Attachment 4 - CBP Medical Services Price Proposal Template.xlsx

XLSX spreadsheet 87 KB Posted Aug 5, 2020

Attached to: Draft Solicitation - CBP Medical Services Federal contract opportunity
Solicitation number: DRAFT70B06C20R00000044
Issued by: Department of Homeland Security Customs and Border Protection

About this file

Written by GovTribe AI · Dec 30, 2023

This draft solicitation from U.S. Customs and Border Protection provides an overview of medical services required to support pre-employment and post-employment programs. Services include medical examinations, consultations, fitness evaluations, drug testing, and program support. Requirements include pre-employment candidate screening, employee exams and clinical services, fitness for duty evaluations, return to work assistance, medical records review, consultation, and management of the drug-free workplace program. The statement of work details responsibilities of the CBP Hiring Center for pre-employment coordination and the National Programs Division's Medical and Fitness Branch for post-employment clinical services. Price proposal, past performance, and security templates are included to support potential future solicitation, though no solicitation details are provided.

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Other files for this federal contract opportunity

Other files attached to Draft Solicitation - CBP Medical Services, newest first.
File	Type	Posted
Attachment 2_Small Business Utilization Plan Template.pdf	PDF	Aug 5, 2020
Attachment 6 - Security Documents .zip	ZIP file	Aug 5, 2020
Attachment 3 - Historical Duty Locations.xlsx	XLSX spreadsheet	Aug 5, 2020
70B06C20R00000044 Solicitation_08.05.2020DRAFT.docx	DOCX document	Aug 5, 2020
Atatchment 1_SOW Medical Services DFWP - NPD and HC 07292020.docx	DOCX document	Aug 5, 2020
Attachment 5 - Past Performance Questionnaire 08.05.docx	DOCX document	Aug 5, 2020

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Summary - Base + Options

Master List Pricing Template - Pre-Emp (CBP-HC) & Post-Emp (NPD)
Summary (Base + All Options)
	Period	Post- Emp Total Price	Pre-Emp Total Price	Combined Total Price
	Base Period	$ - 0	$ - 0	$ - 0
	Option Year 1	$ - 0	$ - 0	$ - 0
	Option Year 2	$ - 0	$ - 0	$ - 0
	Option Year 3	$ - 0	$ - 0	$ - 0
	Option Year 4	$ - 0	$ - 0	$ - 0
	Total Price (Base + Option Years)	$ - 0	$ - 0	$ - 0

Option to Extend Services (6 Month Extension) $ - 0 $ - 0 $ - 0

Total Price (Base + Option Years + 6 month Extension) $ - 0 $ - 0 $ - 0

Note to Vendors:

- Any cancellation fees shall be considered a cost of doing business and are not separately priced. Offerors shall incorporate this cost into their Price.

- The Agency recognizes the fiscal, environmental, and health issues inherent in travel. The Government will consider technology related methods for interaction, such as virtual attendance. When feasible, the Agency may implement such practices.

Base Year

	Master List of Services - Pre-Emp (CBP-HC) & Post-Emp (NPD)
	Base Year: Estimate
	Category	Description	Est. Quantity			Unit Price	Unit	Total Price
			Post-Emp	Pre-Emp	Combined Total			Post-Emp	Pre-Emp	Total Combined
CLIN	Medical Services
	Medical Examinations
0001	POST	Employee medical examination (including physician review)	150	0	150		each	$ - 0	$ - 0	$ - 0
0002	POST	No show fee for employee medical examination (General Examination)	8	0	8		each	$ - 0	$ - 0	$ - 0
0003	PRE/POST	IME (including physician review)	50	1	51		each	$ - 0	$ - 0	$ - 0
0004	PRE/POST	No show fee IME (day of appointment)	5	1	6		each	$ - 0	$ - 0	$ - 0
0005	PRE/POST	Psychiatric IME (including physician review)	65	1	66		each	$ - 0	$ - 0	$ - 0
0006	POST	Medical Hardship/Compassionate Transfer Reassignment I	40	0	40		each	$ - 0	$ - 0	$ - 0
0007	POST	Medical Hardship/Compassionate Transfer Reassignment II	40	0	40		each	$ - 0	$ - 0	$ - 0
0008	PRE	Pre-employment medical exam - all positions	0	5,000	5,000		each	$ - 0	$ - 0	$ - 0
0009	PRE	Pre-employment medical exam/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
0010	PRE	Pre-employment fitness test/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
0011	PRE	Pre-employment medical exam/fitness test combination	0	40,000	40,000		each	$ - 0	$ - 0	$ - 0
0012	PRE	Pre-employment medical exam/fitness test/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
0013	PRE	Pre-employment Overseas Medical Examination	0	10	10		each	$ - 0	$ - 0	$ - 0
	Non-Psychiatric Consultation
0014	POST	Non-Psychiatric Level I Consultation (1-15 pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
0015	POST	Non-Psychiatric Level II Consultation (16-30 pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
0016	POST	Non-Psychiatric Level III Consultation (31 and over pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
0017	PRE	Non-Psychiatric Level I Consultation	0	1,000	1,000		each	$ - 0	$ - 0	$ - 0
0018	PRE	Non-Psychiatric Level II Consultation			0
0019	PRE	Level 2-1 (100 pages or less)	0	5	5		each	$ - 0	$ - 0	$ - 0
0020	PRE	Level 2-2 (101-200 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
0021	PRE	Level 2-3 (201-300 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
0022	PRE	Level 2-4 (301-400 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
0023	PRE	Level 2-5 (401-500 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
0024	PRE	Level 2-6 (501-600 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
0025	PRE	Level 2-7 (601-700 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
0026	PRE	Level 2-8 (701-800 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
0027	PRE	Level 2-9 (801-900 pages)	0	1	1		each	$ - 0	$ - 0	$ - 0
0028	PRE	Level 2-10 (901-1000 pages)	0	1	1		each	$ - 0	$ - 0	$ - 0
0029	PRE	Non-Psychiatric Level III Specialist Consultation	0	180	180		each	$ - 0	$ - 0	$ - 0
0030	PRE	Vision Consultation	0	2,147	2,147		each	$ - 0	$ - 0	$ - 0
	Psychiatric Specialist Consultation
0031	POST	Psychiatric Level I Consultation	30	0	30		each	$ - 0	$ - 0	$ - 0
0032	POST	Psychiatric Level II Consultation	25	0	25		each	$ - 0	$ - 0	$ - 0
0033	POST	Psychiatric Level III Consultation	25	0	25		each	$ - 0	$ - 0	$ - 0
0034	POST	Psychiatric Level IV Consultation	3	0	3		each	$ - 0	$ - 0	$ - 0
0035	PRE/POST	Physician legal consult/testimony	30	4	34		hour	$ - 0	$ - 0	$ - 0
0036	PRE/POST	IME physician legal consult/testimony	3	1	4		each	$ - 0	$ - 0	$ - 0
0037	PRE	Mental Health Screening Consultation	0	400	400		each	$ - 0	$ - 0	$ - 0
0038	PRE	Psychiatric Level I Consultation	0	50	50		each	$ - 0	$ - 0	$ - 0
0039	PRE	Psychiatric Level II Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
0040	PRE	Psychiatric Level III Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
0041	PRE	Psychiatric Level IV Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
	Additional Medical Tests
0042	POST	Chest X-Ray (single view)	5	0	5		each	$ - 0	$ - 0	$ - 0
0043	POST	Chest X-Ray (PA and Lateral)	5	0	5		each	$ - 0	$ - 0	$ - 0
0044	POST	X-Ray (general)	10	0	10		each	$ - 0	$ - 0	$ - 0
0045	POST	TB Skin Test (with chest x-ray if indicated)	5	0	5		each	$ - 0	$ - 0	$ - 0
0046	POST	Audiometry	5	0	5		each	$ - 0	$ - 0	$ - 0
0047	POST	Lab Profile: CBC with differential, CHEM profile, Urinalysis	5	0	5		each	$ - 0	$ - 0	$ - 0
0048	POST	Resting EKG with interpretation	15	0	15		each	$ - 0	$ - 0	$ - 0
0049	POST	Visual Acuity (Corrected and uncorrected, near and distance)	15	0	15		each	$ - 0	$ - 0	$ - 0
0050	POST	Vital Signs	5	0	5		each	$ - 0	$ - 0	$ - 0
0051	POST	Thyroid Stimulating Hormone (TSH) w/Reflex Free T4	60	0	60		each	$ - 0	$ - 0	$ - 0
0052	POST	Hemoglobin A1C (HgBA1C)	30	0	30		each	$ - 0	$ - 0	$ - 0
0053	POST	Blood Glucose	30	0	30		each	$ - 0	$ - 0	$ - 0
0054	POST	Blood Lead Level	5	0	5		each	$ - 0	$ - 0	$ - 0
0055	POST	Cardiac Risk Profile/Lipid Panel	30	0	30		each	$ - 0	$ - 0	$ - 0
0056	POST	Color Vision Assessment	5	0	5		each	$ - 0	$ - 0	$ - 0
0057	POST	Maximal Stress EKG with MD interpretation	5	0	5		each	$ - 0	$ - 0	$ - 0
0058	POST	Peripheral Vision and Visual Depth Perception	5	0	5		each	$ - 0	$ - 0	$ - 0
0059	POST	Protoporphyrin, Zinc (ZPP) Blood Test	5	0	5		each	$ - 0	$ - 0	$ - 0
0060	POST	Resting 12 Lead EKG with MD Interpretation	5	0	5		each	$ - 0	$ - 0	$ - 0
0061	POST	Spirometry (FVC%, FEV1, FEV1/FVC%)	5	0	5		each	$ - 0	$ - 0	$ - 0
0062	POST	Blood Alcohol Test	5	0	5		each	$ - 0	$ - 0	$ - 0
0063	POST	Exercise Stress Echo	5	0	5		each	$ - 0	$ - 0	$ - 0
0064	POST	Echocardiogram	5	0	5		each	$ - 0	$ - 0	$ - 0
0065	POST	Sleep study	5	0	5		each	$ - 0	$ - 0	$ - 0
0066	POST	Functional capacity Evaluation (FCE)	10	0	10		each	$ - 0	$ - 0	$ - 0
0067	POST	Folate	5	0	5		each	$ - 0	$ - 0	$ - 0
0068	POST	Vitamin B-12	5	0	5		each	$ - 0	$ - 0	$ - 0
0069	POST	Prothrombin Time with INR	5	0	5		each	$ - 0	$ - 0	$ - 0
0070	POST	Partial Thromboplastin Time, Activated	5	0	5		each	$ - 0	$ - 0	$ - 0
0071	POST	Miscellaneous IME Tests (NTE)	20	0	20		each	$ - 0	$ - 0	$ - 0
	Fitness for Duty Drug Test
0072	POST	Negative drug test	20	0	20		each	$ - 0	$ - 0	$ - 0
0073	POST	Positive drug test	10	0	10		each	$ - 0	$ - 0	$ - 0
	Fitness Test Services
	Fitness Tests
0074	PRE	Pre-employment Fitness Test - BPA	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
0075	PRE	Pre-employment Fitness Test - CBPO	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
0076	PRE	Pre-employment Fitness Test - AMO	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
0077	PRE	Pre-employment Fitness Test Overseas - BPA	0	4	4		each	$ - 0	$ - 0	$ - 0
0078	PRE	Pre-employment Fitness Test Overseas - CBPO	0	4	4		each	$ - 0	$ - 0	$ - 0
0079	PRE	Pre-employment Fitness Test Overseas - AMO	0	2	2		each	$ - 0	$ - 0	$ - 0
	Drug Program Services
0080	POST	Employee Random	7,280	0	7,280		each	$ - 0	$ - 0	$ - 0
0081	POST	Reasonable Suspicion	50	0	50		each	$ - 0	$ - 0	$ - 0
0082	POST	Post Accident (unsafe practice)	20	0	20		each	$ - 0	$ - 0	$ - 0
0083	POST	Return-to-duty/follow-up	20	0	20		each	$ - 0	$ - 0	$ - 0
0084	POST	Positive Drug Test Results (Includes Litigation package)	40	0	40		each	$ - 0	$ - 0	$ - 0
0085	POST	Split Specimen TX to the HHS Labs(TX, GC/MS, MRO & Litigation package)	30	0	30		each	$ - 0	$ - 0	$ - 0
0086	POST/PRE	Blind Sample (Collection and shipping supplies, Lab and MRO)	300	250	550		each	$ - 0	$ - 0	$ - 0
0087	POST/PRE	MRO Meeting and Consultations	15	5	20		hour	$ - 0	$ - 0	$ - 0
0088	POST/PRE	MRO Expert Testimony	36	8	44		hour	$ - 0	$ - 0	$ - 0
0089	POST/PRE	Laboratory Director Expert Testimony	10	4	14		hour	$ - 0	$ - 0	$ - 0
0090	PRE	Pre-employment Drug Test - all positions	0	3,023	3,023		each	$ - 0	$ - 0	$ - 0
0091	PRE	Pre-employment Onsite - all positions	0	1	1		each	$ - 0	$ - 0	$ - 0
0092	PRE	Pre-employment Modified Onsites - all positions	0	1	1		each	$ - 0	$ - 0	$ - 0
0093	PRE	Pre-employment Overseas Drug Test - all positions	0	10	10		each	$ - 0	$ - 0	$ - 0
0094	PRE	Pre-Employment Positive (without Litigation package)	0	10	10		each	$ - 0	$ - 0	$ - 0
0095	PRE	Split Specimen TX to the HHS Labs (TX, GC/MS, MRO)	0	5	5		each	$ - 0	$ - 0	$ - 0
0096	PRE	Litigation Package	0	2	2		each	$ - 0	$ - 0	$ - 0
	Other Services
	Development of Medical Standards and Clinical Policy Consultation
0097	POST	Assist Gov't with Development of Hearing Standards (CBPO, AMO Positions)	2	0	2		each	$ - 0	$ - 0	$ - 0
0098	POST	Assist Gov't with Development of Vision Standards (CBPO, AMO Positions)	2	0	2		each	$ - 0	$ - 0	$ - 0
0099	POST	Clinical Consultation for Policy Determinations (e.g., use of insulin pumps; post-operative refractive surgical procedures).	2	0	2		each	$ - 0	$ - 0	$ - 0
	Travel
0100	POST/PRE	Medical Services Travel (i.e. Meetings)	3	4	7		each	$ - 0	$ - 0	$ - 0
0101	POST/PRE	MRO and Laboratory Travel	5	2	7		each	$ - 0	$ - 0	$ - 0

			POST-EMP
TOTAL PRICE	PRE-EMP
TOTAL PRICE	BASE YEAR TOTAL PRICE
			$ - 0	$ - 0	$ - 0
		Note to Vendors:

Any cancellation fees shall be considered a cost of doing business and are not separately priced. Offerors shall incorporate this cost into their Price

Option Year 1

	Master List of Services - Pre-Emp (CBP-HC) & Post-Emp (NPD)
	Option Year 1: Estimate
	Category	Description	Est. Quantity			Unit Price	Unit	Total Price
			Post-Emp	Pre-Emp	Combined Total			Post-Emp	Pre-Emp	Total Combined
CLIN	Medical Services
	Medical Examinations
1001	POST	Employee medical examination (including physician review)	150	0	150		each	$ - 0	$ - 0	$ - 0
1002	POST	No show fee for employee medical examination (General Examination)	8	0	8		each	$ - 0	$ - 0	$ - 0
1003	PRE/POST	IME (including physician review)	50	1	51		each	$ - 0	$ - 0	$ - 0
1004	PRE/POST	No show fee IME (day of appointment)	5	1	6		each	$ - 0	$ - 0	$ - 0
1005	PRE/POST	Psychiatric IME (including physician review)	65	1	66		each	$ - 0	$ - 0	$ - 0
1006	POST	Medical Hardship/Compassionate Transfer Reassignment I	40	0	40		each	$ - 0	$ - 0	$ - 0
1007	POST	Medical Hardship/Compassionate Transfer Reassignment II	40	0	40		each	$ - 0	$ - 0	$ - 0
1008	PRE	Pre-employment medical exam - all positions	0	5,000	5,000		each	$ - 0	$ - 0	$ - 0
1009	PRE	Pre-employment medical exam/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
1010	PRE	Pre-employment fitness test/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
1011	PRE	Pre-employment medical exam/fitness test combination	0	40,000	40,000		each	$ - 0	$ - 0	$ - 0
1012	PRE	Pre-employment medical exam/fitness test/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
1013	PRE	Pre-employment Overseas Medical Examination	0	10	10		each	$ - 0	$ - 0	$ - 0
	Non-Psychiatric Consultation
1014	POST	Non-Psychiatric Level I Consultation (1-15 pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
1015	POST	Non-Psychiatric Level II Consultation (16-30 pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
1016	POST	Non-Psychiatric Level III Consultation (31 and over pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
1017	PRE	Non-Psychiatric Level I Consultation	0	1,000	1,000		each	$ - 0	$ - 0	$ - 0
1018	PRE	Non-Psychiatric Level II Consultation			0
1019	PRE	Level 2-1 (100 pages or less)	0	5	5		each	$ - 0	$ - 0	$ - 0
1020	PRE	Level 2-2 (101-200 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
1021	PRE	Level 2-3 (201-300 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
1022	PRE	Level 2-4 (301-400 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
1023	PRE	Level 2-5 (401-500 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
1024	PRE	Level 2-6 (501-600 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
1025	PRE	Level 2-7 (601-700 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
1026	PRE	Level 2-8 (701-800 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
1027	PRE	Level 2-9 (801-900 pages)	0	1	1		each	$ - 0	$ - 0	$ - 0
1028	PRE	Level 2-10 (901-1000 pages)	0	1	1		each	$ - 0	$ - 0	$ - 0
1029	PRE	Non-Psychiatric Level III Specialist Consultation	0	180	180		each	$ - 0	$ - 0	$ - 0
1030	PRE	Vision Consultation	0	2,147	2,147		each	$ - 0	$ - 0	$ - 0
	Psychiatric Specialist Consultation
1031	POST	Psychiatric Level I Consultation	30	0	30		each	$ - 0	$ - 0	$ - 0
1032	POST	Psychiatric Level II Consultation	25	0	25		each	$ - 0	$ - 0	$ - 0
1033	POST	Psychiatric Level III Consultation	25	0	25		each	$ - 0	$ - 0	$ - 0
1034	POST	Psychiatric Level IV Consultation	3	0	3		each	$ - 0	$ - 0	$ - 0
1035	PRE/POST	Physician legal consult/testimony	30	4	34		hour	$ - 0	$ - 0	$ - 0
1036	PRE/POST	IME physician legal consult/testimony	3	1	4		each	$ - 0	$ - 0	$ - 0
1037	PRE	Mental Health Screening Consultation	0	400	400		each	$ - 0	$ - 0	$ - 0
1038	PRE	Psychiatric Level I Consultation	0	50	50		each	$ - 0	$ - 0	$ - 0
1039	PRE	Psychiatric Level II Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
1040	PRE	Psychiatric Level III Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
1041	PRE	Psychiatric Level IV Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
	Additional Medical Tests
1042	POST	Chest X-Ray (single view)	5	0	5		each	$ - 0	$ - 0	$ - 0
1043	POST	Chest X-Ray (PA and Lateral)	5	0	5		each	$ - 0	$ - 0	$ - 0
1044	POST	X-Ray (general)	10	0	10		each	$ - 0	$ - 0	$ - 0
1045	POST	TB Skin Test (with chest x-ray if indicated)	5	0	5		each	$ - 0	$ - 0	$ - 0
1046	POST	Audiometry	5	0	5		each	$ - 0	$ - 0	$ - 0
1047	POST	Lab Profile: CBC with differential, CHEM profile, Urinalysis	5	0	5		each	$ - 0	$ - 0	$ - 0
1048	POST	Resting EKG with interpretation	15	0	15		each	$ - 0	$ - 0	$ - 0
1049	POST	Visual Acuity (Corrected and uncorrected, near and distance)	15	0	15		each	$ - 0	$ - 0	$ - 0
1050	POST	Vital Signs	5	0	5		each	$ - 0	$ - 0	$ - 0
1051	POST	Thyroid Stimulating Hormone (TSH) w/Reflex Free T4	60	0	60		each	$ - 0	$ - 0	$ - 0
1052	POST	Hemoglobin A1C (HgBA1C)	30	0	30		each	$ - 0	$ - 0	$ - 0
1053	POST	Blood Glucose	30	0	30		each	$ - 0	$ - 0	$ - 0
1054	POST	Blood Lead Level	5	0	5		each	$ - 0	$ - 0	$ - 0
1055	POST	Cardiac Risk Profile/Lipid Panel	30	0	30		each	$ - 0	$ - 0	$ - 0
1056	POST	Color Vision Assessment	5	0	5		each	$ - 0	$ - 0	$ - 0
1057	POST	Maximal Stress EKG with MD interpretation	5	0	5		each	$ - 0	$ - 0	$ - 0
1058	POST	Peripheral Vision and Visual Depth Perception	5	0	5		each	$ - 0	$ - 0	$ - 0
1059	POST	Protoporphyrin, Zinc (ZPP) Blood Test	5	0	5		each	$ - 0	$ - 0	$ - 0
1060	POST	Resting 12 Lead EKG with MD Interpretation	5	0	5		each	$ - 0	$ - 0	$ - 0
1061	POST	Spirometry (FVC%, FEV1, FEV1/FVC%)	5	0	5		each	$ - 0	$ - 0	$ - 0
1062	POST	Blood Alcohol Test	5	0	5		each	$ - 0	$ - 0	$ - 0
1063	POST	Exercise Stress Echo	5	0	5		each	$ - 0	$ - 0	$ - 0
1064	POST	Echocardiogram	5	0	5		each	$ - 0	$ - 0	$ - 0
1065	POST	Sleep study	5	0	5		each	$ - 0	$ - 0	$ - 0
1066	POST	Functional capacity Evaluation (FCE)	10	0	10		each	$ - 0	$ - 0	$ - 0
1067	POST	Folate	5	0	5		each	$ - 0	$ - 0	$ - 0
1068	POST	Vitamin B-12	5	0	5		each	$ - 0	$ - 0	$ - 0
1069	POST	Prothrombin Time with INR	5	0	5		each	$ - 0	$ - 0	$ - 0
1070	POST	Partial Thromboplastin Time, Activated	5	0	5		each	$ - 0	$ - 0	$ - 0
1071	POST	Miscellaneous IME Tests (NTE)	20	0	20		each	$ - 0	$ - 0	$ - 0
	Fitness for Duty Drug Test
1072	POST	Negative drug test	20	0	20		each	$ - 0	$ - 0	$ - 0
1073	POST	Positive drug test	10	0	10		each	$ - 0	$ - 0	$ - 0
	Fitness Test Services
	Fitness Tests
1074	PRE	Pre-employment Fitness Test - BPA	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
1075	PRE	Pre-employment Fitness Test - CBPO	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
1076	PRE	Pre-employment Fitness Test - AMO	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
1077	PRE	Pre-employment Fitness Test Overseas - BPA	0	4	4		each	$ - 0	$ - 0	$ - 0
1078	PRE	Pre-employment Fitness Test Overseas - CBPO	0	4	4		each	$ - 0	$ - 0	$ - 0
1079	PRE	Pre-employment Fitness Test Overseas - AMO	0	2	2		each	$ - 0	$ - 0	$ - 0
	Drug Program Services
1080	POST	Employee Random	7,280	0	7,280		each	$ - 0	$ - 0	$ - 0
1081	POST	Reasonable Suspicion	50	0	50		each	$ - 0	$ - 0	$ - 0
1082	POST	Post Accident (unsafe practice)	20	0	20		each	$ - 0	$ - 0	$ - 0
1083	POST	Return-to-duty/follow-up	20	0	20		each	$ - 0	$ - 0	$ - 0
1084	POST	Positive Drug Test Results (Includes Litigation package)	40	0	40		each	$ - 0	$ - 0	$ - 0
1085	POST	Split Specimen TX to the HHS Labs(TX, GC/MS, MRO & Litigation package)	30	0	30		each	$ - 0	$ - 0	$ - 0
1086	POST/PRE	Blind Sample (Collection and shipping supplies, Lab and MRO)	300	250	550		each	$ - 0	$ - 0	$ - 0
1087	POST/PRE	MRO Meeting and Consultations	15	5	20		hour	$ - 0	$ - 0	$ - 0
1088	POST/PRE	MRO Expert Testimony	36	8	44		hour	$ - 0	$ - 0	$ - 0
1089	POST/PRE	Laboratory Director Expert Testimony	10	4	14		hour	$ - 0	$ - 0	$ - 0
1090	PRE	Pre-employment Drug Test - all positions	0	3,023	3,023		each	$ - 0	$ - 0	$ - 0
1091	PRE	Pre-employment Onsite - all positions	0	1	1		each	$ - 0	$ - 0	$ - 0
1092	PRE	Pre-employment Modified Onsites - all positions	0	1	1		each	$ - 0	$ - 0	$ - 0
1093	PRE	Pre-employment Overseas Drug Test - all positions	0	10	10		each	$ - 0	$ - 0	$ - 0
1094	PRE	Pre-Employment Positive (without Litigation package)	0	10	10		each	$ - 0	$ - 0	$ - 0
1095	PRE	Split Specimen TX to the HHS Labs (TX, GC/MS, MRO)	0	5	5		each	$ - 0	$ - 0	$ - 0
1096	PRE	Litigation Package	0	2	2		each	$ - 0	$ - 0	$ - 0
	Other Services
	Development of Medical Standards and Clinical Policy Consultation
1097	POST	Assist Gov't with Development of Hearing Standards (CBPO, AMO Positions)	2	0	2		each	$ - 0	$ - 0	$ - 0
1098	POST	Assist Gov't with Development of Vision Standards (CBPO, AMO Positions)	2	0	2		each	$ - 0	$ - 0	$ - 0
1099	POST	Clinical Consultation for Policy Determinations (e.g., use of insulin pumps; post-operative refractive surgical procedures).	2	0	2		each	$ - 0	$ - 0	$ - 0
	Travel
1100	POST/PRE	Medical Services Travel (i.e. Meetings)	3	4	7		each	$ - 0	$ - 0	$ - 0
1101	POST/PRE	MRO and Laboratory Travel	5	2	7		each	$ - 0	$ - 0	$ - 0

			POST-EMP
TOTAL PRICE	PRE-EMP
TOTAL PRICE	OPTION YEAR 1 TOTAL PRICE
			$ - 0	$ - 0	$ - 0
		Note to Vendors:

Any cancellation fees shall be considered a cost of doing business and are not separately priced. Offerors shall incorporate this cost into their Price

Option Year 2

		Master List of Services - Pre-Emp (CBP-HC) & Post-Emp (NPD)
		Option Year 2: Estimate
		Category	Description	Est. Quantity			Unit Price	Unit	Total Price
				Post-Emp	Pre-Emp	Combined Total			Post-Emp	Pre-Emp	Total Combined
	CLIN	Medical Services
		Medical Examinations
	2001	POST	Employee medical examination (including physician review)	150	0	150		each	$ - 0	$ - 0	$ - 0
	2002	POST	No show fee for employee medical examination (General Examination)	8	0	8		each	$ - 0	$ - 0	$ - 0
	2003	PRE/POST	IME (including physician review)	50	1	51		each	$ - 0	$ - 0	$ - 0
	2004	PRE/POST	No show fee IME (day of appointment)	5	1	6		each	$ - 0	$ - 0	$ - 0
	2005	PRE/POST	Psychiatric IME (including physician review)	65	1	66		each	$ - 0	$ - 0	$ - 0
	2006	POST	Medical Hardship/Compassionate Transfer Reassignment I	40	0	40		each	$ - 0	$ - 0	$ - 0
	2007	POST	Medical Hardship/Compassionate Transfer Reassignment II	40	0	40		each	$ - 0	$ - 0	$ - 0
	2008	PRE	Pre-employment medical exam - all positions	0	5,000	5,000		each	$ - 0	$ - 0	$ - 0
	2009	PRE	Pre-employment medical exam/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
	2010	PRE	Pre-employment fitness test/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
	2011	PRE	Pre-employment medical exam/fitness test combination	0	40,000	40,000		each	$ - 0	$ - 0	$ - 0
	2012	PRE	Pre-employment medical exam/fitness test/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
	2013	PRE	Pre-employment Overseas Medical Examination	0	10	10		each	$ - 0	$ - 0	$ - 0
		Non-Psychiatric Consultation
	2014	POST	Non-Psychiatric Level I Consultation (1-15 pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
	2015	POST	Non-Psychiatric Level II Consultation (16-30 pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
	2016	POST	Non-Psychiatric Level III Consultation (31 and over pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
	2017	PRE	Non-Psychiatric Level I Consultation	0	1,000	1,000		each	$ - 0	$ - 0	$ - 0
	2018	PRE	Non-Psychiatric Level II Consultation			0
	2019	PRE	Level 2-1 (100 pages or less)	0	5	5		each	$ - 0	$ - 0	$ - 0
	2020	PRE	Level 2-2 (101-200 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	2021	PRE	Level 2-3 (201-300 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	2022	PRE	Level 2-4 (301-400 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	2023	PRE	Level 2-5 (401-500 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	2024	PRE	Level 2-6 (501-600 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	2025	PRE	Level 2-7 (601-700 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	2026	PRE	Level 2-8 (701-800 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	2027	PRE	Level 2-9 (801-900 pages)	0	1	1		each	$ - 0	$ - 0	$ - 0
	2028	PRE	Level 2-10 (901-1000 pages)	0	1	1		each	$ - 0	$ - 0	$ - 0
	2029	PRE	Non-Psychiatric Level III Specialist Consultation	0	180	180		each	$ - 0	$ - 0	$ - 0
	2030	PRE	Vision Consultation	0	2,147	2,147		each	$ - 0	$ - 0	$ - 0
		Psychiatric Specialist Consultation
	2031	POST	Psychiatric Level I Consultation	30	0	30		each	$ - 0	$ - 0	$ - 0
	2032	POST	Psychiatric Level II Consultation	25	0	25		each	$ - 0	$ - 0	$ - 0
	2033	POST	Psychiatric Level III Consultation	25	0	25		each	$ - 0	$ - 0	$ - 0
	2034	POST	Psychiatric Level IV Consultation	3	0	3		each	$ - 0	$ - 0	$ - 0
	2035	PRE/POST	Physician legal consult/testimony	30	4	34		hour	$ - 0	$ - 0	$ - 0
	2036	PRE/POST	IME physician legal consult/testimony	3	1	4		each	$ - 0	$ - 0	$ - 0
	2037	PRE	Mental Health Screening Consultation	0	400	400		each	$ - 0	$ - 0	$ - 0
	2038	PRE	Psychiatric Level I Consultation	0	50	50		each	$ - 0	$ - 0	$ - 0
	2039	PRE	Psychiatric Level II Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
	2040	PRE	Psychiatric Level III Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
	2041	PRE	Psychiatric Level IV Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
		Additional Medical Tests
	2042	POST	Chest X-Ray (single view)	5	0	5		each	$ - 0	$ - 0	$ - 0
	2043	POST	Chest X-Ray (PA and Lateral)	5	0	5		each	$ - 0	$ - 0	$ - 0
	2044	POST	X-Ray (general)	10	0	10		each	$ - 0	$ - 0	$ - 0
	2045	POST	TB Skin Test (with chest x-ray if indicated)	5	0	5		each	$ - 0	$ - 0	$ - 0
	2046	POST	Audiometry	5	0	5		each	$ - 0	$ - 0	$ - 0
	2047	POST	Lab Profile: CBC with differential, CHEM profile, Urinalysis	5	0	5		each	$ - 0	$ - 0	$ - 0
	2048	POST	Resting EKG with interpretation	15	0	15		each	$ - 0	$ - 0	$ - 0
	2049	POST	Visual Acuity (Corrected and uncorrected, near and distance)	15	0	15		each	$ - 0	$ - 0	$ - 0
	2050	POST	Vital Signs	5	0	5		each	$ - 0	$ - 0	$ - 0
	2051	POST	Thyroid Stimulating Hormone (TSH) w/Reflex Free T4	60	0	60		each	$ - 0	$ - 0	$ - 0
	2052	POST	Hemoglobin A1C (HgBA1C)	30	0	30		each	$ - 0	$ - 0	$ - 0
	2053	POST	Blood Glucose	30	0	30		each	$ - 0	$ - 0	$ - 0
	2054	POST	Blood Lead Level	5	0	5		each	$ - 0	$ - 0	$ - 0
	2055	POST	Cardiac Risk Profile/Lipid Panel	30	0	30		each	$ - 0	$ - 0	$ - 0
	2056	POST	Color Vision Assessment	5	0	5		each	$ - 0	$ - 0	$ - 0
	2057	POST	Maximal Stress EKG with MD interpretation	5	0	5		each	$ - 0	$ - 0	$ - 0
	2058	POST	Peripheral Vision and Visual Depth Perception	5	0	5		each	$ - 0	$ - 0	$ - 0
	2059	POST	Protoporphyrin, Zinc (ZPP) Blood Test	5	0	5		each	$ - 0	$ - 0	$ - 0
	2060	POST	Resting 12 Lead EKG with MD Interpretation	5	0	5		each	$ - 0	$ - 0	$ - 0
	2061	POST	Spirometry (FVC%, FEV1, FEV1/FVC%)	5	0	5		each	$ - 0	$ - 0	$ - 0
	2062	POST	Blood Alcohol Test	5	0	5		each	$ - 0	$ - 0	$ - 0
	2063	POST	Exercise Stress Echo	5	0	5		each	$ - 0	$ - 0	$ - 0
	2064	POST	Echocardiogram	5	0	5		each	$ - 0	$ - 0	$ - 0
	2065	POST	Sleep study	5	0	5		each	$ - 0	$ - 0	$ - 0
	2066	POST	Functional capacity Evaluation (FCE)	10	0	10		each	$ - 0	$ - 0	$ - 0
	2067	POST	Folate	5	0	5		each	$ - 0	$ - 0	$ - 0
	2068	POST	Vitamin B-12	5	0	5		each	$ - 0	$ - 0	$ - 0
	2069	POST	Prothrombin Time with INR	5	0	5		each	$ - 0	$ - 0	$ - 0
	2070	POST	Partial Thromboplastin Time, Activated	5	0	5		each	$ - 0	$ - 0	$ - 0
	2071	POST	Miscellaneous IME Tests (NTE)	20	0	20		each	$ - 0	$ - 0	$ - 0
		Fitness for Duty Drug Test
	2072	POST	Negative drug test	20	0	20		each	$ - 0	$ - 0	$ - 0
	2073	POST	Positive drug test	10	0	10		each	$ - 0	$ - 0	$ - 0
		Fitness Test Services
		Fitness Tests
	2074	PRE	Pre-employment Fitness Test - BPA	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
	2075	PRE	Pre-employment Fitness Test - CBPO	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
	2076	PRE	Pre-employment Fitness Test - AMO	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
	2077	PRE	Pre-employment Fitness Test Overseas - BPA	0	4	4		each	$ - 0	$ - 0	$ - 0
	2078	PRE	Pre-employment Fitness Test Overseas - CBPO	0	4	4		each	$ - 0	$ - 0	$ - 0
	2079	PRE	Pre-employment Fitness Test Overseas - AMO	0	2	2		each	$ - 0	$ - 0	$ - 0
		Drug Program Services
	2080	POST	Employee Random	7,280	0	7,280		each	$ - 0	$ - 0	$ - 0
	2081	POST	Reasonable Suspicion	50	0	50		each	$ - 0	$ - 0	$ - 0
	2082	POST	Post Accident (unsafe practice)	20	0	20		each	$ - 0	$ - 0	$ - 0
	2083	POST	Return-to-duty/follow-up	20	0	20		each	$ - 0	$ - 0	$ - 0
	2084	POST	Positive Drug Test Results (Includes Litigation package)	40	0	40		each	$ - 0	$ - 0	$ - 0
	2085	POST	Split Specimen TX to the HHS Labs(TX, GC/MS, MRO & Litigation package)	30	0	30		each	$ - 0	$ - 0	$ - 0
	2086	POST/PRE	Blind Sample (Collection and shipping supplies, Lab and MRO)	300	250	550		each	$ - 0	$ - 0	$ - 0
	2087	POST/PRE	MRO Meeting and Consultations	15	5	20		hour	$ - 0	$ - 0	$ - 0
	2088	POST/PRE	MRO Expert Testimony	36	8	44		hour	$ - 0	$ - 0	$ - 0
	2089	POST/PRE	Laboratory Director Expert Testimony	10	4	14		hour	$ - 0	$ - 0	$ - 0
	2090	PRE	Pre-employment Drug Test - all positions	0	3,023	3,023		each	$ - 0	$ - 0	$ - 0
	2091	PRE	Pre-employment Onsite - all positions	0	1	1		each	$ - 0	$ - 0	$ - 0
	2092	PRE	Pre-employment Modified Onsites - all positions	0	1	1		each	$ - 0	$ - 0	$ - 0
	2093	PRE	Pre-employment Overseas Drug Test - all positions	0	10	10		each	$ - 0	$ - 0	$ - 0
	2094	PRE	Pre-Employment Positive (without Litigation package)	0	10	10		each	$ - 0	$ - 0	$ - 0
	2095	PRE	Split Specimen TX to the HHS Labs (TX, GC/MS, MRO)	0	5	5		each	$ - 0	$ - 0	$ - 0
	2096	PRE	Litigation Package	0	2	2		each	$ - 0	$ - 0	$ - 0
		Other Services
		Development of Medical Standards and Clinical Policy Consultation
	2097	POST	Assist Gov't with Development of Hearing Standards (CBPO, AMO Positions)	2	0	2		each	$ - 0	$ - 0	$ - 0
	2098	POST	Assist Gov't with Development of Vision Standards (CBPO, AMO Positions)	2	0	2		each	$ - 0	$ - 0	$ - 0
	2099	POST	Clinical Consultation for Policy Determinations (e.g., use of insulin pumps; post-operative refractive surgical procedures).	2	0	2		each	$ - 0	$ - 0	$ - 0
		Travel
	2100	POST/PRE	Medical Services Travel (i.e. Meetings)	3	4	7		each	$ - 0	$ - 0	$ - 0
	2101	POST/PRE	MRO and Laboratory Travel	5	2	7		each	$ - 0	$ - 0	$ - 0
									POST-EMP
TOTAL PRICE	PRE-EMP
TOTAL PRICE	OPTION YEAR 2 TOTAL PRICE
									$ - 0	$ - 0	$ - 0
			Note to Vendors:

Any cancellation fees shall be considered a cost of doing business and are not separately priced. Offerors shall incorporate this cost into their Price

Option Year 3

	Master List of Services - Pre-Emp (CBP-HC) & Post-Emp (NPD)
	Option Year 3: Estimate
	Category	Description	Est. Quantity			Unit Price	Unit	Total Price
			Post-Emp	Pre-Emp	Combined Total			Post-Emp	Pre-Emp	Total Combined
CLIN	Medical Services
	Medical Examinations
3001	POST	Employee medical examination (including physician review)	150	0	150		each	$ - 0	$ - 0	$ - 0
3002	POST	No show fee for employee medical examination (General Examination)	8	0	8		each	$ - 0	$ - 0	$ - 0
3003	PRE/POST	IME (including physician review)	50	1	51		each	$ - 0	$ - 0	$ - 0
3004	PRE/POST	No show fee IME (day of appointment)	5	1	6		each	$ - 0	$ - 0	$ - 0
3005	PRE/POST	Psychiatric IME (including physician review)	65	1	66		each	$ - 0	$ - 0	$ - 0
3006	POST	Medical Hardship/Compassionate Transfer Reassignment I	40	0	40		each	$ - 0	$ - 0	$ - 0
3007	POST	Medical Hardship/Compassionate Transfer Reassignment II	40	0	40		each	$ - 0	$ - 0	$ - 0
3008	PRE	Pre-employment medical exam - all positions	0	5,000	5,000		each	$ - 0	$ - 0	$ - 0
3009	PRE	Pre-employment medical exam/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
3010	PRE	Pre-employment fitness test/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
3011	PRE	Pre-employment medical exam/fitness test combination	0	40,000	40,000		each	$ - 0	$ - 0	$ - 0
3012	PRE	Pre-employment medical exam/fitness test/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
3013	PRE	Pre-employment Overseas Medical Examination	0	10	10		each	$ - 0	$ - 0	$ - 0
	Non-Psychiatric Consultation
3014	POST	Non-Psychiatric Level I Consultation (1-15 pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
3015	POST	Non-Psychiatric Level II Consultation (16-30 pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
3016	POST	Non-Psychiatric Level III Consultation (31 and over pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
3017	PRE	Non-Psychiatric Level I Consultation	0	1,000	1,000		each	$ - 0	$ - 0	$ - 0
3018	PRE	Non-Psychiatric Level II Consultation			0
3019	PRE	Level 2-1 (100 pages or less)	0	5	5		each	$ - 0	$ - 0	$ - 0
3020	PRE	Level 2-2 (101-200 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
3021	PRE	Level 2-3 (201-300 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
3022	PRE	Level 2-4 (301-400 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
3023	PRE	Level 2-5 (401-500 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
3024	PRE	Level 2-6 (501-600 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
3025	PRE	Level 2-7 (601-700 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
3026	PRE	Level 2-8 (701-800 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
3027	PRE	Level 2-9 (801-900 pages)	0	1	1		each	$ - 0	$ - 0	$ - 0
3028	PRE	Level 2-10 (901-1000 pages)	0	1	1		each	$ - 0	$ - 0	$ - 0
3029	PRE	Non-Psychiatric Level III Specialist Consultation	0	180	180		each	$ - 0	$ - 0	$ - 0
3030	PRE	Vision Consultation	0	2,147	2,147		each	$ - 0	$ - 0	$ - 0
	Psychiatric Specialist Consultation
3031	POST	Psychiatric Level I Consultation	30	0	30		each	$ - 0	$ - 0	$ - 0
3032	POST	Psychiatric Level II Consultation	25	0	25		each	$ - 0	$ - 0	$ - 0
3033	POST	Psychiatric Level III Consultation	25	0	25		each	$ - 0	$ - 0	$ - 0
3034	POST	Psychiatric Level IV Consultation	3	0	3		each	$ - 0	$ - 0	$ - 0
3035	PRE/POST	Physician legal consult/testimony	30	4	34		hour	$ - 0	$ - 0	$ - 0
3036	PRE/POST	IME physician legal consult/testimony	3	1	4		each	$ - 0	$ - 0	$ - 0
3037	PRE	Mental Health Screening Consultation	0	400	400		each	$ - 0	$ - 0	$ - 0
3038	PRE	Psychiatric Level I Consultation	0	50	50		each	$ - 0	$ - 0	$ - 0
3039	PRE	Psychiatric Level II Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
3040	PRE	Psychiatric Level III Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
3041	PRE	Psychiatric Level IV Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
	Additional Medical Tests
3042	POST	Chest X-Ray (single view)	5	0	5		each	$ - 0	$ - 0	$ - 0
3043	POST	Chest X-Ray (PA and Lateral)	5	0	5		each	$ - 0	$ - 0	$ - 0
3044	POST	X-Ray (general)	10	0	10		each	$ - 0	$ - 0	$ - 0
3045	POST	TB Skin Test (with chest x-ray if indicated)	5	0	5		each	$ - 0	$ - 0	$ - 0
3046	POST	Audiometry	5	0	5		each	$ - 0	$ - 0	$ - 0
3047	POST	Lab Profile: CBC with differential, CHEM profile, Urinalysis	5	0	5		each	$ - 0	$ - 0	$ - 0
3048	POST	Resting EKG with interpretation	15	0	15		each	$ - 0	$ - 0	$ - 0
3049	POST	Visual Acuity (Corrected and uncorrected, near and distance)	15	0	15		each	$ - 0	$ - 0	$ - 0
3050	POST	Vital Signs	5	0	5		each	$ - 0	$ - 0	$ - 0
3051	POST	Thyroid Stimulating Hormone (TSH) w/Reflex Free T4	60	0	60		each	$ - 0	$ - 0	$ - 0
3052	POST	Hemoglobin A1C (HgBA1C)	30	0	30		each	$ - 0	$ - 0	$ - 0
3053	POST	Blood Glucose	30	0	30		each	$ - 0	$ - 0	$ - 0
3054	POST	Blood Lead Level	5	0	5		each	$ - 0	$ - 0	$ - 0
3055	POST	Cardiac Risk Profile/Lipid Panel	30	0	30		each	$ - 0	$ - 0	$ - 0
3056	POST	Color Vision Assessment	5	0	5		each	$ - 0	$ - 0	$ - 0
3057	POST	Maximal Stress EKG with MD interpretation	5	0	5		each	$ - 0	$ - 0	$ - 0
3058	POST	Peripheral Vision and Visual Depth Perception	5	0	5		each	$ - 0	$ - 0	$ - 0
3059	POST	Protoporphyrin, Zinc (ZPP) Blood Test	5	0	5		each	$ - 0	$ - 0	$ - 0
3060	POST	Resting 12 Lead EKG with MD Interpretation	5	0	5		each	$ - 0	$ - 0	$ - 0
3061	POST	Spirometry (FVC%, FEV1, FEV1/FVC%)	5	0	5		each	$ - 0	$ - 0	$ - 0
3062	POST	Blood Alcohol Test	5	0	5		each	$ - 0	$ - 0	$ - 0
3063	POST	Exercise Stress Echo	5	0	5		each	$ - 0	$ - 0	$ - 0
3064	POST	Echocardiogram	5	0	5		each	$ - 0	$ - 0	$ - 0
3065	POST	Sleep study	5	0	5		each	$ - 0	$ - 0	$ - 0
3066	POST	Functional capacity Evaluation (FCE)	10	0	10		each	$ - 0	$ - 0	$ - 0
3067	POST	Folate	5	0	5		each	$ - 0	$ - 0	$ - 0
3068	POST	Vitamin B-12	5	0	5		each	$ - 0	$ - 0	$ - 0
3069	POST	Prothrombin Time with INR	5	0	5		each	$ - 0	$ - 0	$ - 0
3070	POST	Partial Thromboplastin Time, Activated	5	0	5		each	$ - 0	$ - 0	$ - 0
3071	POST	Miscellaneous IME Tests (NTE)	20	0	20		each	$ - 0	$ - 0	$ - 0
	Fitness for Duty Drug Test
3072	POST	Negative drug test	20	0	20		each	$ - 0	$ - 0	$ - 0
3073	POST	Positive drug test	10	0	10		each	$ - 0	$ - 0	$ - 0
	Fitness Test Services
	Fitness Tests
3074	PRE	Pre-employment Fitness Test - BPA	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
3075	PRE	Pre-employment Fitness Test - CBPO	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
3076	PRE	Pre-employment Fitness Test - AMO	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
3077	PRE	Pre-employment Fitness Test Overseas - BPA	0	4	4		each	$ - 0	$ - 0	$ - 0
3078	PRE	Pre-employment Fitness Test Overseas - CBPO	0	4	4		each	$ - 0	$ - 0	$ - 0
3079	PRE	Pre-employment Fitness Test Overseas - AMO	0	2	2		each	$ - 0	$ - 0	$ - 0
	Drug Program Services
3080	POST	Employee Random	7,280	0	7,280		each	$ - 0	$ - 0	$ - 0
3081	POST	Reasonable Suspicion	50	0	50		each	$ - 0	$ - 0	$ - 0
3082	POST	Post Accident (unsafe practice)	20	0	20		each	$ - 0	$ - 0	$ - 0
3083	POST	Return-to-duty/follow-up	20	0	20		each	$ - 0	$ - 0	$ - 0
3084	POST	Positive Drug Test Results (Includes Litigation package)	40	0	40		each	$ - 0	$ - 0	$ - 0
3085	POST	Split Specimen TX to the HHS Labs(TX, GC/MS, MRO & Litigation package)	30	0	30		each	$ - 0	$ - 0	$ - 0
3086	POST/PRE	Blind Sample (Collection and shipping supplies, Lab and MRO)	300	250	550		each	$ - 0	$ - 0	$ - 0
3087	POST/PRE	MRO Meeting and Consultations	15	5	20		hour	$ - 0	$ - 0	$ - 0
3088	POST/PRE	MRO Expert Testimony	36	8	44		hour	$ - 0	$ - 0	$ - 0
3089	POST/PRE	Laboratory Director Expert Testimony	10	4	14		hour	$ - 0	$ - 0	$ - 0
3090	PRE	Pre-employment Drug Test - all positions	0	3,023	3,023		each	$ - 0	$ - 0	$ - 0
3091	PRE	Pre-employment Onsite - all positions	0	1	1		each	$ - 0	$ - 0	$ - 0
3092	PRE	Pre-employment Modified Onsites - all positions	0	1	1		each	$ - 0	$ - 0	$ - 0
3093	PRE	Pre-employment Overseas Drug Test - all positions	0	10	10		each	$ - 0	$ - 0	$ - 0
3094	PRE	Pre-Employment Positive (without Litigation package)	0	10	10		each	$ - 0	$ - 0	$ - 0
3095	PRE	Split Specimen TX to the HHS Labs (TX, GC/MS, MRO)	0	5	5		each	$ - 0	$ - 0	$ - 0
3096	PRE	Litigation Package	0	2	2		each	$ - 0	$ - 0	$ - 0
	Other Services
	Development of Medical Standards and Clinical Policy Consultation
3097	POST	Assist Gov't with Development of Hearing Standards (CBPO, AMO Positions)	2	0	2		each	$ - 0	$ - 0	$ - 0
3098	POST	Assist Gov't with Development of Vision Standards (CBPO, AMO Positions)	2	0	2		each	$ - 0	$ - 0	$ - 0
3099	POST	Clinical Consultation for Policy Determinations (e.g., use of insulin pumps; post-operative refractive surgical procedures).	2	0	2		each	$ - 0	$ - 0	$ - 0
	Travel
3100	POST/PRE	Medical Services Travel (i.e. Meetings)	3	4	7		each	$ - 0	$ - 0	$ - 0
3101	POST/PRE	MRO and Laboratory Travel	5	2	7		each	$ - 0	$ - 0	$ - 0

			POST-EMP
TOTAL PRICE	PRE-EMP
TOTAL PRICE	OPTION YEAR 3 TOTAL PRICE
			$ - 0	$ - 0	$ - 0
		Note to Vendors:

Any cancellation fees shall be considered a cost of doing business and are not separately priced. Offerors shall incorporate this cost into their Price

Option Year 4

		Master List of Services - Pre-Emp (CBP-HC) & Post-Emp (NPD)
		Option Year 4: Estimate
		Category	Description	Est. Quantity			Unit Price	Unit	Total Price
				Post-Emp	Pre-Emp	Combined Total			Post-Emp	Pre-Emp	Total Combined
	CLIN	Medical Services
		Medical Examinations
	4001	POST	Employee medical examination (including physician review)	150	0	150		each	$ - 0	$ - 0	$ - 0
	4002	POST	No show fee for employee medical examination (General Examination)	8	0	8		each	$ - 0	$ - 0	$ - 0
	4003	PRE/POST	IME (including physician review)	50	1	51		each	$ - 0	$ - 0	$ - 0
	4004	PRE/POST	No show fee IME (day of appointment)	5	1	6		each	$ - 0	$ - 0	$ - 0
	4005	PRE/POST	Psychiatric IME (including physician review)	65	1	66		each	$ - 0	$ - 0	$ - 0
	4006	POST	Medical Hardship/Compassionate Transfer Reassignment I	40	0	40		each	$ - 0	$ - 0	$ - 0
	4007	POST	Medical Hardship/Compassionate Transfer Reassignment II	40	0	40		each	$ - 0	$ - 0	$ - 0
	4008	PRE	Pre-employment medical exam - all positions	0	5,000	5,000		each	$ - 0	$ - 0	$ - 0
	4009	PRE	Pre-employment medical exam/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
	4010	PRE	Pre-employment fitness test/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
	4011	PRE	Pre-employment medical exam/fitness test combination	0	40,000	40,000		each	$ - 0	$ - 0	$ - 0
	4012	PRE	Pre-employment medical exam/fitness test/drug test combination	0	1	1		each	$ - 0	$ - 0	$ - 0
	4013	PRE	Pre-employment Overseas Medical Examination	0	10	10		each	$ - 0	$ - 0	$ - 0
		Non-Psychiatric Consultation
	4014	POST	Non-Psychiatric Level I Consultation (1-15 pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
	4015	POST	Non-Psychiatric Level II Consultation (16-30 pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
	4016	POST	Non-Psychiatric Level III Consultation (31 and over pages)	15	0	15		each	$ - 0	$ - 0	$ - 0
	4017	PRE	Non-Psychiatric Level I Consultation	0	1,000	1,000		each	$ - 0	$ - 0	$ - 0
	4018	PRE	Non-Psychiatric Level II Consultation			0
	4019	PRE	Level 2-1 (100 pages or less)	0	5	5		each	$ - 0	$ - 0	$ - 0
	4020	PRE	Level 2-2 (101-200 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	4021	PRE	Level 2-3 (201-300 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	4022	PRE	Level 2-4 (301-400 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	4023	PRE	Level 2-5 (401-500 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	4024	PRE	Level 2-6 (501-600 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	4025	PRE	Level 2-7 (601-700 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	4026	PRE	Level 2-8 (701-800 pages)	0	20	20		each	$ - 0	$ - 0	$ - 0
	4027	PRE	Level 2-9 (801-900 pages)	0	1	1		each	$ - 0	$ - 0	$ - 0
	4028	PRE	Level 2-10 (901-1000 pages)	0	1	1		each	$ - 0	$ - 0	$ - 0
	4029	PRE	Non-Psychiatric Level III Specialist Consultation	0	180	180		each	$ - 0	$ - 0	$ - 0
	4030	PRE	Vision Consultation	0	2,147	2,147		each	$ - 0	$ - 0	$ - 0
		Psychiatric Specialist Consultation
	4031	POST	Psychiatric Level I Consultation	30	0	30		each	$ - 0	$ - 0	$ - 0
	4032	POST	Psychiatric Level II Consultation	25	0	25		each	$ - 0	$ - 0	$ - 0
	4033	POST	Psychiatric Level III Consultation	25	0	25		each	$ - 0	$ - 0	$ - 0
	4034	POST	Psychiatric Level IV Consultation	3	0	3		each	$ - 0	$ - 0	$ - 0
	4035	PRE/POST	Physician legal consult/testimony	30	4	34		hour	$ - 0	$ - 0	$ - 0
	4036	PRE/POST	IME physician legal consult/testimony	3	1	4		each	$ - 0	$ - 0	$ - 0
	4037	PRE	Mental Health Screening Consultation	0	400	400		each	$ - 0	$ - 0	$ - 0
	4038	PRE	Psychiatric Level I Consultation	0	50	50		each	$ - 0	$ - 0	$ - 0
	4039	PRE	Psychiatric Level II Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
	4040	PRE	Psychiatric Level III Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
	4041	PRE	Psychiatric Level IV Consultation	0	1	1		each	$ - 0	$ - 0	$ - 0
		Additional Medical Tests
	4042	POST	Chest X-Ray (single view)	5	0	5		each	$ - 0	$ - 0	$ - 0
	4043	POST	Chest X-Ray (PA and Lateral)	5	0	5		each	$ - 0	$ - 0	$ - 0
	4044	POST	X-Ray (general)	10	0	10		each	$ - 0	$ - 0	$ - 0
	4045	POST	TB Skin Test (with chest x-ray if indicated)	5	0	5		each	$ - 0	$ - 0	$ - 0
	4046	POST	Audiometry	5	0	5		each	$ - 0	$ - 0	$ - 0
	4047	POST	Lab Profile: CBC with differential, CHEM profile, Urinalysis	5	0	5		each	$ - 0	$ - 0	$ - 0
	4048	POST	Resting EKG with interpretation	15	0	15		each	$ - 0	$ - 0	$ - 0
	4049	POST	Visual Acuity (Corrected and uncorrected, near and distance)	15	0	15		each	$ - 0	$ - 0	$ - 0
	4050	POST	Vital Signs	5	0	5		each	$ - 0	$ - 0	$ - 0
	4051	POST	Thyroid Stimulating Hormone (TSH) w/Reflex Free T4	60	0	60		each	$ - 0	$ - 0	$ - 0
	4052	POST	Hemoglobin A1C (HgBA1C)	30	0	30		each	$ - 0	$ - 0	$ - 0
	4053	POST	Blood Glucose	30	0	30		each	$ - 0	$ - 0	$ - 0
	4054	POST	Blood Lead Level	5	0	5		each	$ - 0	$ - 0	$ - 0
	4055	POST	Cardiac Risk Profile/Lipid Panel	30	0	30		each	$ - 0	$ - 0	$ - 0
	4056	POST	Color Vision Assessment	5	0	5		each	$ - 0	$ - 0	$ - 0
	4057	POST	Maximal Stress EKG with MD interpretation	5	0	5		each	$ - 0	$ - 0	$ - 0
	4058	POST	Peripheral Vision and Visual Depth Perception	5	0	5		each	$ - 0	$ - 0	$ - 0
	4059	POST	Protoporphyrin, Zinc (ZPP) Blood Test	5	0	5		each	$ - 0	$ - 0	$ - 0
	4060	POST	Resting 12 Lead EKG with MD Interpretation	5	0	5		each	$ - 0	$ - 0	$ - 0
	4061	POST	Spirometry (FVC%, FEV1, FEV1/FVC%)	5	0	5		each	$ - 0	$ - 0	$ - 0
	4062	POST	Blood Alcohol Test	5	0	5		each	$ - 0	$ - 0	$ - 0
	4063	POST	Exercise Stress Echo	5	0	5		each	$ - 0	$ - 0	$ - 0
	4064	POST	Echocardiogram	5	0	5		each	$ - 0	$ - 0	$ - 0
	4065	POST	Sleep study	5	0	5		each	$ - 0	$ - 0	$ - 0
	4066	POST	Functional capacity Evaluation (FCE)	10	0	10		each	$ - 0	$ - 0	$ - 0
	4067	POST	Folate	5	0	5		each	$ - 0	$ - 0	$ - 0
	4068	POST	Vitamin B-12	5	0	5		each	$ - 0	$ - 0	$ - 0
	4069	POST	Prothrombin Time with INR	5	0	5		each	$ - 0	$ - 0	$ - 0
	4070	POST	Partial Thromboplastin Time, Activated	5	0	5		each	$ - 0	$ - 0	$ - 0
	4071	POST	Miscellaneous IME Tests (NTE)	20	0	20		each	$ - 0	$ - 0	$ - 0
		Fitness for Duty Drug Test
	4072	POST	Negative drug test	20	0	20		each	$ - 0	$ - 0	$ - 0
	4073	POST	Positive drug test	10	0	10		each	$ - 0	$ - 0	$ - 0
		Fitness Test Services
		Fitness Tests
	4074	PRE	Pre-employment Fitness Test - BPA	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
	4075	PRE	Pre-employment Fitness Test - CBPO	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
	4076	PRE	Pre-employment Fitness Test - AMO	0	2,000	2,000		each	$ - 0	$ - 0	$ - 0
	4077	PRE	Pre-employment Fitness Test Overseas - BPA	0	4	4		each	$ - 0	$ - 0	$ - 0
	4078	PRE	Pre-employment Fitness Test Overseas - CBPO	0	4	4		each	$ - 0	$ - 0	$ - 0
	4079	PRE	Pre-employment Fitness Test Overseas - AMO	0	2	2		each	$ - 0	$ - 0	$ - 0
		Drug Program Services
	4080	POST	Employee Random	7,280	0	7,280		each	$ - 0	$ - 0	$ - 0
	4081	POST	Reasonable Suspicion	50	0	50		each	$ - 0	$ - 0	$ - 0
	4082	POST	Post Accident (unsafe practice)	20	0	20		each	$ - 0	$ - 0	$ - 0
	4083	POST	Return-to-duty/follow-up	20	0	20		each	$ - 0	$ - 0	$ - 0
	4084	POST	Positive Drug Test Results (Includes Litigation package)	40	0	40		each	$ - 0	$ - 0	$ - 0
	4085	POST	Split Specimen TX to the HHS Labs(TX, GC/MS, MRO & Litigation package)	30	0	30		each	$ - 0	$ - 0	$ - 0
	4086	POST/PRE	Blind Sample (Collection and shipping supplies, Lab and MRO)	300	250	550		each	$ - 0	$ - 0	$ - 0
	4087	POST/PRE	MRO Meeting and Consultations	15	5	20		hour	$ - 0	$ - 0	$ - 0
	4088	POST/PRE	MRO Expert Testimony	36	8	44		hour	$ - 0	$ - 0	$ - 0
	4089	POST/PRE	Laboratory Director Expert Testimony	10	4	14		hour	$ - 0	$ - 0	$ - 0
	4090	PRE	Pre-employment Drug Test - all positions	0	3,023	3,023		each	$ - 0	$ - 0	$ - 0
	4091	PRE	Pre-employment Onsite - all positions	0	1	1		each	$ - 0	$ - 0	$ - 0
	4092	PRE	Pre-employment Modified Onsites - all positions	0	1	1		each	$ - 0	$ - 0	$ - 0
	4093	PRE	Pre-employment Overseas Drug Test - all positions	0	10	10		each	$ - 0	$ - 0	$ - 0
	4094	PRE	Pre-Employment Positive (without Litigation package)	0	10	10		each	$ - 0	$ - 0	$ - 0
	4095	PRE	Split Specimen TX to the HHS Labs (TX, GC/MS, MRO)	0	5	5		each	$ - 0	$ - 0	$ - 0
	4096	PRE	Litigation Package	0	2	2		each	$ - 0	$ - 0	$ - 0
		Other Services
		Development of Medical Standards and Clinical Policy Consultation
	4097	POST	Assist Gov't with Development of Hearing Standards (CBPO, AMO Positions)	2	0	2		each	$ - 0	$ - 0	$ - 0
	4098	POST	Assist Gov't with Development of Vision Standards (CBPO, AMO Positions)	2	0	2		each	$ - 0	$ - 0	$ - 0
	4099	POST	Clinical Consultation for Policy Determinations (e.g., use of insulin pumps; post-operative refractive surgical procedures).	2	0	2		each	$ - 0	$ - 0	$ - 0
		Travel
	4100	POST/PRE	Medical Services Travel (i.e. Meetings)	3	4	7		each	$ - 0	$ - 0	$ - 0
	4101	POST/PRE	MRO and Laboratory Travel	5	2	7		each	$ - 0	$ - 0	$ - 0
									POST-EMP
TOTAL PRICE	PRE-EMP
TOTAL PRICE	OPTION YEAR 4 TOTAL PRICE
									$ - 0	$ - 0	$ - 0
			Note to Vendors:

Any cancellation fees shall be considered a cost of doing business and are not separately priced. Offerors shall incorporate this cost into their Price

6 Month Extension

Master List of Services - Pre-Emp (CBP-HC) & Post-Emp (NPD)

6 Month Extension: Estimate

(Option to Extend Services)

Category	Description	Est. Quantity			Unit Price	Unit	Total Price
		Post-Emp	Pre-Emp	Combined Total			Post-Emp	Pre-Emp	Total Combined
Medical Services
Medical Examinations
POST	Employee medical examination (including physician review)	75	0	75	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	No show fee for employee medical examination (General Examination)	4	0	4	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE/POST	IME (including physician review)	20	1	21	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE/POST	No show fee IME (day of appointment)	3	1	4	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE/POST	Psychiatric IME (including physician review)	30	1	31	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Medical Hardship/Compassionate Transfer Reassignment I	20	0	20	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Medical Hardship/Compassionate Transfer Reassignment II	20	0	20	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Pre-employment medical exam - all positions	0	2,500	2,500	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Pre-employment medical exam/drug test combination	0	1	1	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Pre-employment fitness test/drug test combination	0	1	1	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Pre-employment medical exam/fitness test combination	0	23,000	23,000	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Pre-employment medical exam/fitness test/drug test combination	0	1	1	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Pre-employment Overseas Medical Examination	0	3	3	$ - 0	each	$ - 0	$ - 0	$ - 0
Non-Psychiatric Consultation
POST	Non-Psychiatric Level I Consultation (1-15 pages)	8	0	8	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Non-Psychiatric Level II Consultation (16-30 pages)	8	0	8	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Non-Psychiatric Level III Consultation (31 and over pages)	8	0	8	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Non-Psychiatric Level I Consultation	0	500	500	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Non-Psychiatric Level II Consultation			0
PRE	Level 2-1 (100 pages or less)	0	3	3	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Level 2-2 (101-200 pages)	0	10	10	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Level 2-3 (201-300 pages)	0	10	10	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Level 2-4 (301-400 pages)	0	10	10	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Level 2-5 (401-500 pages)	0	10	10	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Level 2-6 (501-600 pages)	0	10	10	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Level 2-7 (601-700 pages)	0	10	10	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Level 2-8 (701-800 pages)	0	10	10	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Level 2-9 (801-900 pages)	0	1	1	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Level 2-10 (901-1000 pages)	0	1	1	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Non-Psychiatric Level III Specialist Consultation	0	90	90	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Vision Consultation	0	1,073	1073	$ - 0	each	$ - 0	$ - 0	$ - 0
Psychiatric Specialist Consultation
POST	Psychiatric Level I Consultation	30	0	30	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Psychiatric Level II Consultation	25	0	25	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Psychiatric Level III Consultation	25	0	25	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Psychiatric Level IV Consultation	3	0	3	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE/POST	Physician legal consult/testimony	10	2	12	$ - 0	hour	$ - 0	$ - 0	$ - 0
PRE/POST	IME physician legal consult/testimony	3	1	4	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Mental Health Screening Consultation	0	250	250	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Psychiatric Level I Consultation	0	25	25	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Psychiatric Level II Consultation	0	1	1	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Psychiatric Level III Consultation	0	1	1	$ - 0	each	$ - 0	$ - 0	$ - 0
PRE	Psychiatric Level IV Consultation	0	1	1	$ - 0	each	$ - 0	$ - 0	$ - 0
Additional Medical Tests
POST	Chest X-Ray (single view)	2	0	2	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Chest X-Ray (PA and Lateral)	2	0	2	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	X-Ray (general)	5	0	5	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	TB Skin Test (with chest x-ray if indicated)	2	0	2	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Audiometry	2	0	2	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Lab Profile: CBC with differential, CHEM profile, Urinalysis	2	0	2	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Resting EKG with interpretation	8	0	8	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Visual Acuity (Corrected and uncorrected, near and distance)	8	0	8	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Vital Signs	2	0	2	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Thyroid Stimulating Hormone (TSH) w/Reflex Free T4	30	0	30	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Hemoglobin A1C (HgBA1C)	15	0	15	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Blood Glucose	15	0	15	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Blood Lead Level	2	0	2	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Cardiac Risk Profile/Lipid Panel	15	0	15	$ - 0	each	$ - 0	$ - 0	$ - 0
POST	Color Vision Assessment	2	0	2	$ - 0	each	$ - 0	$ - 0	$ - 0

This is the start of the file's text. The full file is on GovTribe.

File details come from the government source that posted it. Updated Aug 5, 2020.