Attachment A - Chemistry Immunoassay Schedule of Pricing - 0005.xlsx

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6640--Chemistry/Immunoassay ID/IQ CPT VISN 22/West
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This document appears to be an attachment containing the Chemistry Immunoassay Schedule of Pricing for VISN 22, related to a federal contract opportunity for Chemistry/Immunoassay ID/IQ CPT services.

The document provides detailed pricing and volume estimates for over 200 individual clinical chemistry and immunoassay tests across 7 locations in VISN 22. It includes information on the estimated annual test volumes, unit prices, and 5-year estimated total costs for each test. The document also includes sections for optional tests, proposed instruments, and total cost summaries. This attachment is likely provided as part of a larger solicitation (Solicitation Number 36C26223R0132) being issued by the Department of Veterans Affairs Veterans Health Administration for VISN 22/West.

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ChemIA Tradeoffs RFP 36C26223R0132 0009.docx DOCX document
Attachment A - Chemistry Immunoassay Schedule of Pricing - 0009.xlsx XLSX spreadsheet
Amendment 36C26223R0132 0009.docx DOCX document
Attachment B - Chemistry Immunoassay SOW - 0009.docx DOCX document
Attachment A - Chemistry Immunoassay Schedule of Pricing - 0008.xlsx XLSX spreadsheet
ChemIA Tradeoffs RFP 36C26223R0132 0008.docx DOCX document
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Attachment B - Chemistry Immunoassay SOW - 0008.docx DOCX document
Attachment E - Assay Data - 0008.xlsx XLSX spreadsheet
Amendment 36C26223R0132 0008.docx DOCX document
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LIST OF COMPATIBLE LABEL PRINTER Cerner- List of Validated Peripheral List 6.1.21.xlsx XLSX spreadsheet
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Attachment A - Chemistry Immunoassay Schedule of Pricing - 0007.xlsx XLSX spreadsheet
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1. VISN CPT

Test DescriptionCPT (Reagents, Supplies, Consumables, Parts, Training, Service / Maintenance, Software License)VISN 22 ESTIMATED ANNUAL TEST VOLUMEVISN 22 ESTIMATED ANNUAL EXTENDED COST
Est. 3% increaseEst. 3% increaseEst. 3% increaseEst. 3% increaseVISN 22 Estimated Base 5-Year Test Total
(SUM of Column D-H)Base Year 1Base Year 2Base Year 3Base Year 4Base Year 5VISN 22 Estimated Base 5-Year Test Extended Price

(Column C x Column I)

Base Year 1Base Year 2Base Year 3Base Year 4Base Year 5
Alpha 1 Antitrypsan$0.00002,7582,8412,9273,0153,10614,647$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Acetaminophen$0.00004,2484,3764,5084,6444,78422,560$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
ALBUMIN, Blood$0.0000448,735462,198476,064490,346505,0572,382,400$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
ALBUMIN, Urine$0.000022,87723,56424,27125,00025,750121,462$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Alkaline Phosphatase$0.0000381,744393,197404,993417,143429,6582,026,735$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
ALPHA-FETO PROTEIN (AFP)$0.00009,77810,07210,37510,68711,00851,920$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Alanine Aminotransferase (ALT) (SGPT$0.0000397,823409,758422,051434,713447,7552,112,100$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Amikacin$0.00001,5851,6331,6821,7331,7858,418$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Ammonia$0.00006,2336,4206,6136,8127,01733,095$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Amphetamines$0.0000116,115119,599123,187126,883130,690616,474$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Amylase, Blood and Urine$0.000013,68214,09314,51614,95215,40172,644$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Aspartate Aminotransferase (AST) (SGOT)$0.0000362,305373,175384,371395,903407,7811,923,535$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Barbiturates$0.000064,60466,54368,54070,59772,715342,999$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Benzodiazepines$0.0000115,969119,449123,033126,724130,526615,701$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Benzoylecgonine$0.000039,99841,19842,43443,70845,020212,358$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Beta 2 Microglobulin$0.00001,6731,7241,7761,8301,8858,888$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Bicarbonate (CO2)$0.0000462,627476,506490,802505,527520,6932,456,155$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Bilirubin, Direct$0.000086,68189,28291,96194,72097,562460,206$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Bilirubin, Total$0.0000382,897394,384406,216418,403430,9562,032,856$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Blood Urea Nitrogen (BUN)$0.0000597,028614,939633,388652,390671,9623,169,707$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
**B-type Natriuretic Peptide (BNP)$0.000036,17237,25838,37639,52840,714192,048$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Buprenorphone$0.000088,29290,94193,67096,48199,376468,760$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
CALCIUM, Urine and Blood$0.0000410,998423,328436,028449,109462,5832,182,046$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Cannabinoids$0.000093,00695,79798,671101,632104,681493,787$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
CARBAMEZAPINE$0.00003,1583,2533,3513,4523,55616,770$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Carcinoembryonic Antigen (CEA)$0.00005,8135,9886,1686,3546,54530,868$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
CHLORIDE, URINE, BLOOD and, CSF$0.0000472,646486,826501,431516,474531,9692,509,346$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Cholesterol, Total, Blood and Fluid$0.0000249,085256,558264,255272,183280,3491,322,430$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
CK-MB$0.000011,02311,35411,69512,04612,40858,526$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Complement Component 3 (C3)$0.00004,1294,2534,3814,5134,64921,925$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Complement Component 4(C4)$0.00004,2234,3504,4814,6164,75522,425$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Cortisol$0.00007,0907,3037,5237,7497,98237,647$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
C-REACTIVE PROTEIN$0.0000- 0- 0- 0- 0- 0- 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
C-REACTIVE PROTEIN, High Sensitive$0.000036,92638,03439,17640,35241,563196,051$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Creatine Kinase (CK)$0.000042,08443,34744,64845,98847,368223,435$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
CREATININE, Urine and Blood$0.0000754,551777,188800,504824,520849,2564,006,019$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
DIGOXIN$0.00006,5486,7456,9487,1577,37234,770$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Estradiol$0.00004,0064,1274,2514,3794,51121,274$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Ethanol, Urine and Blood$0.000027,08227,89528,73229,59430,482143,785$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Ferritin$0.000042,28243,55144,85846,20447,591224,486$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
FOLIC ACID (Folate)$0.000042,61943,89845,21546,57247,970226,274$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Free T4$0.000058,71260,47462,28964,15866,083311,716$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Follicle-Stimulating Hormone (FSH)$0.00008,0628,3048,5548,8119,07642,807$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Gamma-Glutamyl Transferase (GGT)$0.000043,95845,27746,63648,03649,478233,385$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Gentamicin$0.00002,6932,7742,8582,9443,03314,302$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
GLUCOSE, Urine, Blood, Fluid, CSF$0.0000595,491613,356631,757650,710670,2323,161,546$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Haptoglobin$0.00004,1524,2774,4064,5394,67622,050$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
HDL Cholesterol$0.0000250,034257,536265,263273,221281,4181,327,472$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Hepatitis A IgM$0.00003,8443,9604,0794,2024,32920,414$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Hepatitis A IgG$0.0000- 0- 0- 0- 0- 0- 0$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Hepatitis A Total$0.000013,28713,68614,09714,52014,95670,546$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Hepatitis B Core AB Total$0.000018,40218,95519,52420,11020,71497,705$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Hepatitis B Core IgM$0.00004,2964,4254,5584,6954,83622,810$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Hepatitis B Surface Ab$0.000027,78728,62129,48030,36531,276147,529$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Hepatitis B Surface Ag$0.000027,06427,87628,71329,57530,463143,691$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Hepatitis C Ab$0.000046,98348,39349,84551,34152,882249,444$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Hiv- 1/2 Antibody with antigen ("4th generation" HIV testing)$0.000031,79632,75033,73334,74535,788168,812$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Homocysteine$0.00005,1865,3425,5035,6695,84027,540$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Human Chorionic Gonadotropin, Beta, Quant (HCG. Beta)$0.00006,2316,4186,6116,8107,01533,085$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
IgA$0.00009,6069,89510,19210,49810,81351,004$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
IgE$0.00004,9415,0905,2435,4015,56426,239$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
IgG$0.00008,9389,2079,4849,76910,06347,461$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
IgM$0.00008,7539,0169,2879,5669,85346,475$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
IRON$0.000042,89644,18345,50946,87548,282227,745$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Kappa light chain, free$0.00004,0704,1934,3194,4494,58321,614$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
LACTIC ACID, BLOOD and CSF$0.000033,79734,81135,85636,93238,040179,436$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Lactate Dehydrogenase, Blood, Fluid, CSF (LDH)$0.000036,74037,84338,97940,14941,354195,065$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Lambda light chain, free$0.00004,0704,1934,3194,4494,58321,614$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
LDL Cholesterol, Direct$0.000075,89378,17080,51682,93285,420402,931$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Lipase$0.000023,26423,96224,68125,42226,185123,514$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Lithium$0.00006,7266,9287,1367,3517,57235,713$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Lutenizing Hormone (LH)$0.00007,8868,1238,3678,6198,87841,873$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Magnesium, Blood and Urine$0.0000163,001167,892172,929178,117183,461865,400$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Methadone$0.000083,57186,07988,66291,32294,062443,696$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Microalbumin$0.000067,80369,83871,93474,09376,316359,984$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Microprotein/M-TP (CSF)$0.00002,5682,6462,7262,8082,89313,641$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Opiates$0.0000116,180119,666123,256126,954130,763616,819$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Oxycodone$0.0000103,940107,059110,271113,580116,988551,838$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
PARATHYROID HORMONE (Intact)$0.000017,84218,37818,93019,49820,08394,731$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Phencyclidine$0.000045,93247,31048,73050,19251,698243,862$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Phenobarbital$0.00002,8812,9683,0583,1503,24515,302$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
PHENYTOIN, (Dilantin)$0.00003,5753,6833,7943,9084,02618,986$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
PHOSPHORUS, Urine, Blood$0.0000196,995202,905208,993215,263221,7211,045,877$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
POTASSIUM, Urine, Blood$0.0000577,919595,257613,115631,509650,4553,068,255$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Prealbumin$0.00007,3567,5777,8058,0408,28239,060$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Prolactin$0.00006,7426,9457,1547,3697,59135,801$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Prostate Specific Antigen (PSA)$0.0000110,787114,111117,535121,062124,694588,189$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
PSA, Free$0.00008288538799069344,400$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Protein, TOTOAL Blood, Urine and Fluid$0.0000242,503249,779257,273264,992272,9421,287,489$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Rheumatoid Factor$0.00006,6526,8527,0587,2707,48935,321$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Salicylate$0.00005,6005,7685,9426,1216,30529,736$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
SODIUM, Urine and Blood$0.0000593,452611,256629,594648,482667,9373,150,721$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
TESTOSTERONE, Total$0.000024,96025,70926,48127,27628,095132,521$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Theophylline$0.00002,7562,8392,9253,0133,10414,637$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Thyroid-Stimulating Hormone (TSH)$0.0000158,767163,531168,437173,491178,696842,922$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Tobramycin$0.00007627858098348604,050$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Total T-3$0.00007,6077,8368,0728,3158,56540,395$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
TRANSFERRIN$0.000042,46443,73845,05146,40347,796225,452$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Triglycerides$0.0000249,253256,731264,433272,366280,5371,323,320$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Troponin T or Troponin I (5th Generation or High Sensitive)$0.000058,19259,93861,73763,59065,498308,955$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
UREA NITROGEN, Urine and Blood$0.0000323,573333,281343,280353,579364,1871,717,900$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
URIC ACID, Urine and Blood$0.000033,04934,04135,06336,11537,199175,467$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Valproic Acid$0.00007,9728,2128,4598,7138,97542,331$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Vancomycin$0.000012,71213,09413,48713,89214,30967,494$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Vit-D-25 Hydroxy Total$0.0000126,666130,466134,380138,412142,565672,489$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Vitamin B-12$0.000053,36454,96556,61458,31360,063283,319$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Free T3$0.00001,3501,3911,4331,4761,5217,171$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Hemoglobin A1c$0.0000200,208206,215212,402218,775225,3391,062,939$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
**NT-pro-B-type Natriuretic Peptide (NT-proBNP)$0.00002,2992,3682,4402,5142,59012,211$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Procalcitonin$0.000011,87212,22912,59612,97413,36463,035$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Tacrolimus (EK506)$0.00004,3194,4494,5834,7214,86322,935$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
Total T-4$0.00001,8161,8711,9281,9862,0469,647$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
10,956,73911,285,49411,624,11211,972,89012,332,13358,171,368$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
IMPORTANT
Reagents with two asterisks are an either or, vendor must have 1; BNP or pro NT-proBNP

&"-,Bold"ATTACHMENT C

2. EST ANNUAL SITE VOL

Loma LindaLong BeachLos Angeles ACCSan DiegoSanta MariaSepulvedaWest Los AngelesVISN 22 TOTAL ANNUAL VOLUME
Test DescriptionEst. Test Volume# of ControlsEst. 5% Repeat Rate (B+C)*.05Est. Test Volume# of ControlsEst. 5% Repeat RateEst. Test Volume# of ControlsEst. 5% Repeat RateEst. Test Volume# of ControlsEst. 5% Repeat RateEst. Test Volume# of ControlsEst. Test Volume# of ControlsEst. 5% Repeat RateEst. Test Volume# of ControlsEst. 5% Repeat Rate
Alpha 1 Antitrypsan244132571267133- 0- 02351,080661,381- 0- 0190750479872,758
Acetaminophen1391,460801,67989845943- 0- 01431,080621,285- 0- 0324173414,248
ALBUMIN, Blood124,1361,4606,280131,87669,0411,5003,52874,0698,82975047910,058133,0592,8806,797142,7367,88175030,2767501,55232,57853,1831,5002,73557,418448,735
ALBUMIN, Urine19,6071,4601,05422,121- 0- 0- 0- 0-72036756- 0-- 0- 022,877
Alkaline Phosphatase122,2851,4606,188129,93368,3311,5003,49273,3238,5147504649,72886,2407204,34891,3087,66475028,4637501,46130,67443,0501,5002,22846,778381,744
ALPHA-FETO PROTEIN (AFP)2,5685221553,24563332665- 0-1,2101,0801152,405- 0-2,5487501653,4639,778
Alanine Aminotransferase (ALT) (SGPT123,5261,4606,250131,23679,5361,5004,05285,0889,14575049510,39086,3537204,35491,4277,99075029,0537501,49131,29444,5831,5002,30548,388397,823
Amikacin01,460731,53321223- 0-1- 012- 0-252271,585
Ammonia4761,460972,033806750781,634- 0-4681,440962,004- 0-535275626,233
Amphetamines21,9011,4601,16924,53019,2181,5001,03621,754- 0-17,4231,44094419,807- 0-46,1411,5002,38350,024116,115
Amylase, Blood and Urine3,6781,4602575,3952,2547501513,15560750418511,2787201002,09843750209750481,007370750561,17613,682
Aspartate Aminotransferase (AST) (SGOT)123,4601,4606,246131,16669,7831,5003,56574,8485,7177503246,79186,3427204,35491,4167,14675020,9997501,08822,83732,0681,5001,67935,247362,305
Barbiturates21,9011,4601,16924,53019,21996120,180- 0-17,4261,44094419,810- 0-8048464,604
Benzodiazepines21,9011,4601,16924,53019,1751,5001,03421,709- 0-17,4221,44094419,806- 0-46,0461,5002,37849,924115,969
Benzoylecgonine41519,21996120,180- 0-17,4241,44094419,808- 0-41539,998
Beta 2 Microglobulin225122371217128- 0-1081,080601,248- 0-573601,673
Bicarbonate (CO2)145,7274,3807,506157,61368,5081,5003,50173,5097,4147504098,573100,3512,8805,162108,3933,56175023,8187501,22925,79783,0161,5004,22688,742462,627
Bilirubin, Direct4,9841,4603236,76758,1987502,94861,896- 0-14,00972073715,466- 0-1,6807501222,55286,681
Bilirubin, Total123,2851,4606,238130,98365,0951,5003,33069,9258,5117504649,72585,4867204,31190,5177,66875028,4997501,46330,71247,1041,5002,43151,035382,897
Blood Urea Nitrogen (BUN)153,4261,4607,745162,631121,0611,5006,129128,69010,50975056311,822140,0311,4407,074148,5458,87175036,5927501,86839,21099,5761,5005,054106,130597,028
**B-type Natriuretic Peptide (BNP)3,9797302364,9458,3437504559,548- 0-11,9972,16070814,865- 0-5,7397503256,81436,172
Buprenorphone9,85675053111,13719,1791,5001,03421,713- 0-3,8161,4402635,519- 0-46,0451,5002,37849,92388,292
CALCIUM, Urine and Blood146,0664,3807,523157,96970,7571,5003,61375,8705,3147503046,368100,9912,8805,194109,0656,71975015,53475081517,09941,0011,5002,12644,627410,998
Cannabinoids01,460731,53319,2091,5001,03621,745- 0-17,4211,44094419,805- 0-46,0451,5002,37849,92393,006
CARBAMEZAPINE1181,460791,6571016107- 0-1381,080611,279- 0-10961153,158
Carcinoembryonic Antigen (CEA)1,085522811,688309750531,112- 0-4641,080781,622- 0-574750671,3915,813
CHLORIDE, URINE, BLOOD and, CSF147,2284,3807,581159,18968,5731,5003,50473,5777,4217504098,580100,3492,8805,162108,3913,57075023,8507501,23025,83090,9561,5004,62397,079472,646
Cholesterol, Total, Blood and Fluid62,8481,4603,21667,52451,8141,5002,66655,9808,0887504429,28056,3581,4402,89060,6886,87275023,5847501,21725,55127,1301,5001,43230,062249,085
CK-MB0- 0- 07,0413537,394- 0-1,2412,1601713,572- 0-5435711,023
Complement Component 3 (C3)41121432211750491,010- 0-3591,080721,511- 0-370750561,1764,129
Complement Component 4(C4)43022452211750491,010- 0-3591,080721,511- 0-440750601,2504,223
Cortisol915750841,749580750671,397- 0-1,0361,0801062,222- 0-890750821,7227,090
C-REACTIVE PROTEIN- 0- 0- 0- 0- 0-- 0- 0- 0-- 0- 0- 0
C-REACTIVE PROTEIN, High Sensitive8,5871,46050310,5505,9267503347,010- 0-10,9341,44061912,993- 0-5,3197503046,37336,926
Creatine Kinase (CK)14,8361,46081517,11111,74175062513,116- 0-7,2041,0804158,699- 0-2,2577501513,15842,084
CREATININE, Urine and Blood199,2361,46010,035210,731145,8541,5007,368154,72216,15175084617,747141,4252,8807,216151,52112,12575051,5297502,61454,893155,5821,5007,855164,937754,551
DIGOXIN4021,460941,956607750681,425- 0-5611,080831,724- 0-624750691,4436,548
Estradiol88593274750521,076- 0-2701,080681,418- 0-601750681,4194,006
Ethanol, Urine and Blood3,5331,4602505,24312,76275067614,188- 0-2,2472,8802575,384- 0-1,4097501082,26727,082
Ferritin11,2001,04461312,8577,9977504389,185- 0-7,0381,0804068,524- 0-10,40875055811,71642,282
FOLIC ACID (Folate)10,5821,04458212,2088,1197504449,313- 0-4,1091,0802605,449- 0-14,15375074615,64942,619
Free T410,2891,04456711,90024,1667501,24626,162- 0-9,8982,16060312,661- 0-6,8587503817,98958,712
Follicle-Stimulating Hormone (FSH)1,7725221152,409610750681,428- 0-8741,080982,052- 0-1,3197501042,1738,062
Gamma-Glutamyl Transferase (GGT)4,2771,4602876,0247,7061,5004619,6671,5867501172,4534,1041,4402785,8222697506,7677503767,89310,0221,50057712,09943,958
Gentamicin81,460741,54230232- 0-231,028531,104- 0-141152,693
GLUCOSE, Urine, Blood, Fluid, CSF149,7774,3807,708161,865118,0961,5005,980125,57610,47175056211,783134,9392,8806,891144,7108,90175036,4207501,85939,029105,6691,5005,359112,528595,491
Haptoglobin39520415359750561,165- 0-1441,080621,286- 0-474750621,2864,152
HDL Cholesterol62,3871,4603,19367,04050,8901,5002,62055,0108,0857504429,27756,2212,8802,95662,0576,87175023,6207501,21925,58928,0811,5001,48031,061250,034
Hepatitis A IgM37319392204750481,002- 0-371,080561,173- 0-466750611,2773,844
Hepatitis A IgG- 0- 0- 0- 0- 0-- 0- 0- 0-- 0- 0- 0
Hepatitis A Total1,3537501062,209988750871,825- 0-4,2881,0802695,637- 0-2,6937501733,61613,287
Hepatitis B Core AB Total1,9057501332,7882,8257501793,754- 0-3,7171,0802405,037- 0-5,7487503256,82318,402
Hepatitis B Core IgM421750591,230175038789- 0-11,080551,136- 0-336750551,1414,296
Hepatitis B Surface Ab5,1865222865,9944,7607502765,786- 0-5,9911,0803547,425- 0-7,4237504098,58227,787
Hepatitis B Surface Ag4,5105222525,2845,5217503146,585- 0-5,9051,0803507,335- 0-6,7357503757,86027,064
Hepatitis C Ab9,18552248610,1938,4507504609,660- 0-12,3071,08067014,057- 0-11,70075062313,07346,983
Hiv- 1/2 Antibody with antigen ("4th generation" HIV testing)2,9815221763,6794,3517502565,357- 0-8,4791,44049610,415- 0-11,00775058812,34531,796
Homocysteine14375045938273750521,075- 0-1871,080641,331- 0-1,004750881,8425,186
Human Chorionic Gonadotropin, Beta, Quant (HCG. Beta)32252243887404750581,212- 0-7462,1601463,052- 0-278750521,0806,231
IgA1,7517501262,627636750701,456- 0-2,2561,0801673,503- 0-1,173750972,0209,606
IgE1207504491416675046962- 0-6211,080861,787- 0-467750611,2784,941
IgG1,7167501242,590636750701,456- 0-1,6551,0801372,872- 0-1,173750972,0208,938
IgM1,5407501152,405636750701,456- 0-1,6551,0801372,872- 0-1,173750972,0208,753
IRON9,91975053411,2038,1511,50048310,134- 0-7,4251,0804268,931- 0-10,5261,50060212,62842,896
Kappa light chain, free600750681,41836419383- 0-1,0221,0801062,208- 0-583614,070
LACTIC ACID, BLOOD and CSF3,7891,4602635,5126,3991,5003958,294- 0-3,3072,8803106,497- 0-11,3511,50064313,49433,797
Lactate Dehydrogenase, Blood, Fluid, CSF (LDH)6,5041,4603998,3631,7361,5001623,3981,3607501062,2162,3667201553,2412317505,6657503216,73610,6771,50060912,78636,740
Lambda light chain, free600750681,41836419383- 0-1,0221,0801062,208- 0-583614,070
LDL Cholesterol, Direct7,2771,4604379,1741,2467501002,096741750751,5662,0591,4401753,6742817502,7367501753,66152,3187502,65455,72275,893
Lipase3,8771,4602675,6045,3487503056,403- 0-5,5461,4403507,336- 0-2,9847501873,92123,264
Lithium5631,4601022,125510750631,323- 0-906720821,708- 0-745750751,5706,726
Lutenizing Hormone (LH)1,7355221132,370610750681,428- 0-7641,080931,937- 0-1,2987501032,1517,886
Magnesium, Blood and Urine28,6991,4601,50831,66736,4451,5001,89839,8431,9047501332,78735,9922,8801,94440,8168367503,3547502064,31040,0021,5002,07643,578163,001
Methadone9,9481,46057111,9792701,500891,859- 0-17,4261,44094419,810- 0-46,0451,5002,37849,92383,571
Microalbumin19,6071,4601,05422,1217171,5001112,328- 0-12,8741,44071615,030- 0-25,4751,5001,34928,32467,803
Microprotein/M-TP (CSF)651,460771,60281586- 0-11872042880- 0-- 0- 02,568
Opiates22,0631,4601,17724,70019,2121,5001,03621,748- 0-17,4251,44094419,809- 0-46,0451,5002,37849,923116,180
Oxycodone10,3741,46059212,42619,2451,5001,03821,783- 0-17,4241,44094419,808- 0-46,0451,5002,37849,923103,940
PARATHYROID HORMONE (Intact)2,6915221613,3741,6097501182,477- 0-3,0511,0802074,338- 0-6,5387503657,65317,842
Phencyclidine21,9021,4601,16924,53119,22096120,181- 0-71,080551,142- 0-7447845,932
Phenobarbital291,460751,5641458153- 0-91,080551,144- 0-191202,881
PHENYTOIN, (Dilantin)2271,460851,77224313256- 0-1351,080611,276- 0-258132713,575
PHOSPHORUS, Urine, Blood26,5585,8401,62034,01825,6731,5001,35928,5321,6537501212,52489,1342,8804,60196,6156627502,9457501853,88028,4291,5001,49731,426196,995
POTASSIUM, Urine, Blood149,1784,3807,678161,236119,7301,5006,062127,29210,47675056211,788134,9192,8806,890144,6898,89775026,2297501,34928,32898,1051,5004,981104,586577,919
Prealbumin5171,460992,076919750841,753- 0-1,1311,0801112,322- 0-397750581,2057,356
Prolactin792522661,380518750641,332- 0-8881,080992,067- 0-1,119750941,9636,742
Prostate Specific Antigen (PSA)27,9741,0441,45130,46923,9081,5001,27126,679- 0-20,2022,1601,11923,481- 0-27,2211,5001,43730,158110,787
PSA, Free714751297136- 0-73477- 0-51426540828
Protein, TOTOAL Blood, Urine and Fluid124,9262,9206,393134,23962,5361,5003,20267,238675750721,49713,1402,88080116,8211167508,4087504589,61610,9681,50062413,092242,503
Rheumatoid Factor1,155581,213560750661,376- 0-8031,080951,978- 0-1,2357501002,0856,652
Salicylate851,460781,623835750801,665- 0-1161,080601,256- 0-255750511,0565,600
SODIUM, Urine and Blood148,8801,4607,517157,857119,1937505,998125,94110,46075056111,771135,3742,8806,913145,1678,88075036,6397501,87039,259107,3047505,403113,457593,452
TESTOSTERONE, Total3,1394,3803767,8952,0621,5001793,741- 0-4,5001,0802795,859- 0-5,6091,5003567,46524,960
Theophylline321,460751,56710111- 0-151,080551,150- 0-262282,756
Thyroid-Stimulating Hormone (TSH)51,3961,0442,62255,062418481,5002,1683,668- 0-42,2392,1602,22046,619- 0-49,3741,5002,54453,418158,767
Tobramycin0- 0- 0- 0- 0- 0- 0- 0-572037762- 0-- 0- 0- 0762
Total T-36821,4601082,25047124495- 0-5161,080801,676- 0-2,2847501523,1867,607
TRANSFERRIN8,7961,46051310,7698,1751,50048410,159- 0-7,4771,0804288,985- 0-10,4531,50059812,55142,464
Triglycerides62,7221,4603,21067,39250,9811,5002,62555,1068,0867504429,27856,4901,4402,89760,8276,87275023,5717501,21725,53828,1301,5001,48231,112249,253
Troponin T or Troponin I (5th Generation or High Sensitive)12,9354,38086618,18112,1511,50068314,334- 0-10,8184,32075715,895- 0-7,8161,5004669,78258,192
UREA NITROGEN, Urine and Blood153,7811,4607,763163,0047161,5001112,32710,52575056411,839292720511,0638,87775036,5927501,86839,21099,5761,5005,054106,130323,573
URIC ACID, Urine and Blood4,9371,4603206,7175,1951,5003357,0302,0267501392,9157,8657204309,0154487501,8247501292,7032,9461,5002234,66933,049
Valproic Acid1,2271,4601352,822741750751,566- 0-580720651,365- 0-1,3637501062,2197,972
Vancomycin1,7291,4601603,3492,0697501412,960- 0-1,9391,4401693,548- 0-1,9697501362,85512,712
Vit-D-25 Hydroxy Total35,2501,4601,83638,54629,2601,5001,53832,298- 0-19,1132,1601,06422,337- 0-30,3901,5001,59533,485126,666
Vitamin B-1216,5971,46090318,9608,1251,50048210,107- 0-6,3741,0803737,827- 0-14,1851,50078516,47053,364
Free T3911063467- 0-1291,080611,270- 0-2131,350
Hemoglobin A1c59,3001,4603,03863,798496862,4852,485- 0-57,2537202,89960,872- 0-69,5743,47973,053200,208
**NT-pro-B-type Natriuretic Peptide (NT-proBNP)0- 0- 0- 0- 0- 0- 0- 0-- 02,1601082,268- 0-292312,299
Procalcitonin3,0961,4602284,7842,9627501863,898- 0-721,080581,210- 0-1,135750951,98011,872
Tacrolimus (EK506)7193675534618364- 0-6021,080851,767- 0-614750691,4334,319
Total T-40- 0- 011112- 0-6361,080861,802- 0-1121,816
- 0
2,942,236141,162154,2213,237,6191,951,81392,250106,8302,150,893163,72118,7509,136191,6072,268,947155,468121,2722,545,687132,25118,750527,17618,75027,308573,2342,055,63894,500107,5612,257,69910,956,739
IMPORTANT
Reagents with two asterisks are an either or, vendor must have 1; BNP or pro NT-proBNP

3. REAGENT CPT

TEST DESCRIPTIONManufacturer Part NumberPARTIAL COST PER TEST
(Cost of single test including all Reagents, Supplies, Consumables, Parts, Training, Service / Maintenance, Software License)VISN22

ANNUAL VOLUME PER TEST

(VOLUME PROVIDED FOR INFORMATIONAL PURPOSES ONLY ---DO NOT PROVIDE AN EXTENDED OR PACKAGE COST)Please identify what Reagents and Consumables are required to run a single test.
Alpha 1 Antitrypsan2,758
Acetaminophen4,248
ALBUMIN, Blood448,735
ALBUMIN, Urine22,877
Alkaline Phosphatase381,744
ALPHA-FETO PROTEIN (AFP)9,778
Alanine Aminotransferase (ALT) (SGPT397,823
Amikacin1,585
Ammonia6,233
Amphetamines116,115
Amylase, Blood and Urine13,682
Aspartate Aminotransferase (AST) (SGOT)362,305
Barbiturates64,604
Benzodiazepines115,969
Benzoylecgonine39,998
Beta 2 Microglobulin1,673
Bicarbonate (CO2)462,627
Bilirubin, Direct86,681
Bilirubin, Total382,897
Blood Urea Nitrogen (BUN)597,028
**B-type Natriuretic Peptide (BNP)36,172
Buprenorphone88,292
CALCIUM, Urine and Blood410,998
Cannabinoids93,006
CARBAMEZAPINE3,158
Carcinoembryonic Antigen (CEA)5,813
CHLORIDE, URINE, BLOOD and, CSF472,646
Cholesterol, Total, Blood and Fluid249,085
CK-MB11,023
Complement Component 3 (C3)4,129
Complement Component 4(C4)4,223
Cortisol7,090
C-REACTIVE PROTEIN- 0
C-REACTIVE PROTEIN, High Sensitive36,926
Creatine Kinase (CK)42,084
CREATININE, Urine and Blood754,551
DIGOXIN6,548
Estradiol4,006
Ethanol, Urine and Blood27,082
Ferritin42,282
FOLIC ACID (Folate)42,619
Free T458,712
Follicle-Stimulating Hormone (FSH)8,062
Gamma-Glutamyl Transferase (GGT)43,958
Gentamicin2,693
GLUCOSE, Urine, Blood, Fluid, CSF595,491
Haptoglobin4,152
HDL Cholesterol250,034
Hepatitis A IgM3,844
Hepatitis A IgG- 0
Hepatitis A Total13,287
Hepatitis B Core AB Total18,402
Hepatitis B Core IgM4,296
Hepatitis B Surface Ab27,787
Hepatitis B Surface Ag27,064
Hepatitis C Ab46,983
Hiv- 1/2 Antibody with antigen ("4th generation" HIV testing)31,796
Homocysteine5,186
Human Chorionic Gonadotropin, Beta, Quant (HCG. Beta)6,231
IgA9,606
IgE4,941
IgG8,938
IgM8,753
IRON42,896
Kappa light chain, free4,070
LACTIC ACID, BLOOD and CSF33,797
Lactate Dehydrogenase, Blood, Fluid, CSF (LDH)36,740
Lambda light chain, free4,070
LDL Cholesterol, Direct75,893
Lipase23,264
Lithium6,726
Lutenizing Hormone (LH)7,886
Magnesium, Blood and Urine163,001
Methadone83,571
Microalbumin67,803
Microprotein/M-TP (CSF)2,568
Opiates116,180
Oxycodone103,940
PARATHYROID HORMONE (Intact)17,842
Phencyclidine45,932
Phenobarbital2,881
PHENYTOIN, (Dilantin)3,575
PHOSPHORUS, Urine, Blood196,995
POTASSIUM, Urine, Blood577,919
Prealbumin7,356
Prolactin6,742
Prostate Specific Antigen (PSA)110,787
PSA, Free828
Protein, TOTOAL Blood, Urine and Fluid242,503
Rheumatoid Factor6,652
Salicylate5,600
SODIUM, Urine and Blood593,452
TESTOSTERONE, Total24,960
Theophylline2,756
Thyroid-Stimulating Hormone (TSH)158,767
Tobramycin762
Total T-37,607
TRANSFERRIN42,464
Triglycerides249,253
Troponin T or Troponin I (5th Generation or High Sensitive)58,192
UREA NITROGEN, Urine and Blood323,573
URIC ACID, Urine and Blood33,049
Valproic Acid7,972
Vancomycin12,712
Vit-D-25 Hydroxy Total126,666
Vitamin B-1253,364
Free T31,350
Hemoglobin A1c200,208
**NT-pro-B-type Natriuretic Peptide (NT-proBNP)2,299
Procalcitonin11,872
Tacrolimus (EK506)4,319
Total T-41,816
10,956,739

4. PROPOSED INSTRUMENTS

InstrumentsPart/Product #CostLoma LindaLong BeachLos Angeles
ACCSan DiegoSepulvedaWest
Los AngelesVISN 22
TOTAL QTYVISN 22

EXTENDED

COSTS

DescriptionIndicate quantity per site
CHEMISTRY
Instrument A1000 (example)(Example, please replace with actual price and item)$100,000.0000- 0$0.0000
Instrument B2000 (example)(Example, please replace with actual price and item)$150,000.0000- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
IMMUNOCHEMISTRY- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
CENTRIFUGES- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
REFRIGERATED STORAGE MODULE- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
ALIQUOTER- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
BULK INPUT- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
Contractor Misc- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
Track - Automation Line- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
- 0$0.0000
Total, 1 time, cost$0.0000

5. OPT ITEMS

Optional Items / Tests (INFORMATIONAL PURPOSES ONLY; Additional tests not listed in Tab 2 may also be added.)Manufacturer Part NumberUnit of MeasureUnit Price
*FOR TESTS - Cost including all Reagents and Consumables OnlyPlease identify what Reagents and Consumables are required to run a single test
Beta-Hydroxybutyrate
Cyclosporine
Quantiferon TB
Testosterone, Free
Sirolimus

6. Proposed Total

TermsReagent Annual CPT PriceInstrument Purchase PriceTotal Annual Cost
Base Year$ - 0$ - 0$ - 0
Base Year 2$ - 0$ - 0
Base Year 3$ - 0$ - 0
Base Year 4$ - 0$ - 0
Base Year 5$ - 0$ - 0

Total Cost $ - 0 $ - 0 $ - 0

File details come from the government source that posted it. Updated .