36C25918Q9874-0001002.docx

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Radiopharmaceuticals
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36C25918Q9874
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36C25918Q9874 0001 Schedule of Supplies - 30AUG2018.docx

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SCHEDULE OF SUPPLIES

1. The Contractor shall provide items on a unit dose basis, pre-drawn into a syringe, calibrated and delivered to the Nuclear Medicine department of the Montana VA Health Care System, 3687 Veterans Drive, Fort Harrison, Montana. Items will be required Monday through Friday during the hours of 7:30am to 4:00pm, and outside of these specified hours on an “as needed” basis.

2. Quantities listed are estimated usage only.

BASE YEAR: October 1, 2018 – September 30, 2019

Line Item
Product Description
Method of Supply
Estimated Annual Quantity
Unit Price
Total Price
Unit Doses
per dose
0001
HDP
Per dose
159
0002
MDP
per dose
0
0003
MAA
per dose
17
0004
DTPA
per dose
0
0005
Choletec/Mebrofenin
per dose
31
0006
Sulfur Colloid
Per dose
10
0007
Sulfur Colloid, Filtered
per dose
0
0008
MAG-3
per dose
3
0009
Cardiolite/Sestamibi
Per dose
543
0010
Myoview/Tetrofosmin
per 1 mCi
0
0011
Tc-99m
Per vial
52
0012
Tc-99m (Bulk)
per mCi
11
0013
Thallium-201
per mCi
0
0014
Gallium-67
per capsule
0
0015
I-123 (100uCi)
per capsule
0
0016
I-123 (200uCi)
each
0
0017
20mCi Cobalt57 Sheet Source
Per vial
1
0018
Xenon 133
White Blood Cells
per study
0019
In-111 WBC
per study
2
0020
Ceretec
per occurrence
0
0021
WBC Prep Kit

Cold Kits

0022
Choletec/Mebrofenin
per vial
0
0023
Hepatolite/Disofenin
per vial
0
0024
DTPA
per vial
0
0025
HDP
per vial
0
0026
MAA
per vial
0
0027
Sulfur Colloid
per vial
0
0028
Kinevac/Sincalide/CCK
per vial
0
0029
Ultratag
Per kit
0
0030
DMSA
Per vial
0
0031
MDP
Per vial
0
0032
Cardiolite/Sestamibi
Per vial
0
0033
Myoview/Tetrofosmin
Per vial
0

Incidentals

0034
Persantine
per dose
0
0035
Lexiscan
per dose
0
0036
Dobutamine
per dose
0

Delivery

0037
Delivery Fee - Weekday
per trip
320
0038
Delivery Fee - Weekend
per trip
4
0039
Delivery Fee – STAT call out
per trip
8

OPTION YEAR 1: October 1, 2019 – September 30, 2020

Line Item
Product Description
Method of Supply
Estimated Annual Quantity
Unit Price
Total Price
Unit Doses
per dose
1001
HDP
Per dose
159
1002
MDP
per dose
0
1003
MAA
per dose
17
1004
DTPA
per dose
0
1005
Choletec/Mebrofenin
per dose
31
1006
Sulfur Colloid
Per dose
10
1007
Sulfur Colloid, Filtered
per dose
0
1008
MAG-3
per dose
3
1009
Cardiolite/Sestamibi
Per dose
543
1010
Myoview/Tetrofosmin
per 1 mCi
0
1011
Tc-99m
Per vial
52
1012
Tc-99m (Bulk)
per mCi
11
1013
Thallium-201
per mCi
0
1014
Gallium-67
per capsule
0
1015
I-123 (100uCi)
per capsule
0
1016
I-123 (200uCi)
each
0
1017
20mCi Cobalt57 Sheet Source
Per vial
1
1018
Xenon 133
White Blood Cells
per study
1019
In-111 WBC
per study
2
1020
Ceretec
per occurrence
0
1021
WBC Prep Kit

Cold Kits

1022
Choletec/Mebrofenin
per vial
0
1023
Hepatolite/Disofenin
per vial
0
1024
DTPA
per vial
0
1025
HDP
per vial
0
1026
MAA
per vial
0
1027
Sulfur Colloid
per vial
0
1028
Kinevac/Sincalide/CCK
per vial
0
1029
Ultratag
Per kit
0
1030
DMSA
Per vial
0
1031
MDP
Per vial
0
1032
Cardiolite/Sestamibi
Per vial
0
1033
Myoview/Tetrofosmin
Per vial
0

Incidentals

1034
Persantine
per dose
0
1035
Lexiscan
per dose
0
1036
Dobutamine
per dose
0

Delivery

1037
Delivery Fee - Weekday
per trip
320
1038
Delivery Fee - Weekend
per trip
4
1039
Delivery Fee – STAT call out
per trip
8

OPTION YEAR 2: October 1, 2020 – September 30, 2021

Line Item
Product Description
Method of Supply
Estimated Annual Quantity
Unit Price
Total Price
Unit Doses
per dose
2001
HDP
Per dose
159
2002
MDP
per dose
0
2003
MAA
per dose
17
2004
DTPA
per dose
0
2005
Choletec/Mebrofenin
per dose
31
2006
Sulfur Colloid
Per dose
10
2007
Sulfur Colloid, Filtered
per dose
0
2008
MAG-3
per dose
3
2009
Cardiolite/Sestamibi
Per dose
543
2010
Myoview/Tetrofosmin
per 1 mCi
0
2011
Tc-99m
Per vial
52
2012
Tc-99m (Bulk)
per mCi
11
2013
Thallium-201
per mCi
0
2014
Gallium-67
per capsule
0
2015
I-123 (100uCi)
per capsule
0
2016
I-123 (200uCi)
each
0
2017
20mCi Cobalt57 Sheet Source
Per vial
1
2018
Xenon 133
White Blood Cells
per study
2019
In-111 WBC
per study
2
2020
Ceretec
per occurrence
0
2021
WBC Prep Kit

Cold Kits

2022
Choletec/Mebrofenin
per vial
0
2023
Hepatolite/Disofenin
per vial
0
2024
DTPA
per vial
0
2025
HDP
per vial
0
2026
MAA
per vial
0
2027
Sulfur Colloid
per vial
0
2028
Kinevac/Sincalide/CCK
per vial
0
2029
Ultratag
Per kit
0
2030
DMSA
Per vial
0
2031
MDP
Per vial
0
2032
Cardiolite/Sestamibi
Per vial
0
2033
Myoview/Tetrofosmin
Per vial
0

Incidentals

2034
Persantine
per dose
0
2035
Lexiscan
per dose
0
2036
Dobutamine
per dose
0

Delivery

2037
Delivery Fee - Weekday
per trip
320
2038
Delivery Fee - Weekend
per trip
4
2039
Delivery Fee – STAT call out
per trip
8

OPTION YEAR 3: October 1, 2021 – September 30, 2022

Line Item
Product Description
Method of Supply
Estimated Annual Quantity
Unit Price
Total Price
Unit Doses
per dose
3001
HDP
Per dose
159
3002
MDP
per dose
0
3003
MAA
per dose
17
3004
DTPA
per dose
0
3005
Choletec/Mebrofenin
per dose
31
3006
Sulfur Colloid
Per dose
10
3007
Sulfur Colloid, Filtered
per dose
0
3008
MAG-3
per dose
3
3009
Cardiolite/Sestamibi
Per dose
543
3010
Myoview/Tetrofosmin
per 1 mCi
0
3011
Tc-99m
Per vial
52
3012
Tc-99m (Bulk)
per mCi
11
3013
Thallium-201
per mCi
0
3014
Gallium-67
per capsule
0
3015
I-123 (100uCi)
per capsule
0
3016
I-123 (200uCi)
each
0
3017
20mCi Cobalt57 Sheet Source
Per vial
1
3018
Xenon 133
White Blood Cells
per study
3019
In-111 WBC
per study
2
3020
Ceretec
per occurrence
0
3021
WBC Prep Kit

Cold Kits

3022
Choletec/Mebrofenin
per vial
0
3023
Hepatolite/Disofenin
per vial
0
3024
DTPA
per vial
0
3025
HDP
per vial
0
3026
MAA
per vial
0
3027
Sulfur Colloid
per vial
0
3028
Kinevac/Sincalide/CCK
per vial
0
3029
Ultratag
Per kit
0
3030
DMSA
Per vial
0
3031
MDP
Per vial
0
3032
Cardiolite/Sestamibi
Per vial
0
3033
Myoview/Tetrofosmin
Per vial
0

Incidentals

3034
Persantine
per dose
0
3035
Lexiscan
per dose
0
3036
Dobutamine
per dose
0

Delivery

3037
Delivery Fee - Weekday
per trip
320
3038
Delivery Fee - Weekend
per trip
4
3039
Delivery Fee – STAT call out
per trip
8

OPTION YEAR 4: October 1, 2022 – September 30, 2023

Line Item
Product Description
Method of Supply
Estimated Annual Quantity
Unit Price
Total Price
Unit Doses
per dose
4001
HDP
Per dose
159
4002
MDP
per dose
0
4003
MAA
per dose
17
4004
DTPA
per dose
0
4005
Choletec/Mebrofenin
per dose
31
4006
Sulfur Colloid
Per dose
10
4007
Sulfur Colloid, Filtered
per dose
0
4008
MAG-3
per dose
3
4009
Cardiolite/Sestamibi
Per dose
543
4010
Myoview/Tetrofosmin
per 1 mCi
0
4011
Tc-99m
Per vial
52
4012
Tc-99m (Bulk)
per mCi
11
4013
Thallium-201
per mCi
0
4014
Gallium-67
per capsule
0
4015
I-123 (100uCi)
per capsule
0
4016
I-123 (200uCi)
each
0
4017
20mCi Cobalt57 Sheet Source
Per vial
1
4018
Xenon 133
White Blood Cells
per study
4019
In-111 WBC
per study
2
4020
Ceretec
per occurrence
0
4021
WBC Prep Kit

Cold Kits

4022
Choletec/Mebrofenin
per vial
0
4023
Hepatolite/Disofenin
per vial
0
4024
DTPA
per vial
0
4025
HDP
per vial
0
4026
MAA
per vial
0
4027
Sulfur Colloid
per vial
0
4028
Kinevac/Sincalide/CCK
per vial
0
4029
Ultratag
Per kit
0
4030
DMSA
Per vial
0
4031
MDP
Per vial
0
4032
Cardiolite/Sestamibi
Per vial
0
4033
Myoview/Tetrofosmin
Per vial
0

Incidentals

4034
Persantine
per dose
0
4035
Lexiscan
per dose
0
4036
Dobutamine
per dose
0

Delivery

4037
Delivery Fee - Weekday
per trip
320
4038
Delivery Fee - Weekend
per trip
4
4039
Delivery Fee – STAT call out
per trip
8

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