36C25818Q0069-008.pdf

Base Period

Option Year 1

Option Year 2

Option Year 3

Option Year 4

AA General Radiographic Procedure (Plain Film X-ray); Emergent and Non-emergent 501 506 511 516 521

AB Computed Tomography (CT)/Computerized Axial Tomography (CAT Scan);

Emergent and Non-emergent 2,715 2,742 2,770 2,797 2,825

AC

Teleradiology Services for the Southern Arizona VA Health Care System in accordance with the performance work statement for the interpretation of Magnetic Resonance Imaging (MRI)/Magnetic Resonance Aniography (MRA); Emergent and Non-emergent

1,697 1,714 1,731 1,748 1,766

AD

Teleradiology Services for the Southern Arizona VA Health Care System in accordance with the performance work statement for the interpretation of Nuclear Medicine (NM); Emergent and Non-emergent

16 16 16 16 16

AE

Teleradiology Services for the Southern Arizona VA Health Care System in accordance with the performance work statement for the interpretation of Ultrasound Imagining; Emergent and Non-emergent

285 288 291 294 297

Teleradiology Services for the Southern Arizona VA Health Care System in accordance with the performance work statement for the interpretation of the following Modalities:

*ESTIMATED QUANTITES

Price Worksheet

It is understood that no obligation beyond the minimum guarantee amount specified below will be incurred by the Department of Veteran The amounts below are for the entire term of the contract, which includes the base period and any exercised option periods.

Minimum Guarantee Amount: The guaranteed minimum $ 75.00 Estimated Maximum Amount: The estimated maximum $5,000,000.00

*VA estimates that it will require 5,214 cases of teleradiology services during the base year and option years.

DESCRIPTION OF SUPPLIES/SERVICESCLIN