36C79119R0009-0002001.pdf
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- Attached to
- PAP New Issue TIERED EVALUATIONS Federal contract opportunity
- Solicitation number
- 36C79119R0009
About this file
This document outlines a federal contract opportunity for Positive Airway Pressure devices and accessories. The Department of Veterans Affairs intends to issue a solicitation on July 12, 2019 seeking proposals from Service Disabled Veteran Owned Small Businesses, Veteran Owned Small Businesses, and other small businesses to supply Positive Airway Pressure devices, masks, tubing, filters, and other accessories to various VA medical facilities. The solicitation will be for multiple firm fixed price, indefinite delivery indefinite quantity contracts with a base period of 12 months and four additional 12-month option periods that may or may not be exercised at the government's discretion. Interested parties should monitor FedBizOpps for the full solicitation and instructions for proposal submission.
36C79119R0009 0002 ATTACHMENT F PRE-APPROVED PRODUCTS.pdf
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ATTACHMENT F
LIST OF APPROVED PAP DEVICES AND ASSOCIATED ACCESSORIES
The below lists are the approved Positive Airway Pressure (PAP) devices listed in the four (4) Contract
Line Items (CLIN) identified within this requirement. Additionally, an approved list for associated
Accessories is also identified within these lists of approved products. Every PAP device make and model listed below that is proposed by a vendor will need to have its own sub-CLIN under the appropriate L
Code/CLIN identified in Attachment D Price/Cost Schedule. The list below is categorized by the
CLIN> HCPCS/L Code>Manufacturer > Model>Part Number.
POSITIVE AIRWAY PRESSURE DEVICES
CLIN 001: Auto-Titrating Continuous Positive Airway Pressure (APAP) Device
HCPCS/L Code: E0601
MANUFACTURER: RESMED
BRAND MODEL PRODUCT NUMBER
RESMED AirSense 10 AutoSet 37207
RESMED AirSense 10 AutoSet 37208
RESMED
AirSense 10 Autoset for
Her 37210
RESMED
AirSense 10 Autoset for
Her 37209
MANUFACTURER: PHILLIPS
PHILLIPS
SYSTEM, CPAP,
DREAMSTATION,
AUTO-CPAP, HEATED
HUMIDIFIER DSX500H11
PHILLIPS
DREAMSTATION
AUTO CPAP WITH
HUMIDIFIER, HEATED
TUBING DSX500T11
MANUFACTURER: DEVILBISS HEALTHCARE
DEVILBISS
HEALTHCARE
SYSTEM, CPAP,
INTELLIPAP2
AUTOADJUST, DV64D
DEVILBISS
HEALTHCARE
SYSTEM, CPAP,
INTELLIPAP2
AUTOADJUST,
W/HEATED
HUMIDIFIER DV64DHH
HEALTHCARE
SYSTEM, CPAP,
INTELLIPAP 2 AUTO
ADJUST, W/ PULSE
DOSE HEATED
HUMIDIFIER DV64D-HHPD
CLIN 002: Adaptive Servo-Ventilation (ASV)
HCPCS/L Code E0471 (with backup rate feature)
RESMED AirCurve 10 ASV 37216
RESMED AirCurve 10 ASV 37215
CLIN 003: Bi-level Positive Airway Pressure (BPAP)
HCPCS/L Code: E0470 (without backup rate); E0471 (with backup rate feature)
RESMED AirCurve 10 ST 37306
RESMED AirCurve10 VAuto 37211
RESMED AirCurve10 VAuto 37212
RESMED AirCurve 10 ST (VPAP) 37307
RESMED
AirCurve 10 ST-A
(VPAP) 28210
DREAMSTATION
AUTO BIPAP WITH
HUMIDIFIER,
DOMESTIC DV57D-HH-S2
PHILLIPS
DREAMSTATION
AUTO BIPAP WITH
HUMIDIFIER, HEATED
TUBING DSX700T11
PHILLIPS
AUTOSV 960DS
ADVANCED, HEATED
HUMIDIFIER DS960HS
HEALTHCARE
SYSTEM, BIPAP,
INTELLIPAP 2 AUTO
BILEVEL S, UNIT
ONLY DV57D
HEALTHCARE
SYSTEM, BIPAP,
INTELLIPAP 2
BILEVEL AND
HEATED
HUMIDIFICATION
SYSTEM DV57D-HH
DEVILBISS
HEALTHCARE
SYSTEM, BIPAP,
INTELLIPAP2 BILEVEL
AND HEATED
HUMIDIFICATION
SYSTEM and HEATED
TUBE DV57D-HH-HT
DEVILBISS
HEALTHCARE
SYSTEM, BIPAP,
INTELLIPAP2 BILEVEL
AND HEATED
HUMIDIFICATION
SYSTEM, SMARTLINK
MODULE and DATA
CARD DV57D-HH-S
CLIN 004: Volume Assured Pressure Support (VAPS)
HCPCS/L Code: E0471 (with backup rate feature)
RESMED AirCurve 10 ST-A 28211
RESMED AirCurve 10 ST-A 28210
AVAPS, PRES RANGE
4 30CM H20, WT 3LB
PAP ACCESSORIES
TUBING
HCPCS/L Code: A7037
RESMED
MODEL
PRODUCT
NUMBER
RESMED SlimLine tubing (for S9 & A10) 36810
RESMED ClimateLineAir heated tubing (for A10) 37296
RESMED ClimateLineAir Oxy tubing (for A10) 37357
PRODUCT
NUMBER
PHILLIPS TUBING, CPAP/BIPAP, L 6FT, FLEX, GRAY, REUSABLE 622038
PHILLIPS
HEATED TUBING, CPAP/BIPAP, FOR USE WITH
RESPIRONICS SYSTEM ONE 60 SERIES
SYS1HT15
PHILLIPS DREAMSTATION 15MM HEATED TUBE HT15
FILTERS
HCPCS/L Code: A7038
PRODUCT
NUMBER
RESMED Filters (2 pack) (for S9 & A10) 36851
RESMED Filters (12 Pack) (for S9 & A10) 36852
RESMED Hypoallergenic filters (12 pack) (for S9 & A10) 36857
RESMED Hypoallergenic filters (2 pack) (for S9 & A10) 36856
RESMED Filters (50 Pack) (for S9 & A10) 36853
PRODUCT
NUMBER
PHILLIPS
FILTER, CPAP, USE W/M SERIES, ULTRA FINE, DISP, 1
¼ X 1 ¾ inch 1029331
PHILLIPS
FILTER, CPAP, USE W/M SERIES, REUSABLE, 3/8 X 1 ¾
X 1 inch, POLLEN 1029330
PHILLIPS
FILTER POLLEN FOAM REUSABLE FOR
DREAMSTATION
1122446
MANUFACTURER: DeVILBISS
DeVILBISS
PRODUCT
NUMBER
DeVILBISS Fine Particle Air Filter (4-PK), White DV51D-603
DeVILBISS Air Inlet Filter (4-PK) Grey DV51D-602
CHAMBERS
HCPCS/L Code: A7046 water chamber for humidifier - replacement
PRODUCT
NUMBER
RESMED
Dishwasher Safe Water Chamber for AirSense™ 10, AirStart™ 10, and AirCurve™ 10 HumidAir™ Heated
Humidifier
37300
RESMED
Standard Water Chamber for AirSense™ 10, AirStart™ 10, and AirCurve™ 10 Humidair™ Heated Humidifier 37299
PRODUCT
NUMBER
PHILLIPS Water Chamber for DreamStation Heated Humidifier 1122520
PRODUCT
DeVilbiss Water Chamber for IntelliPAP 2 Heated Humidifier DV6C
OTHER ACCESSORIES
HCPCS/L Code: E1399 (A10 Power Pack) A9279 (SD Card 10 pack with folder)
MODEL
PRODUCT
NUMBER
RESMED Power pack (A10) 37344
RESMED Card with folder (10 pack) 37329
PRODUCT
PHILLIPS DreamStation 80-Watt Power Supply 1118499
MANUFACTURER: DeVILBISS HEALTHCARE
PRODUCT
NUMBER
DeVILBISS DC Power Cord for IntelliPAP 2 CPAP Machines DV6X-619
DeVILBISS IntelliPAP 2 Power Supply DV63D-613
CLIN 0005: FULL FACE MASKS-COMPLETE SYSTEMS
HCPCS/L Code: A7030
BRAND
PRODUCT
NUMBER
RESMED Mirage Quattro M 61202
RESMED Mirage Quattro L 61203
RESMED AirFit F10 M 63102
RESMED Quattro Air M 62702
RESMED AirFit F10 L 63103
RESMED Quattro Air L 62703
RESMED Quattro FX M 61701
RESMED Mirage Quattro S 61201
RESMED AirFit F10 S 63101
RESMED Quattro Air S 62701
RESMED AirFit F20 M 63402
RESMED Quattro FX S 61700
RESMED AirFit F20 L 63402
RESMED AirFit F20 S 63400
RESMED AirFit F10 for Her XS 63139
RESMED AirFit F20 for Her S 63403
RESMED AirFit F10 for Her M 63141
RESMED AirFit F10 for Her S 63140
RESMED Quattro FX L 61702
MANUFACTURER: FISHER PAYKEL
FISHER PAYKEL
PRODUCT
NUMBER
FISHER PAYKEL
MASK, CPAP/BIPAP, FULL FACE, MED, SIMPLUS,
AUTO-ADJUSTING CUSHION
400476
FISHER PAYKEL
MASK, CPAP/BIPAP, FULL FACE, LG, SIMPLUS, AUTO-
ADJUSTING CUSHION
400477
FISHER PAYKEL
MASK, CPAP/BIPAP, FULL FACE, SM, SIMPLUS, AUTO-
ADJUSTING CUSHION
400475
FISHER PAYKEL FACEPIECE MASK F&P SIMPLUS MEDIUM ROLLFIT 400476SL
FISHER PAYKEL FACEPIECE MASK F&P SIMPLUS LARGE ROLLFIT 400477SL
FISHER PAYKEL F&P SIMPLUS FULL FACE MASK SL - SMALL 400475SL
PRODUCT
NUMBER
PHILLIPS AMARA VIEW, Full Face W/HEADGEAR, ADJ Large 1090624
PHILLIPS AMARA, Full Face, W/HEADGEAR Medium 1090623
PHILLIPS
FULL FACE, MED, AMARA, W/HEADGEAR Medium
Silicone 1090226
PHILLIPS
FULL FACE, LG, AMARA, SIL, FOREHEAD PAD, ADJ
Large Silicone 1090227
PHILLIPS Comfort Gel Blue Full-Face Size Large with headgear 1081872
PHILLIPS
FULL FACE, LG, AMARA, W/HEADGEAR, GEL PILLOWS
Large Gel 1090406
PHILLIPS AMARA VIEW Full Face Mask W/HEADGEAR – Fit Pack 1090670
PHILLIPS Comfort Gel Blue Full-Face Size Med with headgear 1081871
CLIN 0006: NASAL MASKS-COMPLETE SYSTEM
HCPCS/L Code: A7034
PRODUCT
NUMBER
RESMED Mirage FX St 62103
RESMED Mirage FX W 62118
RESMED AirFit N10 St 63200
RESMED Mirage Activa LT M 60148
RESMED AirFit N10 W 63202
RESMED Mirage SoftGel M 61601
RESMED Mirage Activa LT L 60149
RESMED Swift FX Nano St 62200
RESMED Mirage SoftGel L 61602
RESMED AirFit N20 M 63501
RESMED Mirage Activa LT LW 60150
RESMED AirFit N20 L 63502
RESMED Mirage FX for Her St 62128
RESMED AirFit N20 S 63503
RESMED Mirage SoftGel LW 61603
RESMED AirFit N10 for Her 63201
RESMED AirFit N10 Sm 63229
RESMED Mirage Activa LT M 60148
RESMED AirFit N10 St 63200
PRODUCT
NUMBER
PHILLIPS
WISP, HEADGEAR WITH FABRIC FRAME, SILICONE,
FLEXIBLE TUBING
1094053
PHILLIPS Comfort Gel Blue Size Med 1071270
PHILLIPS MASK NASAL DREAMWEAR FIT PACK 1116700
PHILLIPS Comfort Gel Blue Size Small 1071269
MANUFACTURER: FISHER PAYKEL
Fisher Paykel
PRODUCT
NUMBER
FISHER PAYKEL
MASK, CPAP/BIPAP, NASAL, MED, ESON, ERGOFIT
HEADGEAR, SWIVEL
400450
FISHER PAYKEL
MASK, CPAP/BIPAP, NASAL, LG, ESON, EASY FIT
HEADGEAR, ADJ STRAPS
400451
CLIN 0007: ORAL INTERFACE
HCPCS/L Code: A7035
No Products to List
CLIN 0008: NASAL PILLOWS
HCPCS/L Code: A7028, A7029, A7033
PRODUCT DESCRIPTION: NASAL PILLOWS
PRODUCT
NUMBER
RESMED Swift FX 61500
RESMED AirFit P10 62900
RESMED Swift FX Bella Gray 61568
RESMED AirFit P10 for Her 62910
RESMED Swift FX for Her 61540
RESMED Swift FX Bella 61560
PRODUCT
PHILLIPS NASAL, SM/MED/LG PILLOWS, NUANCE PRO, ADJ 1106447
MANUFACTURER: FYSHER PAYKEL
FYSHER PAYKEL
PRODUCT
FYSHER PAYKEL F&P BREVIDA NASAL PILLOWS MASK - XS-S/M- BRE1SMSL
CLIN 009: TOTAL FACIAL INTERFACE
HCPCS/L Code: A7030, A7035
CLIN 0010: MASK LINERS
HCPCS/L Code: A7031, A7032
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