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PRICE SCHEDULE
Contract Period: Base Year (6 months only)
| CLIN |
| Deliverable |
| Deliverable Description |
| Unit/ QTY |
| Unit Cost |
| Cost |
Task 1: Preparation
| 0001 |
| 1.1 |
| New Technical Specifications Low to Moderate Complexity |
| 2 |
| 0002 |
| 1.1a |
| OPTIONAL CLIN: Additional New Technical Specifications, Low to Moderate Complexity |
(Up to 7)
| 0003 |
| 1.2 |
| New Technical Specifications High Complexity |
| 1 |
Task 2: Revisions
| 0004 |
| 2.1 |
| Quarterly Review and Revision of Measure Specifications |
| 2 |
Task 3: Abstraction
| 0005 |
| 3.1 |
| Record Review (includes DAC format) |
| 212,500 |
| 0006 |
| 3.1a |
| OPTIONAL CLIN: Additional Record Reviews |
(Up to 175,000)
Task 4: Data Transmission
Task 5: Data Reporting
| 0010 |
| 5.1 |
| Monthly (includes Exit conference provide one format to be used for each pull list for each facility (153)) |
| 6 |
| 0012 |
| 5.3 |
| Missing Data/External Reports |
| 6 |
Task 6: Communication
| 0013 |
| 6.1 |
| Monthly Management Reports |
| 6 |
Task 7: Analysis
| 0014 |
| 7.1 |
| Ad hoc Analysis |
| 3 |
| 0015 |
| 7.1a |
| OPTIONAL CLIN: Additional Analysis |
(Up to 9)
Task 8: Quality
| 0016 |
| 8.1 |
| Quality Control (Quarterly reports) |
| 2 |
Task 9. Annual Summary Report
| 0017 |
| 9.1 |
| Annual Summary Report |
| 1 |
TRAVEL
| Travel NTE-cost reimbursement |
| 1 |
| NTE |
| $100,000.00 |
TOTAL Base Year (Excluding Travel):
Contract Period: Option Year 1 (12 months)
| CLIN |
| Deliverable |
| Deliverable Description |
| Unit/ QTY |
| Unit Cost |
| Cost |
Task 1: Preparation
| 1001 |
| 1.1 |
| New Technical Specifications Low to Moderate Complexity |
| 3 |
| 1002 |
| 1.1a |
| OPTIONAL CLIN: Additional New Technical Specifications, Low to Moderate Complexity |
| 1003 |
| 1.2 |
| New Technical Specifications High Complexity |
| 2 |
Task 2: Revisions
| 1004 |
| 2.1 |
| Quarterly Review and Revision of Measure Specifications |
| 4 |
Task 3: Abstraction
| 1005 |
| 3.1 |
| Record Review (includes DAC format) |
| 425,000 |
| 1006 |
| 3.1a |
| OPTIONAL CLIN: Additional Record Reviews |
175,000
Task 4: Data Transmission
Task 5: Data Reporting
| 1010 |
| 5.1 |
| Monthly (includes Exit conference provide one format to be used for each pull list for each facility (153)) |
| 12 |
| 1012 |
| 5.3 |
| Missing Data/External Reports |
| 12 |
Task 6: Communication
| 1013 |
| 6.1 |
| Monthly Management Reports |
| 12 |
Task 7: Analysis
| 1014 |
| 7.1 |
| Ad hoc Analysis |
| 3 |
| 1015 |
| 7.1a |
| OPTIONAL CLIN: Additional Analysis |
Task 8: Quality
| 1016 |
| 8.1 |
| Quality Control (Quarterly reports) |
| 4 |
Task 9. Annual Summary Report
| 1017 |
| 9.1 |
| Annual Summary Report |
| 1 |
TRAVEL
| Travel NTE-cost reimbursement |
| 1 |
| NTE |
| $200,000.00 |
TOTAL Option Year 1 (Excluding Travel):
Contract Period: Option Year 2 (12 months)
| CLIN |
| Deliverable |
| Deliverable Description |
| Unit/ QTY |
| Unit Cost |
| Cost |
Task 1: Preparation
| 2001 |
| 1.1 |
| New Technical Specifications Low to Moderate Complexity |
| 3 |
| 2002 |
| 1.1a |
| OPTIONAL CLIN: Additional New Technical Specifications, Low to Moderate Complexity |
| 2003 |
| 1.2 |
| New Technical Specifications High Complexity |
| 2 |
Task 2: Revisions
| 2004 |
| 2.1 |
| Quarterly Review and Revision of Measure Specifications |
| 4 |
Task 3: Abstraction
| 2005 |
| 3.1 |
| Record Review (includes DAC format) |
| 425,000 |
| 2006 |
| 3.1a |
| OPTIONAL CLIN: Additional Record Reviews |
175,000
Task 4: Data Transmission
Task 5: Data Reporting
| 2010 |
| 5.1 |
| Monthly (includes Exit conference provide one format to be used for each pull list for each facility (153)) |
| 12 |
| 2012 |
| 5.3 |
| Missing Data/External Reports |
| 12 |
Task 6: Communication
| 2013 |
| 6.1 |
| Monthly Management Reports |
| 12 |
Task 7: Analysis
| 2014 |
| 7.1 |
| Ad hoc Analysis |
| 3 |
| 2015 |
| 7.1a |
| OPTIONAL CLIN: Additional Analysis |
Task 8: Quality
| 2016 |
| 8.1 |
| Quality Control (Quarterly reports) |
| 4 |
Task 9. Annual Summary Report
| 2017 |
| 9.1 |
| Annual Summary Report |
| 1 |
TRAVEL
Travel NTE-cost reimbursement
$200,000.00
TOTAL Option Year 2 (Excluding Travel):
Contract Period: Option Year 3 (12 months)
| CLIN |
| Deliverable |
| Deliverable Description |
| Unit/ QTY |
| Unit Cost |
| Cost |
Task 1: Preparation
| 3001 |
| 1.1 |
| New Technical Specifications Low to Moderate Complexity |
| 3 |
| 3002 |
| 1.1a |
| OPTIONAL CLIN: Additional New Technical Specifications, Low to Moderate Complexity |
| 3003 |
| 1.2 |
| New Technical Specifications High Complexity |
| 2 |
Task 2: Revisions
| 3004 |
| 2.1 |
| Quarterly Review and Revision of Measure Specifications |
| 4 |
Task 3: Abstraction
| 3005 |
| 3.1 |
| Record Review (includes DAC format) |
| 425,000 |
| 3006 |
| 3.1a |
| OPTIONAL CLIN: Additional Record Reviews |
175,000
Task 4: Data Transmission
Task 5: Data Reporting
| 3010 |
| 5.1 |
| Monthly (includes Exit conference provide one format to be used for each pull list for each facility (153)) |
| 12 |
| 3012 |
| 5.3 |
| Missing Data/External Reports |
| 12 |
Task 6: Communication
| 3013 |
| 6.1 |
| Monthly Management Reports |
| 12 |
Task 7: Analysis
| 3014 |
| 7.1 |
| Ad hoc Analysis |
| 3 |
| 3015 |
| 7.1a |
| OPTIONAL CLIN: Additional Analysis |
Task 8: Quality
| 3016 |
| 8.1 |
| Quality Control (Quarterly reports) |
| 4 |
Task 9. Annual Summary Report
| 3017 |
| 9.1 |
| Annual Summary Report |
| 1 |
TRAVEL
Travel NTE-cost reimbursement
$200,000.00
TOTAL Option Year 3 (Excluding Travel):
Contract Period: Option Year 4 (12 months)
| CLIN |
| Deliverable |
| Deliverable Description |
| Unit/ QTY |
| Unit Cost |
| Cost |
Task 1: Preparation
| 4001 |
| 1.1 |
| New Technical Specifications Low to Moderate Complexity |
| 3 |
| 4002 |
| 1.1a |
| OPTIONAL CLIN: Additional New Technical Specifications, Low to Moderate Complexity |
| 4003 |
| 1.2 |
| New Technical Specifications High Complexity |
| 2 |
Task 2: Revisions
| 4004 |
| 2.1 |
| Quarterly Review and Revision of Measure Specifications |
| 4 |
Task 3: Abstraction
| 4005 |
| 3.1 |
| Record Review (includes DAC format) |
| 425,000 |
| 4006 |
| 3.1a |
| OPTIONAL CLIN: Additional Record Reviews |
175,000
Task 4: Data Transmission
Task 5: Data Reporting
| 4010 |
| 5.1 |
| Monthly (includes Exit conference provide one format to be used for each pull list for each facility (153)) |
| 12 |
| 4012 |
| 5.3 |
| Missing Data/External Reports |
| 12 |
Task 6: Communication
| 4013 |
| 6.1 |
| Monthly Management Reports |
| 12 |
Task 7: Analysis
| 4014 |
| 7.1 |
| Ad hoc Analysis |
| 3 |
| 4015 |
| 7.1a |
| OPTIONAL CLIN: Additional Analysis |
Task 8: Quality
| 4016 |
| 8.1 |
| Quality Control (Quarterly reports) |
| 4 |
Task 9. Annual Summary Report
| 4017 |
| 9.1 |
| Annual Summary Report |
| 1 |
TRAVEL
Travel NTE-cost reimbursement
$200,000.00
TOTAL Option Year 4 (Excluding Travel):
GRAND TOTAL (BASE + OPTION YEARS, EXCLUDING TRAVEL):