Attachement A RFQ 36C25221Q0569.xlsx

XLSX spreadsheet 51 KB Posted May 20, 2021

Attached to: 6505--Madison VA Blood and Blood Products
Solicitation number: 36C25221Q0569
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 12

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VISN 12 Yearly Est

VISN 12 PRICING SCHEDULE
Description	10/1/20 - 9/30/21
	Qty	Unit Price	Estimated Total

**TIMED Delivery Charge	ERROR:#REF!	$ - 0	ERROR:#REF!
**STAT Delivery Charge	ERROR:#REF!	$ - 0	ERROR:#REF!
Allogeneic Components and Product Modifications:

Leukoreduced Red Blood Cells	ERROR:#REF!	$ - 0	ERROR:#REF!
Fresh Frozen Plasma	ERROR:#REF!	$ - 0	ERROR:#REF!
Apheresis Platelets	ERROR:#REF!	$ - 0	ERROR:#REF!
Pathogen Reduced Platelet Apheresis	ERROR:#REF!	$ - 0	ERROR:#REF!
Large Volume Delayed Sampling Platelet Apheresis	ERROR:#REF!	$ - 0	ERROR:#REF!
Variable Content Platelet Apheresis	ERROR:#REF!	$ - 0	ERROR:#REF!
Cryopreciptate, Random	ERROR:#REF!	$ - 0	ERROR:#REF!
Cryopreciptate, Pooled	ERROR:#REF!	$ - 0	ERROR:#REF!
Whole Blood	ERROR:#REF!	$ - 0	ERROR:#REF!
Leukoreduced Whole Blood	ERROR:#REF!	$ - 0	$ - 0
Liquid Plasma	ERROR:#REF!	$ - 0	ERROR:#REF!
Cryoprecipitate Reduced Plasma (Cryo-poor)	ERROR:#REF!	$ - 0	ERROR:#REF!
Granulocytes	ERROR:#REF!	$ - 0	ERROR:#REF!
LRBCD (Pediatric Red Cell Set): 3/set	ERROR:#REF!	$ - 0	$ - 0
LRBCD (Pediatric Red Cell Set): 6/set	ERROR:#REF!	$ - 0	$ - 0
LRBCD (Pediatric Red Cell Set): 9/set	ERROR:#REF!	$ - 0	$ - 0
LSDPN (Neonate Platelet Aliquot): Single Unit	ERROR:#REF!	$ - 0	$ - 0
FFPD (Pediatric Fresh Frozen Plasma Set): 6/set	ERROR:#REF!	$ - 0	$ - 0
Attached Empty Pediatric Bag Set: 3/set	ERROR:#REF!	$ - 0	$ - 0
Attached Empty Pediatric Bag Set: 6/set	ERROR:#REF!	$ - 0	$ - 0
Attached Empty Pediatric Bag Set: 9/set	ERROR:#REF!	$ - 0	$ - 0
Irradiation (per uit)	ERROR:#REF!	$ - 0	ERROR:#REF!
CMV Screening (per unit)	ERROR:#REF!	$ - 0	ERROR:#REF!
HLA Matching (per unit)	ERROR:#REF!	$ - 0	ERROR:#REF!
Volume reduction (per unit)	ERROR:#REF!	$ - 0	ERROR:#REF!
Washing (per unit)	ERROR:#REF!	$ - 0	ERROR:#REF!
Divided (per unit)	ERROR:#REF!	$ - 0	ERROR:#REF!
Deglycerized (per unit)	ERROR:#REF!	$ - 0	ERROR:#REF!
Restocking Fee	ERROR:#REF!	$ - 0	ERROR:#REF!
Autologous Donation Surcharge	ERROR:#REF!	$ - 0	ERROR:#REF!
Directed Donation Surcharge	ERROR:#REF!	$ - 0	ERROR:#REF!
Blood Import Fee	0	$ - 0	$ - 0
Additional ancillary transfusion reference processing and testing services listed below	VISN Total	Unit Price	Estimated Total

ABO and Rh	70	$ - 0	$ - 0
ABO Antibody Titer	1	$ - 0	$ - 0
ADAMTS13 Activity	1	$ - 0	$ - 0
ADAMTS13 Antibody	1	$ - 0	$ - 0
ADAMTS13 Inhibitor	1	$ - 0	$ - 0
ADAMTS13 Sequence Analysis	1	$ - 0	$ - 0
Alloadsorption (per adsorption)	50	$ - 0	$ - 0
Antibody Adsorption RESt/WARM	40	$ - 0	$ - 0
Antibody Identification Panel - Saline IAT	21	$ - 0	$ - 0
Antibody Identification Panel - PEG IAT	8	$ - 0	$ - 0
Antibody Identification Panel - LISS IAT	8	$ - 0	$ - 0
Antibody Identification Panel - GEL IAT	1	$ - 0	$ - 0
Antibody Identification Panel - Prewarm IAT	8	$ - 0	$ - 0
Antibody Identification Panel - Ficin IAT	8	$ - 0	$ - 0
Antibody Identification Panel - DTT/AET IAT	8	$ - 0	$ - 0
Antibody Identification Panel - Chlorquine/EGA IAT	8	$ - 0	$ - 0
Antigen Query - 1 Antigen (C,E, or K)	5	$ - 0	$ - 0
Antigen Query - 1 Antigen (all others)	5	$ - 0	$ - 0
Antigen Query - 2 Antigens	5	$ - 0	$ - 0
Antigen Query - 3 Antigens	1	$ - 0	$ - 0
Antigen Query - 4 Antigens	1	$ - 0	$ - 0
Antibody Screen - Saline IAT	21	$ - 0	$ - 0
Antibody Screen - PEG IAT	8	$ - 0	$ - 0
Antibody Screen - LISS IAT	8	$ - 0	$ - 0
Antibody Screen - GEL IAT	1	$ - 0	$ - 0
Antibody Screen -Prewarm IAT	8	$ - 0	$ - 0
Antibody Screen - Ficin IAT	8	$ - 0	$ - 0
Antibody Screen - DTT/AET IAT	8	$ - 0	$ - 0
Antibody Screen - Chlorquine/EGA IAT	8	$ - 0	$ - 0
Antibody Titration	10	$ - 0	$ - 0
Antigen Typing (other than Rh)	90	$ - 0	$ - 0
Antigen Typing (Rare)	5	$ - 0	$ - 0
Autoadsorption - ZZAP (per adsorption)	60	$ - 0	$ - 0
Chemical Treatment of Serum (2-Mercaptoethanol Treated Serum)	1	$ - 0	$ - 0
Cold Agglutinin Panel	4	$ - 0	$ - 0
Compatibility Screen (Crossmatch)	5	$ - 0	$ - 0
Compatiblity Screen with Alloadsorbed Serum	10	$ - 0	$ - 0
DAT Negative Hemolytic Anemia Evaluation	10	$ - 0	$ - 0
Direct Antiglobulin Test - Polyreactive AHG	70	$ - 0	$ - 0
Direct Antiglobulin Test - Monospecific Evaluation	70	$ - 0	$ - 0
Direct Antiglobulin Test IgA Detection	70	$ - 0	$ - 0
Donath Landsteiner	0	$ - 0	$ - 0
Drug Dependent RBC Antibody Study	5	$ - 0	$ - 0
Elution (per elution)	50	$ - 0	$ - 0
Heparin-Induced Thrombocytopenia Evaluation: PF4	20	$ - 0	$ - 0
Heparin-Induced Thombocytopenia Evaluation: Serotonin Release Assay	20	$ - 0	$ - 0
HLA Antibody Identification Class I High Resolution	20	$ - 0	$ - 0
HLA Antibody Low Resolution	20	$ - 0	$ - 0
HLA Antibody Screen	20	$ - 0	$ - 0
Neutralization	1	$ - 0	$ - 0
Neutrophil Antibody	0	$ - 0	$ - 0
Partial RhD Anaylsis (molecular)	1	$ - 0	$ - 0
Partial RhD Screening (serology)	1	$ - 0	$ - 0
Platelet Crossmatch	2	$ - 0	$ - 0
Platelet Transfusion Refractory (PTR) Panel	1	$ - 0	$ - 0
Post Transfusion Purpura (PTP) Panel	0	$ - 0	$ - 0
Rare Cell Rule Out Panel	1	$ - 0	$ - 0
Red Cell Rule-Out Panel (any method)	70	$ - 0	$ - 0
Red Cell Genotyping Panel (44 antigens)	1	$ - 0	$ - 0
Red Cell Genotyping STAT Panel (24 antigens)	1	$ - 0	$ - 0
Rh Phenotype (D,C,E,c,e)	10	$ - 0	$ - 0
Screen Units: 1 Antigen Screened Unit	20	$ - 0	$ - 0
Screen Units: 2 Antigen Screened Unit	20	$ - 0	$ - 0
Screen Units: 3 Antigen Screened Unit	10	$ - 0	$ - 0
Screen Units: 4 Antigen Screened Unit	5	$ - 0	$ - 0
Screen Units: 5 Antigen Screened Unit	1	$ - 0	$ - 0
Screen Units: 6 Antigen Screened Unit	0	$ - 0	$ - 0
Screen Units: 7 Antigen Screened Unit	0	$ - 0	$ - 0
Screen Units: 8 Antigen Screened Unit	0	$ - 0	$ - 0
Screen Units: 9 Antigen Screened Unit	0	$ - 0	$ - 0
Screen Units: 10 or more Antigen Screened Unit	0	$ - 0	$ - 0
Screened Unit - Hemoglobin S	10	$ - 0	$ - 0
Screened Unit - Molecular	1	$ - 0	$ - 0
Screened Unit - Rare Antigen	1	$ - 0	$ - 0
Selected Cell Rule-Out Panel - Saline IAT	21	$ - 0	$ - 0
Selected Cell Rule-Out Panel - PEG IAT	8	$ - 0	$ - 0
Selected Cell Rule-Out Panel - LISS IAT	8	$ - 0	$ - 0
Selected Cell Rule-Out Panel - GEL IAT	1	$ - 0	$ - 0
Selected Cell Rule-Out Panel - Prewarm IAT	8	$ - 0	$ - 0
Selected Cell Rule-Out Panel - Ficin IAT	8	$ - 0	$ - 0
Selected Cell Rule-Out Panel - DTT/AET IAT	8	$ - 0	$ - 0
Selected Cell Rule-Out Panel - Chlorquie/EGA IAT	8	$ - 0	$ - 0
Selected Cell Screen - Saline IAT	21	$ - 0	$ - 0
Selected Cell Screen - PEG IAT	8	$ - 0	$ - 0
Selected Cell Screen - LISS IAT	8	$ - 0	$ - 0
Selected Cell Screen - GEL IAT	1	$ - 0	$ - 0
Selected Cell Screen - Prewarm IAT	8	$ - 0	$ - 0
Selected Cell Screen - Ficin IAT	8	$ - 0	$ - 0
Selected Cell Screen - DTT/AET IAT	8	$ - 0	$ - 0
Selected Cell Screen - Chlorquine/EGA IAT	0	$ - 0	$ - 0
Thermal Amplitude Study	0	$ - 0	$ - 0
Transfusion Related Acute Lung Injury (TRALI) Workup	0	$ - 0	$ - 0
Weak RhD Analysis	1	$ - 0	$ - 0
Yearly Total			ERROR:#REF!

CREDITS: Return Rate

Leukoreduced Red Blood Cells	$ - 0
Fresh Frozen Plasma	$ - 0
Apheresis Platelets	$ - 0
Pathogen Reduced Platelet Apheresis	$ - 0
Large Volume Delayed Sampling Platelet Apheresis	$ - 0
Cryoprecipitate, Pooled	$ - 0
Cryopreciptate, Random	$ - 0
Irradiation (per uit)	$ - 0
Value Added Services:	Estimated Total

Physician coverage and consultative services

Education programs

CLIN 1001 - JESSE BROWN

CLIN 1001 - JESSE BROWN
Description	10/1/20 - 9/30/21
	Qty	Unit Price	Estimated Total

**TIMED Delivery Charge	50	$ - 0	$ - 0
**STAT Delivery Charge	75	$ - 0	$ - 0
Allogeneic Components and Product Modifications:

Leukoreduced Red Blood Cells	1700	$ - 0	$ - 0
Fresh Frozen Plasma	230	$ - 0	$ - 0
Apheresis Platelets	105	$ - 0	$ - 0
Pathogen Reduced Platelet Apheresis	53	$ - 0	$ - 0
Large Volume Delayed Sampling Platelet Apheresis	52	$ - 0	$ - 0
Variable Content Platelet Apheresis	0	$ - 0	$ - 0
Cryopreciptate, Random	0	$ - 0	$ - 0
Cryopreciptate, Pooled	50	$ - 0	$ - 0
Whole Blood	0	$ - 0	$ - 0
Leukoreduced Whole Blood	0	$ - 0	$ - 0
Liquid Plasma	0	$ - 0	$ - 0
Cryoprecipitate Reduced Plasma (Cryo-poor)	0	$ - 0	$ - 0
Granulocytes	0	$ - 0	$ - 0
LRBCD (Pediatric Red Cell Set): 3/set	0	$ - 0	$ - 0
LRBCD (Pediatric Red Cell Set): 6/set	0	$ - 0	$ - 0
LRBCD (Pediatric Red Cell Set): 9/set	0	$ - 0	$ - 0
LSDPN (Neonate Platelet Aliquot): Single Unit	0	$ - 0	$ - 0
FFPD (Pediatric Fresh Frozen Plasma Set): 6/set	0	$ - 0	$ - 0
Attached Empty Pediatric Bag Set: 3/set	0	$ - 0	$ - 0
Attached Empty Pediatric Bag Set: 6/set	0	$ - 0	$ - 0
Attached Empty Pediatric Bag Set: 9/set	0	$ - 0	$ - 0
Irradiation (per uit)	330	$ - 0	$ - 0
CMV Screening (per unit)	1	$ - 0	$ - 0
HLA Matching (per unit)	20	$ - 0	$ - 0
Volume reduction (per unit)	0	$ - 0	$ - 0
Washing (per unit)	0	$ - 0	$ - 0
Divided (per unit)	0	$ - 0	$ - 0
Deglycerized (per unit)	0	$ - 0	$ - 0
Restocking Fee	30	$ - 0	$ - 0
Autologous Donation Surcharge	0	$ - 0	$ - 0
Directed Donation Surcharge	0	$ - 0	$ - 0
Blood Import Fee	0	$ - 0	$ - 0

VA MADISON FY-22

VA MADISON

Order Period 1

Order Period 2

Order Period 3

Order Period 4

Order Period 5

Description

10/1/21 - 9/30/22

10/1/22 - 9/30/23

10/1/23 - 9/30/24

10/1/24 - 9/30/25

10/1/25 - 9/30/26

Qty

Unit Price

Estimated Total

Qty

Unit Price

Estimated Total

Qty

Unit Price

Estimated Total

Qty

Unit Price

Estimated Total

Qty

Unit Price

Estimated Total

**TIMED Delivery Charge	100	$0.00	$ - 0	100	$ - 0	100	$ - 0	100	$ - 0	100	$ - 0
**STAT Delivery Charge	100		$ - 0	100	$ - 0	100	$ - 0	100	$ - 0	100	$ - 0
Allogeneic Components and Product Modifications:

Leukoreduced Red Blood Cells	2256		$ - 0	2256		$ - 0	2256		$ - 0	2256		$ - 0	2256		$ - 0
Fresh Frozen Plasma	250		$ - 0	250		$ - 0	250		$ - 0	250		$ - 0	250		$ - 0
Apheresis Platelets	1		$ - 0	1		$ - 0	1		$ - 0	1		$ - 0	1		$ - 0
Pathogen Reduced Platelet Apheresis	100		$ - 0	100		$ - 0	100		$ - 0	100		$ - 0	100		$ - 0
Large Volume Delayed Sampling Platelet Apheresis	100		$ - 0	100		$ - 0	100		$ - 0	100		$ - 0	100		$ - 0
Variable Content Platelet Apheresis	1		$ - 0	1		$ - 0	1		$ - 0	1		$ - 0	1		$ - 0
Cryopreciptate, Random	1		$ - 0	1		$ - 0	1		$ - 0	1		$ - 0	1		$ - 0
Cryopreciptate, Pooled	15		$ - 0	15		$ - 0	15		$ - 0	15		$ - 0	15		$ - 0
Whole Blood	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Leukoreduced Whole Blood	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Liquid Plasma	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Cryoprecipitate Reduced Plasma (Cryo-poor)	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Granulocytes	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
LRBCD (Pediatric Red Cell Set): 3/set	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
LRBCD (Pediatric Red Cell Set): 6/set	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
LRBCD (Pediatric Red Cell Set): 9/set	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
LSDPN (Neonate Platelet Aliquot): Single Unit	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
FFPD (Pediatric Fresh Frozen Plasma Set): 6/set	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Attached Empty Pediatric Bag Set: 3/set	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Attached Empty Pediatric Bag Set: 6/set	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Attached Empty Pediatric Bag Set: 9/set	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Irradiation (per uit)	360		$ - 0	360		$ - 0	360		$ - 0	360		$ - 0	360		$ - 0
CMV Screening (per unit)	6	$ - 0	$ - 0	6	$ - 0	$ - 0	6	$ - 0	$ - 0	6	$ - 0	$ - 0	6	$ - 0	$ - 0
HLA Matching (per unit)	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Volume reduction (per unit)	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Washing (per unit)	4		$ - 0	4		$ - 0	4		$ - 0	4		$ - 0	4		$ - 0
Divided (per unit)	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Deglycerized (per unit)	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Restocking Fee	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Autologous Donation Surcharge	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Directed Donation Surcharge	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Blood Import Fee	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0	1	$ - 0	$ - 0
Total			$ - 0			$ - 0

IRL FY-22

Additional ancillary transfusion reference processing and testing services listed below Madison Total Unit Price Estimated Total Madison Total Unit Price Estimated Total Madison Total Unit Price Estimated Total Madison Total Unit Price Estimated Total Madison Total Unit Price Estimated Total

	Period of Performance 10/1/2021 to 09/30/2022			Period of Performance 10/1/2022 to 09/30/2023		Period of Performance 10/1/2023 to 09/30/2024		Period of Performance 10/1/2024 to 09/30/2025		Period of Performance 10/1/2025 to 09/30/2026
ABO and Rh	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
ABO Antibody Titer	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
ADAMTS13 Activity	1	$ - 0	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
ADAMTS13 Antibody	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
ADAMTS13 Inhibitor	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
ADAMTS13 Sequence Analysis	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Alloadsorption (per adsorption)	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Antibody Adsorption RESt/WARM	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Antibody Identification Panel - Saline IAT	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Antibody Identification Panel - PEG IAT	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Antibody Identification Panel - LISS IAT	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Antibody Identification Panel - GEL IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Antibody Identification Panel - Prewarm IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Antibody Identification Panel - Ficin IAT	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Antibody Identification Panel - DTT/AET IAT	5		$ - 0	5	$ - 0	5	$ - 0	5	$ - 0	5	$ - 0
Antibody Identification Panel - Chlorquine/EGA IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Antigen Query - 1 Antigen (C,E, or K)	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Antigen Query - 1 Antigen (all others)	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Antigen Query - 2 Antigens	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Antigen Query - 3 Antigens	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Antigen Query - 4 Antigens	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Antibody Screen - Saline IAT	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Antibody Screen - PEG IAT	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Antibody Screen - LISS IAT	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Antibody Screen - GEL IAT	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Antibody Screen -Prewarm IAT	5		$ - 0	5	$ - 0	5	$ - 0	5	$ - 0	5	$ - 0
Antibody Screen - Ficin IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Antibody Screen - DTT/AET IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Antibody Screen - Chlorquine/EGA IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Antibody Titration	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Antigen Typing (other than Rh)	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Antigen Typing (Rare)	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Autoadsorption - ZZAP (per adsorption)	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Chemical Treatment of Serum (2-Mercaptoethanol Treated Serum)	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Cold Agglutinin Panel	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Compatibility Screen (Crossmatch)	5		$ - 0	5	$ - 0	5	$ - 0	5	$ - 0	5	$ - 0
Compatiblity Screen with Alloadsorbed Serum	5		$ - 0	5	$ - 0	5	$ - 0	5	$ - 0	5	$ - 0
DAT Negative Hemolytic Anemia Evaluation	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Direct Antiglobulin Test - Polyreactive AHG	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Direct Antiglobulin Test - Monospecific Evaluation	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Direct Antiglobulin Test IgA Detection	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Donath Landsteiner	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Drug Dependent RBC Antibody Study	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Elution (per elution)	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Heparin-Induced Thrombocytopenia Evaluation: PF4	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Heparin-Induced Thombocytopenia Evaluation: Serotonin Release Assay	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
HLA Antibody Identification Class I High Resolution	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
HLA Antibody Low Resolution	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
HLA Antibody Screen	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Neutralization	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Neutrophil Antibody	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Partial RhD Anaylsis (molecular)	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Partial RhD Screening (serology)	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Platelet Antigen Genotyping	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Platelet Transfusion Refractory(PTR) Panel	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
HPA Matching (per unit)	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Platelet Crossmatch	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Platelet Transfusion Refractory (PTR) Panel	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Post Transfusion Purpura (PTP) Panel	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Rare Cell Rule Out Panel	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Red Cell Rule-Out Panel (any method)	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Red Cell Genotyping Panel (44 antigens)	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Red Cell Genotyping STAT Panel (24 antigens)	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Rh Phenotype (D,C,E,c,e)	5		$ - 0	5	$ - 0	5	$ - 0	5	$ - 0	5	$ - 0
Screen Units: 1 Antigen Screened Unit	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Screen Units: 2 Antigen Screened Unit	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Screen Units: 3 Antigen Screened Unit	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Screen Units: 4 Antigen Screened Unit	10		$ - 0	10	$ - 0	10	$ - 0	10	$ - 0	10	$ - 0
Screen Units: 5 Antigen Screened Unit	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Screen Units: 6 Antigen Screened Unit	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Screen Units: 7 Antigen Screened Unit	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Screen Units: 8 Antigen Screened Unit	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Screen Units: 9 Antigen Screened Unit	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Screen Units: 10 or more Antigen Screened Unit	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Screened Unit - Hemoglobin S	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Screened Unit - Molecular	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Screened Unit - Rare Antigen	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Rule-Out Panel - Saline IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Rule-Out Panel - PEG IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Rule-Out Panel - LISS IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Rule-Out Panel - GEL IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Rule-Out Panel - Prewarm IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Rule-Out Panel - Ficin IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Rule-Out Panel - DTT/AET IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Rule-Out Panel - Chlorquie/EGA IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Screen - Saline IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Screen - PEG IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Screen - LISS IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Screen - GEL IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Screen - Prewarm IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Screen - Ficin IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Screen - DTT/AET IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Selected Cell Screen - Chlorquine/EGA IAT	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Thermal Amplitude Study	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Transfusion Related Acute Lung Injury (TRALI) Workup	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0
Weak RhD Analysis	1		$ - 0	1	$ - 0	1	$ - 0	1	$ - 0	1	$ - 0

MISC ESTIMATED TOTAL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0

File details come from the government source that posted it. Updated May 20, 2021.