Copy of Attachment A - CLIN schedule.xlsx

XLSX spreadsheet 41 KB Posted Mar 20, 2023

Attached to: 6440 Fargo/BHHCS Chemistry Immunochemistry Base+4 - VISN
Solicitation number: 36C26323Q0361
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 23

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36C26323Q0361 A00003.pdf	PDF	Apr 3, 2023
Fargo BHHCS Chemistry Immunochemistry SOW 2 BPA.pdf	PDF	Mar 23, 2023
36C26323Q0361 A00002.pdf	PDF	Mar 23, 2023
Copy of Attachment A - CLIN schedule 3.22.23.xlsx	XLSX spreadsheet	Mar 23, 2023
36C26323Q0361 A00001.pdf	PDF	Mar 20, 2023
36C26323Q0361.pdf	PDF	Mar 7, 2023
36C26323Q0361 LineItems.xlsx	XLSX spreadsheet	Mar 7, 2023

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Base Year

CLIN	Test Name	Manufacturer Product Number	Fargo Annual Volume	BHHCS-Fort Meade Annual Volume	BHHCS - Hot Springs Annual Volume	BHHCS- Rapid City Annual Volume	Fargo CPRR	Fargo Extended Price	BHHCS Totol Volume	BHHCS CPRR	BBHCS Extended Price	Fargo BHHCS Combined Volume	Fargo BHHCS CPRR	Fargo BHHCS Extended Price
0001	Acetaminophen		450	9	11	0		$0.00	20		$0.00	470		$0.00
0002	Albumin		34,770	11,707	9,658	11,707		$0.00	33,072		$0.00	67,842		$0.00
0003	Ammonia		430	118	76	0		$0.00	194		$0.00	624		$0.00
0004	Amphetamine/ Methamphetamine -UDS		3,460	0	0	0		$0.00	0		$0.00	3,460		$0.00
0005	Amylase		675	269	380	269		$0.00	918		$0.00	1,593		$0.00
0006	Barbiturate Screen -UDS		3,500	0	0	0		$0.00	0		$0.00	3,500		$0.00
0007	Benzodiazepines Screen -UDS		3,500	0	0	0		$0.00	0		$0.00	3,500		$0.00
0008	B-HCG, serum		180	10	7	0		$0.00	17		$0.00	197		$0.00
0009	Bilirubin Direct		5,915	7,194	7,406	7,194		$0.00	21,794		$0.00	27,709		$0.00
0010	Bilirubin Total		34,250	7,428	7,820	7,428		$0.00	22,676		$0.00	56,926		$0.00
0011	BNP		4,000	0	0	0		$0.00	0		$0.00	4,000		$0.00
0012	BNP Pro		0	935	388	0		$0.00	1,323		$0.00	1,323		$0.00
0013	BUN (serum/urine)		57,480	11,797	9,994	11,797		$0.00	33,588		$0.00	91,068		$0.00
0014	C Reactive Protein HS		6,285	1,199	0	0		$0.00	1,199		$0.00	7,484		$0.00
0015	Calcium (serum/urine)		35,340	11,355	9,355	11,355		$0.00	32,065		$0.00	67,405		$0.00
0016	Cannabinoids Screen - UDS		3,500	0	0	0		$0.00	0		$0.00	3,500		$0.00
0017	Carbamazepine		0	26	7	0		$0.00	33		$0.00	33		$0.00
0018	CEA		240	0	0	0		$0.00	0		$0.00	240		$0.00
0019	Chloride (serum/urine)		57,750	11,242	9,402	11,242		$0.00	31,886		$0.00	89,636		$0.00
0020	Cholesterol HDL		33,530	6,526	6,274	6,526		$0.00	19,326		$0.00	52,856		$0.00
0021	Cholesterol Total		33,530	6,527	6,274	6,527		$0.00	19,328		$0.00	52,858		$0.00
0022	CO2		58,390	11,243	9,421	11,243		$0.00	31,907		$0.00	90,297		$0.00
0023	Cocaine/BE -UDS		3,500	0	0	0		$0.00	0		$0.00	3,500		$0.00
0024	Creatine Kinase (CK)		2,325	485	760	0		$0.00	1,245		$0.00	3,570		$0.00
0025	Creatinine (serum/urine)		74,370	14,468	11,834	14,468		$0.00	40,770		$0.00	115,140		$0.00
0026	Digoxin		630	75	32	0		$0.00	107		$0.00	737		$0.00
0027	Ethanol		820	242	27	0		$0.00	269		$0.00	1,089		$0.00
0028	Ferritin		5,045	793	305	0		$0.00	1,098		$0.00	6,143		$0.00
0029	Folate		3,200	510	172	0		$0.00	682		$0.00	3,882		$0.00
0030	Gentamicin		0	2	0	0		$0.00	2		$0.00	2		$0.00
0031	GGT		28,890	88	28	0		$0.00	116		$0.00	29,006		$0.00
0032	Glucose CSF		25	2	0	0		$0.00	2		$0.00	27		$0.00
0033	Glucose Serum		60,180	11,487	9,452	11,487		$0.00	32,426		$0.00	92,606		$0.00
0034	Hepatitis B Surface Antibody		1,120	0	0	0		$0.00	0		$0.00	1,120		$0.00
0035	Hepatitis B Surface Antigen		1,000	0	0	0		$0.00	0		$0.00	1,000		$0.00
0036	Hepatitis C Antibody		1,625	771	557	0		$0.00	1,328		$0.00	2,953		$0.00
0037	HIV 1/2 Antibody		1,150	0	0	0		$0.00	0		$0.00	1,150		$0.00
0038	Ionized Calcium		200	0	0	0		$0.00	0		$0.00	200		$0.00
0039	Iron Total		3,830	330	667	0		$0.00	997		$0.00	4,827		$0.00
0040	Lactate Dehydrogenase		30,220	31	419	31		$0.00	481		$0.00	30,701		$0.00
0041	Lactic Acid		1,510	349	343	349		$0.00	1,041		$0.00	2,551		$0.00
0042	LDL Cholesterol Direct		4,250	97	55	97		$0.00	249		$0.00	4,499		$0.00
0043	Lipase Blood		1,430	352	397	352		$0.00	1,101		$0.00	2,531		$0.00
0044	Lithium		560	93	53	0		$0.00	146		$0.00	706		$0.00
0045	Magnesium		33,370	2,389	3,772	2,389		$0.00	8,550		$0.00	41,920		$0.00
0046	Methadone -UDS		3,500	0	0	0		$0.00	0		$0.00	3,500		$0.00
0047	Microalbumin		8,360	1,745	1,706	1,745		$0.00	5,196		$0.00	13,556		$0.00
0048	Opiate -UDS		3,500	0	0	0		$0.00	0		$0.00	3,500		$0.00
0049	Oxycodone -UDS		3,500	0	0	0		$0.00	0		$0.00	3,500		$0.00
0050	Phencyclidine Screen -UDS		3,500	0	0	0		$0.00	0		$0.00	3,500		$0.00
0051	Phenytoin		545	43	6	0		$0.00	49		$0.00	594		$0.00
0052	Phosphatase Alkaline		34,875	7,416	7,918	7,416		$0.00	22,750		$0.00	57,625		$0.00
0053	Phosphorus		31,840	4,282	1,849	4,282		$0.00	10,413		$0.00	42,253		$0.00
0054	Potassium (serum/urine)		66,000	11,791	9,532	11,791		$0.00	33,114		$0.00	99,114		$0.00
0055	Prostate Specific Ag (PSA)		18,300	4,202	3,711	4,202		$0.00	12,115		$0.00	30,415		$0.00
0056	Protein CSF		100	3	0	0		$0.00	3		$0.00	103		$0.00
0057	Protein Total		35,435	7,265	7,475	7,265		$0.00	22,005		$0.00	57,440		$0.00
0058	Protein UR Quant		2,600	173	72	173		$0.00	418		$0.00	3,018		$0.00
0059	PTH Intact		3,580	473	368	0		$0.00	841		$0.00	4,421		$0.00
0060	Rheumatoid Factor		1,825	222	69	0		$0.00	291		$0.00	2,116		$0.00
0061	Salicylates		455	6	7	0		$0.00	13		$0.00	468		$0.00
0062	SGOT/AST		42,425	8,123	8,295	8,123		$0.00	24,541		$0.00	66,966		$0.00
0063	SGPT/ALT		42,730	8,077	8,294	8,077		$0.00	24,448		$0.00	67,178		$0.00
0064	Sodium (serum/urine)		59,875	11,592	9,470	11,592		$0.00	32,654		$0.00	92,529		$0.00
0065	Testosterone		3,200	799	246	0		$0.00	1,045		$0.00	4,245		$0.00
0066	Theophylline		0	1	2	0		$0.00	3		$0.00	3		$0.00
0067	Thyroid Stimulating Hormone (TSH)		22,560	6,271	6,434	6,271		$0.00	18,976		$0.00	41,536		$0.00
0068	Thyroxine Free (FT4)		4,875	1,253	2,122	0		$0.00	3,375		$0.00	8,250		$0.00
0069	Total iron binding capacity		3,762	653	254	0		$0.00	907		$0.00	4,669		$0.00
0070	Tramadol		60	0	0	0		$0.00	0		$0.00	60		$0.00
0071	Transferrin		0	662	261	0		$0.00	923		$0.00	923		$0.00
0072	Triglyceride		33,610	6,529	6,276	6,529		$0.00	19,334		$0.00	52,944		$0.00
0073	Troponin-I or Troponin-T		4,410	984	503	0		$0.00	1,487		$0.00	5,897		$0.00
0074	Uric Acid (serum/urine)		4,810	735	1,648	735		$0.00	3,118		$0.00	7,928		$0.00
0075	Valproic Acid		500	112	68	0		$0.00	180		$0.00	680		$0.00
0076	Vancomycin		500	107	30	0		$0.00	137		$0.00	637		$0.00
0077	Vitamin B12		4,350	3,636	1,166	0		$0.00	4,802		$0.00	9,152		$0.00
0078	Vitamin D		15,870	8,364	3,690	0		$0.00	12,054		$0.00	27,924		$0.00

Order Period 1

CLIN	Test Name	Manufacturer Product Number	Annual Volume	Price	Extended Price
1001	Acetaminophen		450
1002	Albumin		34,770
1003	Ammonia		430
1004	Amphetamine/ Methamphetamine -UDS		3,460
1005	Amylase		675
1006	Barbiturate Screen -UDS		3,500
1007	Benzodiazepines Screen -UDS		3,500
1008	B-HCG, serum		180
1009	Bilirubin Direct		5,915
1010	Bilirubin Total		34,250
1011	BNP		4,000
1012	BUN (serum/urine)		57,480
1013	C Reactive Protein HS		6,285
1014	Calcium (serum/urine)		35,340
1015	Cannabinoids Screen - UDS		3,500
1016	CEA		240
1017	Chloride (serum/urine)		57,750
1018	Cholesterol HDL		33,530
1019	Cholesterol Total		33,530
1020	CO2		58,390
1021	Cocaine/BE -UDS		3,500
1022	Creatine Kinase (CK)		2,325
1023	Creatinine (serum/urine)		74,370
1024	Digoxin		630
1025	Ethanol		820
1026	Ferritin		5,045
1027	Folate		3,200
1028	GGT		28,890
1029	Glucose CSF		25
1030	Glucose Serum		60,180
1031	Hepatitis B Surface Antibody		1,120
1032	Hepatitis B Surface Antigen		1,000
1033	Hepatitis C Antibody		1,625
1034	HIV 1/2 Antibody		1,150
1035	Ionized Calcium		200
1036	Iron Total		3,830
1037	Lactate Dehydrogenase		30,220
1038	Lactic Acid		1,510
1039	LDL Cholesterol Direct		4,250
1040	Lipase Blood		1,430
1041	Lithium		560
1042	Magnesium		33,370
1043	Methadone -UDS		3,500
1044	Microalbumin		8,360
1045	Opiate -UDS		3,500
1046	Oxycodone -UDS		3,500
1047	Phencyclidine Screen -UDS		3,500
1048	Phenytoin		545
1049	Phosphatase Alkaline		34,875
1050	Phosphorus		31,840
1051	Potassium (serum/urine)		66,000
1052	Prostate Specific Ag (PSA)		18,300
1053	Protein CSF		100
1054	Protein Total		35,435
1055	Protein UR Quant		2,600
1056	PTH Intact		3,580
1057	Rheumatoid Factor		1,825
1058	Salicylates		455
1059	SGOT/AST		42,425
1060	SGPT/ALT		42,730
1061	Sodium (serum/urine)		59,875
1062	Testosterone		3,200
1063	Thyroid Stimulating Hormone (TSH)		22,560
1064	Thyroxine Free (FT4)		4,875
1065	Total iron binding capacity		3,762
1066	Tramadol		60
1067	Triglyceride		33,610
1068	Troponin-I or Troponin-T		4,410
1069	Uric Acid (serum/urine)		4,810
1070	Valproic Acid		500
1071	Vancomycin		500
1072	Vitamin B12		4,350
1073	Vitamin D		15,870

Order Period 2

CLIN	Test Name	Manufacturer Product Number	Annual Volume	Price	Extended Price
2001	Acetaminophen		450
2002	Albumin		34,770
2003	Ammonia		430
2004	Amphetamine/ Methamphetamine -UDS		3,460
2005	Amylase		675
2006	Barbiturate Screen -UDS		3,500
2007	Benzodiazepines Screen -UDS		3,500
2008	B-HCG, serum		180
2009	Bilirubin Direct		5,915
2010	Bilirubin Total		34,250
2011	BNP		4,000
2012	BUN (serum/urine)		57,480
2013	C Reactive Protein HS		6,285
2014	Calcium (serum/urine)		35,340
2015	Cannabinoids Screen - UDS		3,500
2016	CEA		240
2017	Chloride (serum/urine)		57,750
2018	Cholesterol HDL		33,530
2019	Cholesterol Total		33,530
2020	CO2		58,390
2021	Cocaine/BE -UDS		3,500
2022	Creatine Kinase (CK)		2,325
2023	Creatinine (serum/urine)		74,370
2024	Digoxin		630
2025	Ethanol		820
2026	Ferritin		5,045
2027	Folate		3,200
2028	GGT		28,890
2029	Glucose CSF		25
2030	Glucose Serum		60,180
2031	Hepatitis B Surface Antibody		1,120
2032	Hepatitis B Surface Antigen		1,000
2033	Hepatitis C Antibody		1,625
2034	HIV 1/2 Antibody		1,150
2035	Ionized Calcium		200
2036	Iron Total		3,830
2037	Lactate Dehydrogenase		30,220
2038	Lactic Acid		1,510
2039	LDL Cholesterol Direct		4,250
2040	Lipase Blood		1,430
2041	Lithium		560
2042	Magnesium		33,370
2043	Methadone -UDS		3,500
2044	Microalbumin		8,360
2045	Opiate -UDS		3,500
2046	Oxycodone -UDS		3,500
2047	Phencyclidine Screen -UDS		3,500
2048	Phenytoin		545
2049	Phosphatase Alkaline		34,875
2050	Phosphorus		31,840
2051	Potassium (serum/urine)		66,000
2052	Prostate Specific Ag (PSA)		18,300
2053	Protein CSF		100
2054	Protein Total		35,435
2055	Protein UR Quant		2,600
2056	PTH Intact		3,580
2057	Rheumatoid Factor		1,825
2058	Salicylates		455
2059	SGOT/AST		42,425
2060	SGPT/ALT		42,730
2061	Sodium (serum/urine)		59,875
2062	Testosterone		3,200
2063	Thyroid Stimulating Hormone (TSH)		22,560
2064	Thyroxine Free (FT4)		4,875
2065	Total iron binding capacity		3,762
2066	Tramadol		60
2067	Triglyceride		33,610
2068	Troponin-I or Troponin-T		4,410
2069	Uric Acid (serum/urine)		4,810
2070	Valproic Acid		500
2071	Vancomycin		500
2072	Vitamin B12		4,350
2073	Vitamin D		15,870

Order Period 3

CLIN	Test Name	Manufacturer Product Number	Annual Volume	Price	Extended Price
3001	Acetaminophen		450
3002	Albumin		34,770
3003	Ammonia		430
3004	Amphetamine/ Methamphetamine -UDS		3,460
3005	Amylase		675
3006	Barbiturate Screen -UDS		3,500
3007	Benzodiazepines Screen -UDS		3,500
3008	B-HCG, serum		180
3009	Bilirubin Direct		5,915
3010	Bilirubin Total		34,250
3011	BNP		4,000
3012	BUN (serum/urine)		57,480
3013	C Reactive Protein HS		6,285
3014	Calcium (serum/urine)		35,340
3015	Cannabinoids Screen - UDS		3,500
3016	CEA		240
3017	Chloride (serum/urine)		57,750
3018	Cholesterol HDL		33,530
3019	Cholesterol Total		33,530
3020	CO2		58,390
3021	Cocaine/BE -UDS		3,500
3022	Creatine Kinase (CK)		2,325
3023	Creatinine (serum/urine)		74,370
3024	Digoxin		630
3025	Ethanol		820
3026	Ferritin		5,045
3027	Folate		3,200
3028	GGT		28,890
3029	Glucose CSF		25
3030	Glucose Serum		60,180
3031	Hepatitis B Surface Antibody		1,120
3032	Hepatitis B Surface Antigen		1,000
3033	Hepatitis C Antibody		1,625
3034	HIV 1/2 Antibody		1,150
3035	Ionized Calcium		200
3036	Iron Total		3,830
3037	Lactate Dehydrogenase		30,220
3038	Lactic Acid		1,510
3039	LDL Cholesterol Direct		4,250
3040	Lipase Blood		1,430
3041	Lithium		560
3042	Magnesium		33,370
3043	Methadone -UDS		3,500
3044	Microalbumin		8,360
3045	Opiate -UDS		3,500
3046	Oxycodone -UDS		3,500
3047	Phencyclidine Screen -UDS		3,500
3048	Phenytoin		545
3049	Phosphatase Alkaline		34,875
3050	Phosphorus		31,840
3051	Potassium (serum/urine)		66,000
3052	Prostate Specific Ag (PSA)		18,300
3053	Protein CSF		100
3054	Protein Total		35,435
3055	Protein UR Quant		2,600
3056	PTH Intact		3,580
3057	Rheumatoid Factor		1,825
3058	Salicylates		455
3059	SGOT/AST		42,425
3060	SGPT/ALT		42,730
3061	Sodium (serum/urine)		59,875
3062	Testosterone		3,200
3063	Thyroid Stimulating Hormone (TSH)		22,560
3064	Thyroxine Free (FT4)		4,875
3065	Total iron binding capacity		3,762
3066	Tramadol		60
3067	Triglyceride		33,610
3068	Troponin-I or Troponin-T		4,410
3069	Uric Acid (serum/urine)		4,810
3070	Valproic Acid		500
3071	Vancomycin		500
3072	Vitamin B12		4,350
3073	Vitamin D		15,870

Order Period 4

CLIN	Test Name	Manufacturer Product Number	Annual Volume	Price	Extended Price
4001	Acetaminophen		450
4002	Albumin		34,770
4003	Ammonia		430
4004	Amphetamine/ Methamphetamine -UDS		3,460
4005	Amylase		675
4006	Barbiturate Screen -UDS		3,500
4007	Benzodiazepines Screen -UDS		3,500
4008	B-HCG, serum		180
4009	Bilirubin Direct		5,915
4010	Bilirubin Total		34,250
4011	BNP		4,000
4012	BUN (serum/urine)		57,480
4013	C Reactive Protein HS		6,285
4014	Calcium (serum/urine)		35,340
4015	Cannabinoids Screen - UDS		3,500
4016	CEA		240
4017	Chloride (serum/urine)		57,750
4018	Cholesterol HDL		33,530
4019	Cholesterol Total		33,530
4020	CO2		58,390
4021	Cocaine/BE -UDS		3,500
4022	Creatine Kinase (CK)		2,325
4023	Creatinine (serum/urine)		74,370
4024	Digoxin		630
4025	Ethanol		820
4026	Ferritin		5,045
4027	Folate		3,200
4028	GGT		28,890
4029	Glucose CSF		25
4030	Glucose Serum		60,180
4031	Hepatitis B Surface Antibody		1,120
4032	Hepatitis B Surface Antigen		1,000
4033	Hepatitis C Antibody		1,625
4034	HIV 1/2 Antibody		1,150
4035	Ionized Calcium		200
4036	Iron Total		3,830
4037	Lactate Dehydrogenase		30,220
4038	Lactic Acid		1,510
4039	LDL Cholesterol Direct		4,250
4040	Lipase Blood		1,430
4041	Lithium		560
4042	Magnesium		33,370
4043	Methadone -UDS		3,500
4044	Microalbumin		8,360
4045	Opiate -UDS		3,500
4046	Oxycodone -UDS		3,500
4047	Phencyclidine Screen -UDS		3,500
4048	Phenytoin		545
4049	Phosphatase Alkaline		34,875
4050	Phosphorus		31,840
4051	Potassium (serum/urine)		66,000
4052	Prostate Specific Ag (PSA)		18,300
4053	Protein CSF		100
4054	Protein Total		35,435
4055	Protein UR Quant		2,600
4056	PTH Intact		3,580
4057	Rheumatoid Factor		1,825
4058	Salicylates		455
4059	SGOT/AST		42,425
4060	SGPT/ALT		42,730
4061	Sodium (serum/urine)		59,875
4062	Testosterone		3,200
4063	Thyroid Stimulating Hormone (TSH)		22,560
4064	Thyroxine Free (FT4)		4,875
4065	Total iron binding capacity		3,762
4066	Tramadol		60
4067	Triglyceride		33,610
4068	Troponin-I or Troponin-T		4,410
4069	Uric Acid (serum/urine)		4,810
4070	Valproic Acid		500
4071	Vancomycin		500
4072	Vitamin B12		4,350
4073	Vitamin D		15,870

Sheet1

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File details come from the government source that posted it. Updated Mar 20, 2023.