SYSTEM MONTHLY FEE. This shall include the initial set up and all visits related to the system by a Trained Certified Technican, a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), back-up system complete and all related monthly supplies. E0439b.Year 2NSP621610Q201
1011AColumbia, MOYear 201/01/2412/31/242MOPriced621610Q201
1011BKansas City, MOYear 201/01/2412/31/242MOPriced621610Q201
1011CLeavenworth, KSYear 201/01/2412/31/242MOPriced621610Q201
1011DMarion, ILYear 201/01/2412/31/242MOPriced621610Q201
1011EPoplar Bluff, MOYear 201/01/2412/31/242MOPriced621610Q201
1011FSt. Louis, MOYear 201/01/2412/31/242MOPriced621610Q201
1011GTopeka, KSYear 201/01/2412/31/242MOPriced621610Q201
1011HWichita, KSYear 201/01/2412/31/242MOPriced621610Q201
Sub-Total
1012LIQUID OXYGEN SYSTEM (PORTABLE) MONTHLY FEE. This shall include initial set up and all visits related to the system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), and all related monthly supplies. E0434Year 2NSP621610Q201
1012AColumbia, MOYear 201/01/2412/31/242MOPriced621610Q201
1012BKansas City, MOYear 201/01/2412/31/242MOPriced621610Q201
1012CLeavenworth, KSYear 201/01/2412/31/242MOPriced621610Q201
1012DMarion, ILYear 201/01/2412/31/242MOPriced621610Q201
1012EPoplar Bluff, MOYear 201/01/2412/31/242MOPriced621610Q201
1012FSt. Louis, MOYear 201/01/2412/31/242MOPriced621610Q201
1012GTopeka, KSYear 201/01/2412/31/242MOPriced621610Q201
1012HWichita, KSYear 201/01/2412/31/242MOPriced621610Q201
Sub-Total
1013LIQUID OXYGEN PER POUND. Includes all delivery charges. E0442Year 2NSP621610Q201
1013AColumbia, MOYear 201/01/2412/31/24300LBPriced621610Q201
1013BKansas City, MOYear 201/01/2412/31/24300LBPriced621610Q201
1013CLeavenworth, KSYear 201/01/2412/31/24300LBPriced621610Q201
1013DMarion, ILYear 201/01/2412/31/24300LBPriced621610Q201
1013EPoplar Bluff, MOYear 201/01/2412/31/24300LBPriced621610Q201
1013FSt. Louis, MOYear 201/01/2412/31/24300LBPriced621610Q201
1013GTopeka, KSYear 201/01/2412/31/24300LBPriced621610Q201
1013HWichita, KSYear 201/01/2412/31/24300LBPriced621610Q201
Sub-Total
1014AEROSOL COMPRESSOR MONTHLY FEE: This shall include initial set up and all visits related to the system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), and all related monthly supplies. E0565Year 2NSP621610Q201
1014AColumbia, MOYear 201/01/2412/31/245MOPriced621610Q201
1014BKansas City, MOYear 201/01/2412/31/245MOPriced621610Q201
1014CLeavenworth, KSYear 201/01/2412/31/245MOPriced621610Q201
1014DMarion, ILYear 201/01/2412/31/245MOPriced621610Q201
1014EPoplar Bluff, MOYear 201/01/2412/31/245MOPriced621610Q201
1014FSt. Louis, MOYear 201/01/2412/31/2414MOPriced621610Q201
1014GTopeka, KSYear 201/01/2412/31/245MOPriced621610Q201
1014HWichita, KSYear 201/01/2412/31/245MOPriced621610Q201
Sub-Total
1015HEATED INTEGRATED COMPRESSOR MONTHLY FEE: This shall include initial set up and all visits related to the system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), and all related monthly supplies. E0585Year 2NSP621610Q201
1015AColumbia, MOYear 201/01/2412/31/245MOPriced621610Q201
1015BKansas City, MOYear 201/01/2412/31/245MOPriced621610Q201
1015CLeavenworth, KSYear 201/01/2412/31/245MOPriced621610Q201
1015DMarion, ILYear 201/01/2412/31/247MOPriced621610Q201
1015EPoplar Bluff, MOYear 201/01/2412/31/245MOPriced621610Q201
1015FSt. Louis, MOYear 201/01/2412/31/245MOPriced621610Q201
1015GTopeka, KSYear 201/01/2412/31/245MOPriced621610Q201
1015HWichita, KSYear 201/01/2412/31/245MOPriced621610Q201
Sub-Total
1016VENTILATOR MONTHLY FEE. This shall include the initial visit, ventilator, backup ventilator, initial visit, monthly visits, set-up, and service by a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), all related monthly supplies. E0450Year 2NSP621610Q201
1016AColumbia, MOYear 201/01/2412/31/246MOPriced621610Q201
1016BKansas City, MOYear 201/01/2412/31/2418MOPriced621610Q201
1016CLeavenworth, KSYear 201/01/2412/31/245MOPriced621610Q201
1016DMarion, ILYear 201/01/2412/31/248MOPriced621610Q201
1016EPoplar Bluff, MOYear 201/01/2412/31/2414MOPriced621610Q201
1016FSt. Louis, MOYear 201/01/2412/31/2426MOPriced621610Q201
1016GTopeka, KSYear 201/01/2412/31/245MOPriced621610Q201
1016HWichita, KSYear 201/01/2412/31/245MOPriced621610Q201
Sub-Total
1017EMERGENCY SET UP FEE - Set up called in after 3PM and requires same day delivery. VA 120Year 2NSP621610Q201
1017AColumbia, MOYear 201/01/2412/31/245FEEPriced621610Q201
1017BKansas City, MOYear 201/01/2412/31/246FEEPriced621610Q201
1017CLeavenworth, KSYear 201/01/2412/31/245FEEPriced621610Q201
1017DMarion, ILYear 201/01/2412/31/2412FEEPriced621610Q201
1017EPoplar Bluff, MOYear 201/01/2412/31/2414FEEPriced621610Q201
1017FSt. Louis, MOYear 201/01/2412/31/245FEEPriced621610Q201
1017GTopeka, KSYear 201/01/2412/31/245FEEPriced621610Q201
1017HWichita, KSYear 201/01/2412/31/245FEEPriced621610Q201
Sub-Total
1018BI-DIRECTIONAL THERMAL FUSES SET UP FEE - Included in the fee of the bi-directional thermal fuse is installation and patient education of the bi-directional thermal fuses on all oxygen systems.Year 2NSP621610Q201
1018AColumbia, MOYear 201/01/2412/31/24115FEEPriced621610Q201
1018BKansas City, MOYear 201/01/2412/31/2493FEEPriced621610Q201
1018CLeavenworth, KSYear 201/01/2412/31/2425FEEPriced621610Q201
1018DMarion, ILYear 201/01/2412/31/24119FEEPriced621610Q201
1018EPoplar Bluff, MOYear 201/01/2412/31/24112FEEPriced621610Q201
1018FSt. Louis, MOYear 201/01/2412/31/24113FEEPriced621610Q201
1018GTopeka, KSYear 201/01/2412/31/2431FEEPriced621610Q201
1018HWichita, KSYear 201/01/2412/31/2474FEEPriced621610Q201
Sub-Total

Total 0 0

20015 LPM CONCENTRATOR WITH BACKUP SYSTEM AND PORTABLE SYSTEM MONTHLY FEE.This shall include the initial set up and all visits related to the oxygen system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), back-up system complete with cylinder, regulator, stand, tubing, cannulas, filter(s) and humidifier as needed, portable cylinders with wheeled cart and/or bag, regulator and/or demand pulse conserving device and all supplies including cannulas, masks, tubing, filters, and humidifiers. Includes all cylinder demurrage charges. E1390Year 3NSP621610Q201
2001AColumbia, MOYear 301/01/2512/31/25725MOPriced621610Q20100
2001BKansas City, MOYear 301/01/2512/31/25732MOPriced621610Q20100
2001CLeavenworth, KSYear 301/01/2512/31/25271MOPriced621610Q20100
2001DMarion, ILYear 301/01/2512/31/25826MOPriced621610Q20100
2001EPoplar Bluff, MOYear 301/01/2512/31/25587MOPriced621610Q20100
2001FSt. Louis, MOYear 301/01/2512/31/25731MOPriced621610Q20100
2001GTopeka, KSYear 301/01/2512/31/25307MOPriced621610Q20100
2001HWichita, KSYear 301/01/2512/31/25499MOPriced621610Q20100
Sub-Total00
200210 LPM CONCENTRATOR WITH BACKUP SYSTEM AND PORTABLE SYSTEM MONTHLY FEE.
This shall include the initial set up and all visits related to the oxygen system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), back-up system complete with cylinder, regulator, stand, tubing, cannulas, filter(s) and humidifier as needed, portable cylinders with wheeled cart and/or bag, regulator and/or demand pulse conserving device and all supplies including cannulas, masks, tubing, filters, and humidifiers. Includes all cylinder demurrage charges. E1390Year 3NSP621610Q201
2002AColumbia, MOYear 301/01/2512/31/2587MOPriced621610Q20100
2002BKansas City, MOYear 301/01/2512/31/2554MOPriced621610Q20100
2002CLeavenworth, KSYear 301/01/2512/31/2512MOPriced621610Q20100
2002DMarion, ILYear 301/01/2512/31/2527MOPriced621610Q20100
2002EPoplar Bluff, MOYear 301/01/2512/31/2518MOPriced621610Q20100
2002FSt. Louis, MOYear 301/01/2512/31/2560MOPriced621610Q20100
2002GTopeka, KSYear 301/01/2512/31/2510MOPriced621610Q20100
2002HWichita, KSYear 301/01/2512/31/2520MOPriced621610Q20100
Sub-Total00
2003PORTABLE CONCENTRATOR SYSTEM WITH 2 BACKUP BATTERIES, DESK TOP CHARGER AND BACK UP SYSTEM MONTHLY FEE.
This shall include the initial set up and all visits related to the oxygen system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), back-up system complete with cylinder, regulator, stand, tubing, cannulas, masks, filter(s) and humidifier as needed. Includes all cylinder demurrage charges. E1392Year 3NSP621610Q201
2003AColumbia, MOYear 301/01/2512/31/25335MOPriced621610Q20100
2003BKansas City, MOYear 301/01/2512/31/25284MOPriced621610Q20100
2003CLeavenworth, KSYear 301/01/2512/31/25125MOPriced621610Q20100
2003DMarion, ILYear 301/01/2512/31/25174MOPriced621610Q20100
2003EPoplar Bluff, MOYear 301/01/2512/31/25142MOPriced621610Q20100
2003FSt. Louis, MOYear 301/01/2512/31/25721MOPriced621610Q20100
2003GTopeka, KSYear 301/01/2512/31/25146MOPriced621610Q20100
2003HWichita, KSYear 301/01/2512/31/25171MOPriced621610Q20100
Sub-Total00
2004PORTABLE CONCENTRATOR BATTERIES IN EXCESS OF THE 2 PROVIDED WITH THE PORTABLE CONCENTRATOR MONTHLY FEE. (E1357)Year 3NSP621610Q201
2004AColumbia, MOYear 301/01/2512/31/25382MOPriced621610Q20100
2004BKansas City, MOYear 301/01/2512/31/2584MOPriced621610Q20100
2004CLeavenworth, KSYear 301/01/2512/31/25135MOPriced621610Q20100
2004DMarion, ILYear 301/01/2512/31/2534MOPriced621610Q20100
2004EPoplar Bluff, MOYear 301/01/2512/31/2535MOPriced621610Q20100
2004FSt. Louis, MOYear 301/01/2512/31/25134MOPriced621610Q20100
2004GTopeka, KSYear 301/01/2512/31/25157MOPriced621610Q20100
2004HWichita, KSYear 301/01/2512/31/2521MOPriced621610Q20100
Sub-Total00
2005CYLINDER SIZE M or H MONTHLY CHARGE FOR STAND ALONE SYSTEM. This shall include initial set up and all visits related to the oxygen system by a Trained Certified Technican, a Certified Respiratory Therapist (CRT) or a Registered Respiratory Therapist (RRT), the cylinder (s), regulator, flow meter, safety stand, humidifier and all disposable supplies. Includes all cylinder demurrage charges. E0424Year 3NSP621610Q201
2005AColumbia, MOYear 301/01/2512/31/2537MOPriced621610Q20100
2005BKansas City, MOYear 301/01/2512/31/2585MOPriced621610Q20100

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