Attachment A ChemistryImmunoassay Schedule PHX Volumes.xlsx

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6640--VA Phoenix Chemistry/IA CPT IDIQ
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36C26223R0185
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This document provides estimated annual test volumes and proposed reagent costs per test for chemistry and immunoassay laboratory services for VISN 22 of the Department of Veterans Affairs. It includes estimated annual test volumes for over 150 tests across six medical centers in VISN 22 totaling over 3.3 million tests. For each test it provides the estimated annual volume, number of quality controls, and estimated five-year test total. The document requests the reagent and consumable costs per test for the listed tests and identifies the reagents and consumables required to perform each test. It includes proposed instrumentation, including chemistry and immunoassay analyzers, centrifuges, refrigerated storage, and automation equipment but does not include pricing. Annual service costs are estimated at $30,000 for years one through five. Optional tests are listed for informational purposes only. No pricing information or totals are provided.

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1. VISN CPT

Test DescriptionVISN 22 ESTIMATED ANNUAL TEST VOLUME
CPT (Reagents and Consumables only)CPT (Reagents and Consumables only)CPT (Reagents and Consumables only)Total CPT (Years 1-5)Base Year 1Base Year 2Base Year 3Base Year 4Base Year 5Estimated Base 5-Year Test Total
(SUM of Column D-H)VISN 22 Estimated Base 5-Year Test Extended Price

(Column C x Column I)

estimated 3% increaseestimated 3% increaseestimated 3% increaseestimated 3% increase
Acetaminophen$0.003,3203,4203,5223,6283,73717,626$ - 000000
ALBUMIN, Blood$0.00130,662134,582138,619142,778147,061693,702$ - 000000
ALBUMIN, Urine$0.0021,74622,39823,07023,76224,475115,452$ - 000000
Alkaline Phosphatase$0.00128,369132,220136,187140,272144,480681,528$ - 000000
ALPHA-FETO PROTEIN (AFP)$0.003,5013,6063,7143,8263,94018,587$ - 000000
Alanine Aminotransferase (ALT) (SGPT$0.00128,369132,220136,187140,272144,480681,528$ - 000000
Ammonia$0.001,2981,3371,3771,4181,4616,891$ - 000000
Amphetamines$0.0026,93527,74328,57529,43330,316143,002$ - 000000
Amylase, Blood and Urine$0.0010,83211,15711,49211,83612,19257,509$ - 000000
Aspartate Aminotransferase (AST) (SGOT)$0.00128,369132,220136,187140,272144,480681,528$ - 000000
Barbiturates$0.0027,69128,52229,37730,25931,166147,015$ - 000000
Benzodiazepines$0.0027,69128,52229,37730,25931,166147,015$ - 000000
Benzoylecgonine$0.0027,69128,52229,37730,25931,166147,015$ - 000000
Beta-Hydroxybutyrate$0.001,3101,3491,3901,4311,4746,955$ - 000000
Beta 2 Microglobulin$0.001,1741,2091,2451,2831,3216,233$ - 000000
Bicarbonate (CO2)$0.00166,940171,948177,107182,420187,892886,307$ - 000000
Bilirubin, Direct$0.0016,27316,76117,26417,78218,31586,396$ - 000000
Bilirubin, Total$0.00128,747132,609136,588140,685144,906683,535$ - 000000
B-type Natriuretic Peptide (BNP)$0.0012,06212,42412,79713,18013,57664,039$ - 000000
Buprenorphone$0.0026,93527,74328,57529,43330,316143,002$ - 000000
CALCIUM, Urine and Blood$0.00167,637172,666177,846183,181188,677890,008$ - 000000
Cannabinoids$0.0026,93527,74328,57529,43330,316143,002$ - 000000
CARBAMEZAPINE$0.009359639921,0221,0524,964$ - 000000
Carcinoembryonic Antigen (CEA)$0.001,2431,2801,3191,3581,3996,599$ - 000000
CHLORIDE, URINE, BLOOD and, CSF$0.00167,891172,928178,116183,459188,963891,356$ - 000000
Cholesterol, Total, Blood and Fluid$0.0074,55076,78779,09081,46383,907395,796$ - 000000
Complement Component 3 (C3)$0.001,7141,7651,8181,8731,9299,100$ - 000000
Complement Component 4(C4)$0.001,7511,8041,8581,9131,9719,296$ - 000000
Cortisol$0.003,2003,2963,3953,4973,60216,989$ - 000000
C-REACTIVE PROTEIN, High Sensitive$0.0011,52911,87512,23112,59812,97661,209$ - 000000
Creatine Kinase (CK)$0.0013,95014,36914,80015,24415,70174,062$ - 000000
CREATININE, Urine and Blood$0.00224,524231,260238,198245,343252,7041,192,028$ - 000000
DIGOXIN$0.001,2981,3371,3771,4181,4616,891$ - 000000
Estradiol$0.002,4702,5442,6202,6992,78013,114$ - 000000
Ethanol, Urine and Blood$0.0033,06934,06135,08336,13537,219175,568$ - 000000
Ferritin$0.008,3418,5918,8499,1149,38844,284$ - 000000
FOLIC ACID (Folate)$0.005,7335,9056,0826,2656,45330,437$ - 000000
Free T4$0.007,7998,0338,2748,5228,77841,406$ - 000000
Follicle-Stimulating Hormone (FSH)$0.001,9662,0252,0862,1482,21310,438$ - 000000
Gamma-Glutamyl Transferase (GGT)$0.004,2254,3524,4824,6174,75522,431$ - 000000
GLUCOSE, Urine, Blood, Fluid, CSF$0.00168,340173,390178,592183,950189,468893,740$ - 000000
Haptoglobin$0.001,7661,8191,8741,9301,9889,376$ - 000000
HDL Cholesterol$0.0074,38676,61878,91681,28483,722394,925$ - 000000
Hepatitis A IgM$0.002,7152,7962,8802,9673,05614,414$ - 000000
Hepatitis A IgG$0.0011,11311,44611,79012,14312,50859,000$ - 000000
Hepatitis B Core AB Total$0.002,4192,4922,5662,6432,72312,843$ - 000000
Hepatitis B Core IgM$0.003,7933,9074,0244,1454,26920,138$ - 000000
Hepatitis B Surface Ab$0.0020,97921,60822,25722,92423,612111,380$ - 000000
Hepatitis B Surface Ag$0.005,2295,3865,5475,7145,88527,761$ - 000000
Hepatitis C Ab$0.0011,36911,71012,06112,42312,79660,360$ - 000000
Hiv- 1/2 Antibody with antigen ("4th generation" HIV testing)$0.0010,10610,40910,72111,04311,37453,654$ - 000000
Homocysteine$0.002,0952,1582,2232,2892,35811,123$ - 000000
Human Chorionic Gonadotropin, Beta, Quant (HCG. Beta)$0.008588849109389664,555$ - 000000
IgA$0.003,2413,3383,4383,5423,64817,207$ - 000000
IgG$0.002,7502,8332,9173,0053,09514,600$ - 000000
IgM$0.002,6872,7682,8512,9363,02414,266$ - 000000
IRON$0.0010,78611,11011,44311,78612,14057,264$ - 000000
LACTIC ACID, BLOOD and CSF$0.0013,65814,06814,49014,92415,37272,512$ - 000000
Lactate Dehydrogenase, Blood, Fluid, CSF (LDH)$0.002,0732,1352,1992,2652,33311,006$ - 000000
LDL Cholesterol, Direct$0.004,9205,0685,2205,3765,53826,121$ - 000000
Lipase$0.0011,91812,27612,64413,02313,41463,274$ - 000000
Lithium$0.001,3341,3741,4151,4581,5017,082$ - 000000
Lutenizing Hormone (LH)$0.001,8401,8951,9522,0112,0719,769$ - 000000
Magnesium, Blood and Urine$0.0043,16844,46345,79747,17148,586229,185$ - 000000
Methadone$0.0026,17926,96427,77328,60729,465138,988$ - 000000
Microalbumin$0.0021,66822,31822,98823,67724,388115,038$ - 000000
Opiates$0.0026,93527,74328,57529,43330,316143,002$ - 000000
Oxycodone$0.0026,93527,74328,57529,43330,316143,002$ - 000000
PARATHYROID HORMONE (Intra)$0.005785956136326513,069$ - 000000
PHENYTOIN, (Dilantin)$0.009931,0231,0531,0851,1185,272$ - 0
PHOSPHORUS, Urine, Blood$0.0036,30137,39038,51239,66740,857192,727$ - 0
POTASSIUM, Urine, Blood$0.00169,831174,926180,174185,579191,146901,656$ - 0
Prealbumin$0.001,4481,4911,5361,5821,6307,688$ - 0
Prolactin$0.001,8271,8821,9381,9962,0569,700$ - 0
Prostate Specific Antigen (PSA)$0.0029,13830,01230,91331,84032,795154,698$ - 0
PSA, Free$0.004,1584,2834,4114,5444,68022,075$ - 0
Protein, TOTOAL Blood, Urine and Fluid$0.00171,549176,695181,996187,456193,080910,777$ - 0
Rheumatoid Factor$0.002,4732,5472,6242,7022,78313,129$ - 0
Salicylate$0.002,5582,6352,7142,7952,87913,581$ - 0
SODIUM, Urine and Blood$0.00169,827174,922180,169185,575191,142901,635$ - 0
TESTOSTERONE, Total$0.005,1375,2915,4505,6135,78227,273$ - 0
Theophylline$0.009209489761,0051,0354,884$ - 0
Thyroid-Stimulating Hormone (TSH)$0.0065,01066,96068,96971,03873,169345,147$ - 0
TRANSFERRIN$0.0011,64911,99812,35812,72913,11161,846$ - 0
Triglycerides$0.0074,74576,98779,29781,67684,126396,831$ - 0
Troponin$0.0017,69018,22118,76719,33019,91093,919$ - 0
UREA NITROGEN, Urine and Blood$0.00168,378173,429178,632183,991189,511893,942$ - 0
URIC ACID, Urine and Blood$0.005,9726,1516,3366,5266,72231,706$ - 0
Valproic Acid$0.001,8801,9361,9942,0542,1169,981$ - 0
Vancomycin$0.001,8521,9081,9652,0242,0849,833$ - 0
Vit-D-25 Hydroxy Total$0.0046,95648,36549,81651,31052,849249,296$ - 0
Free T3$0.002,2052,2712,3392,4092,48211,707$ - 0
Hemoglobin A1c$0.0083,16085,65588,22490,87193,597441,508$ - 0
Procalcitonin$0.002,7592,8422,9273,0153,10514,648$ - 0
Tacrolimus (EK506)$0.002,9993,0893,1823,2773,37515,922$ - 0

&"-,Bold"ATTACHMENT C

2. EST ANNUAL SITE VOL

PhoenixSan DiegoSanta MariaSepulvedaTucsonWest Los AngelesVISN 22 TOTAL ANNAUL VOLUME
Est. Test Volume# of ControlsEst. 5% Repeat RateEst. Test Volume# of ControlsEst. 5% Repeat RateEst. Test Volume# of ControlsEst. 5% Repeat RateEst. Test Volume# of ControlsEst. 5% Repeat RateEst. Test Volume# of ControlsEst. 5% Repeat RateEst. Test Volume# of ControlsEst. 5% Repeat Rate
Acetaminophen1,7221,4401583,3201431,080611,284- 0- 01,218611,27932416340ERROR:#REF!
ALBUMIN, Blood122,2802,1606,222130,662133,0592,8806,797142,7367,8817504329,06330,2767501,55132,57724,0501,5001,27826,82852,7511,5002,71356,964ERROR:#REF!
ALBUMIN, Urine19,9907201,03621,74672036756--0- 0- 0- 0- 0ERROR:#REF!
Alkaline Phosphatase120,0962,1606,113128,36986,2407204,34891,3087,6647504218,83528,4637501,46130,67474,1581,5003,78379,44142,6291,5002,20646,335ERROR:#REF!
ALPHA-FETO PROTEIN (AFP)2,6147201673,5011,2101,0801152,405--2,0347501392,9232,5487501653,463ERROR:#REF!
Alanine Aminotransferase (ALT) (SGPT120,0962,1606,113128,36986,3537204,35491,4277,9907504379,17729,0537501,49031,29374,2621,5003,78879,55044,1461,5002,28247,928ERROR:#REF!
Ammonia506730621,2984681,440952,003--8184185953527562ERROR:#REF!
Amphetamines24,2121,4401,28326,93517,4231,44094319,806--18,0621,50097820,54046,1411,5002,38250,023ERROR:#REF!
Amylase, Blood and Urine8,8761,44051610,8321,2787201002,0984375040833209750481,0071,208750982,056330750541,134ERROR:#REF!
Aspartate Aminotransferase (AST) (SGOT)120,0962,1606,113128,36986,3427204,35391,4157,1467503958,29120,9997501,08722,83674,3601,5003,79379,65331,6731,5001,65934,832ERROR:#REF!
Barbiturates24,2122,1601,31927,69117,4261,44094319,809--0- 0- 080484ERROR:#REF!
Benzodiazepines24,2122,1601,31927,69117,4221,44094319,805--18,0621,50097820,54046,0461,5002,37749,923ERROR:#REF!
Benzoylecgonine24,2122,1601,31927,69117,4241,44094319,807--18,06290318,965404ERROR:#REF!
Beta-Hydroxybutyrate528720621,3101851,080631,328--192102021337140ERROR:#REF!
Beta 2 Microglobulin398720561,1741081,080591,247--170917957360ERROR:#REF!
Bicarbonate (CO2)156,8302,1607,950166,940100,3512,8805,162108,3933,5617502164,52723,8187501,22825,796127,8261,5006,466135,79282,8701,5004,21988,589ERROR:#REF!
Bilirubin, Direct13,3382,16077516,27314,00972073615,465--430750591,2391,6807501222,552ERROR:#REF!
Bilirubin, Total120,4562,1606,131128,74785,4867204,31090,5167,6687504218,83928,4997501,46230,71178,6001,5004,00584,10546,6831,5002,40950,592ERROR:#REF!
B-type Natriuretic Peptide (BNP)10,0481,44057412,06211,9972,16070814,865--- 05,7397503246,813ERROR:#REF!
Buprenorphone24,2121,4401,28326,9353,8161,4402635,519--1,5761,5001543,23046,0451,5002,37749,922ERROR:#REF!
CALCIUM, Urine and Blood157,4942,1607,983167,637100,9912,8805,194109,0656,7197503737,84215,53475081417,09820,6901,5001,11023,30040,6281,5002,10644,234ERROR:#REF!
Cannabinoids24,2121,4401,28326,93517,4211,44094319,804--18,2121,50098620,69846,0451,5002,37749,922ERROR:#REF!
CARBAMEZAPINE170720459351381,080611,279--11461201095114ERROR:#REF!
Carcinoembryonic Antigen (CEA)464720591,2434641,080771,621--422750591,231574750661,390ERROR:#REF!
CHLORIDE, URINE, BLOOD and, CSF156,2963,6007,995167,891100,3492,8805,161108,3903,5707502164,53623,8507501,23025,830127,8221,5006,466135,78890,7401,5004,61296,852ERROR:#REF!
Cholesterol, Total, Blood and Fluid69,5601,4403,55074,55056,3581,4402,89060,6886,8727503818,00323,5847501,21725,55150,6261,5002,60654,73226,7491,5001,41229,661ERROR:#REF!
Complement Component 3 (C3)5521,080821,7143591,080721,511--606750681,424370750561,176ERROR:#REF!
Complement Component 4(C4)5881,080831,7513591,080721,511--606750681,424440750601,250ERROR:#REF!
Cortisol2,3287201523,2001,0361,0801062,222--318750531,121890750821,722ERROR:#REF!
C-REACTIVE PROTEIN, High Sensitive9,5401,44054911,52910,9341,44061912,993--2,5587501653,4735,3197503036,372ERROR:#REF!
Creatine Kinase (CK)11,8461,44066413,9507,2041,0804148,698--2,1527501453,0472,2577501503,157ERROR:#REF!
CREATININE, Urine and Blood209,5124,32010,692224,524141,4252,8807,215151,52012,12575064413,51951,5297502,61454,893161,9641,5008,173171,637154,9381,5007,822164,260ERROR:#REF!
DIGOXIN516720621,2985611,080821,723--3075039819624750691,443ERROR:#REF!
Estradiol1,6327201182,4702701,080681,418--250750501,050601750681,419ERROR:#REF!
Ethanol, Urine and Blood27,1744,3201,57533,0692,2472,8802565,383--3,4747502114,4351,4097501082,267ERROR:#REF!
Ferritin7,2247203978,3417,0381,0804068,524--9,61875051810,88610,40875055811,716ERROR:#REF!
FOLIC ACID (Folate)4,7407202735,7334,1091,0802595,448--15,55675081517,12114,15375074515,648ERROR:#REF!
Free T46,7087203717,7999,8982,16060312,661--51,1487502,59554,4936,8587503807,988ERROR:#REF!
Follicle-Stimulating Hormone (FSH)1,152720941,9668741,080982,052--412750581,2201,3197501032,172ERROR:#REF!
Gamma-Glutamyl Transferase (GGT)3,2947302014,2254,1041,4402775,821269750511,0706,7677503767,8934,8321,5003176,6499,9711,50057412,045ERROR:#REF!
GLUCOSE, Urine, Blood, Fluid, CSF157,4442,8808,016168,340134,9392,8806,891144,7108,90175048310,13436,4207501,85939,02984,2641,5004,28890,052105,1861,5005,334112,020ERROR:#REF!
Haptoglobin6021,080841,7661441,080611,285--292750521,094474750611,285ERROR:#REF!
HDL Cholesterol69,4041,4403,54274,38656,2212,8802,95562,0566,8717503818,00223,6207501,21925,58950,5641,5002,60354,66727,7001,5001,46030,660ERROR:#REF!
Hepatitis A IgM1,8667201292,715371,080561,173--075038788466750611,277ERROR:#REF!
Hepatitis A IgG9,86472052911,113- 0--- 0- 0- 0ERROR:#REF!
Hepatitis B Core AB Total1,5847201152,4193,7171,0802405,037--5,1747502966,2205,7487503256,823ERROR:#REF!
Hepatitis B Core IgM2,8927201813,79311,080541,135--075038788336750541,140ERROR:#REF!
Hepatitis B Surface Ab19,26072099920,9795,9911,0803547,425--1,056750901,8967,4237504098,582ERROR:#REF!
Hepatitis B Surface Ag4,2607202495,2295,9051,0803497,334--454750601,2646,7357503747,859ERROR:#REF!
Hepatitis C Ab10,10872054111,36912,3071,08066914,056--6,0807503427,17211,70075062313,073ERROR:#REF!
Hiv- 1/2 Antibody with antigen ("4th generation" HIV testing)7,8001,82548110,1068,4791,44049610,415--2,6927501723,61411,00775058812,345ERROR:#REF!
Homocysteine9001,0951002,0951871,080631,330--76750418671,004750881,842ERROR:#REF!
Human Chorionic Gonadotropin, Beta, Quant (HCG. Beta)97720418587462,1601453,051--738750741,562278750511,079ERROR:#REF!
IgA1,9921,0951543,2412,2561,0801673,503--984750871,8211,173750962,019ERROR:#REF!
IgG1,5241,0951312,7501,6551,0801372,872--450750601,2601,173750962,019ERROR:#REF!
IgM1,4641,0951282,6871,6551,0801372,872--392750571,1991,173750962,019ERROR:#REF!
IRON8,8321,44051410,7867,4251,0804258,930--9,6181,50055611,67410,5261,50060112,627ERROR:#REF!
LACTIC ACID, BLOOD and CSF11,5681,44065013,6583,3072,8803096,496--5,4321,5003477,27911,3511,50064313,494ERROR:#REF!
Lactate Dehydrogenase, Blood, Fluid, CSF (LDH)1,254720992,0732,3667201543,240231750491,0305,6657503216,7361,2861,5001392,92510,6281,50060612,734ERROR:#REF!
LDL Cholesterol, Direct3,2461,4402344,9202,0591,4401753,674281750521,0832,7367501743,66050,5647502,56653,8805,2667503016,317ERROR:#REF!
Lipase9,9101,44056811,9185,5461,4403497,335--5,6287503196,6972,9847501873,921ERROR:#REF!
Lithium550720641,334906720811,707--420750591,229745750751,570ERROR:#REF!
Lutenizing Hormone (LH)1,032720881,8407641,080921,936--558750651,3731,2987501022,150ERROR:#REF!
Magnesium, Blood and Urine39,6721,4402,05643,16835,9922,8801,94440,816836750791,6653,3547502054,30936,9641,5001,92340,38739,9231,5002,07143,494ERROR:#REF!
Methadone24,2127201,24726,17917,4261,44094319,809--18,0661,50097820,54446,0451,5002,37749,922ERROR:#REF!
Microalbumin19,9167201,03221,66812,8741,44071615,030--29,1361,5001,53232,16825,4751,5001,34928,324ERROR:#REF!
Opiates24,2121,4401,28326,93517,4251,44094319,808--18,0621,50097820,54046,0451,5002,37749,922ERROR:#REF!
Oxycodone24,2121,4401,28326,93517,4241,44094319,807--18,0621,50097820,54046,0451,5002,37749,922ERROR:#REF!
PARATHYROID HORMONE (Intra)25030028578
PHENYTOIN, (Dilantin)226720479931351,080611,276--2812925813271ERROR:#REF!
PHOSPHORUS, Urine, Blood33,1321,4401,72936,30189,1342,8804,60196,615662750711,4832,9457501853,88026,6261,5001,40629,53228,3581,5001,49331,351ERROR:#REF!
POTASSIUM, Urine, Blood158,1443,6008,087169,831134,9192,8806,890144,6898,89775048210,12926,2297501,34928,328128,1441,5006,482136,12697,6231,5004,956104,079ERROR:#REF!
Prealbumin2841,095691,4481,1311,0801112,322--278750511,079397750571,204ERROR:#REF!
Prolactin1,020720871,8278881,080982,066--594750671,4111,119750931,962ERROR:#REF!
Prostate Specific Antigen (PSA)26,3101,4401,38829,13820,2022,1601,11823,480--25,8181,5001,36628,68427,2211,5001,43630,157ERROR:#REF!
PSA, Free3,2407201984,1587373--4224451426540ERROR:#REF!
Protein, TOTOAL Blood, Urine and Fluid161,2202,1608,169171,54913,1402,88080116,821116750439098,4087504589,6164,8481,5003176,66510,9251,50062113,046ERROR:#REF!
Rheumatoid Factor1,2601,0951182,4738031,080941,977--1,8187501282,6961,235750992,084ERROR:#REF!
Salicylate1,7167201222,5581161,080601,256--1,216750982,064255750501,055ERROR:#REF!
SODIUM, Urine and Blood158,1403,6008,087169,827135,3742,8806,913145,1678,88075048210,11236,6397501,86939,258129,0287506,489136,267106,8227505,379112,951ERROR:#REF!
TESTOSTERONE, Total4,1727202455,1374,5001,0802795,859--4,9461,5003226,7685,6091,5003557,464ERROR:#REF!
Theophylline15672044920151,080551,150--3423626127ERROR:#REF!
Thyroid-Stimulating Hormone (TSH)60,4741,4403,09665,01042,2392,1602,22046,619--51,1701,5002,63455,30449,3741,5002,54453,418ERROR:#REF!
TRANSFERRIN8,9042,19055511,6497,4771,0804288,985--9,6181,50055611,67410,4531,50059812,551ERROR:#REF!
Triglycerides69,7461,4403,55974,74556,4901,4402,89760,8276,8727503818,00323,5717501,21625,53750,6521,5002,60854,76027,7491,5001,46230,711ERROR:#REF!
Troponin15,4081,44084217,69010,8184,32075715,895--14,8821,50081917,2017,8161,5004669,782ERROR:#REF!
UREA NITROGEN, Urine and Blood157,4802,8808,018168,378292720511,0638,87775048110,10836,5927501,86739,209128,3781,5006,494136,37299,0951,5005,030105,625ERROR:#REF!
URIC ACID, Urine and Blood4,9687202845,9727,8657204299,014448750601,2581,8247501292,7034,2481,5002876,0352,8861,5002194,605ERROR:#REF!
Valproic Acid1,070720901,880580720651,365--586750671,4031,3637501062,219ERROR:#REF!
Vancomycin1,044720881,8521,9391,4401693,548--764750761,5901,9697501362,855ERROR:#REF!
Vitamin B-121,5407201132,373
Vit-D-25 Hydroxy Total44,0007202,23646,95619,1132,1601,06422,337--16,1501,50088318,53330,3901,5001,59533,485ERROR:#REF!
Free T31,3807201052,2051291,080601,269--1005105202ERROR:#REF!
Hemoglobin A1c76,2003,0003,96083,16057,2537202,89960,872--55,2162,76157,97769,5743,47973,053ERROR:#REF!
Procalcitonin1,5481,0801312,759721,080581,210--0750387881,135750941,979ERROR:#REF!
Tacrolimus (EK506)2,1367201432,9996021,080841,766--414750581,222614750681,432ERROR:#REF!
3,088,781130,545160,9663,380,2922,109,932136,440112,3152,358,687123,38018,0007,069148,449490,58418,00025,429534,0131,989,10887,000103,8052,179,9131,875,50587,75098,1632,061,418ERROR:#REF!

3. REAGENT CPT

PARTIAL COST PER TEST
(Cost of single test including all Reagents and Consumables Only)VISN22

ANNUAL VOLUME PER TEST

(VOLUME PROVIDED FOR INFORMATIONAL PURPOSES ONLY ---DO NOT PROVIDE AN EXTENDED OR PACKAGE COST)Please identify what Reagents and Consumables are required to run a single test
Acetaminophen3,320
ALBUMIN, Blood130,662
ALBUMIN, Urine21,746
Alkaline Phosphatase128,369
ALPHA-FETO PROTEIN (AFP)3,501
Alanine Aminotransferase (ALT) (SGPT128,369
Ammonia1,298
Amphetamines26,935
Amylase, Blood and Urine10,832
Aspartate Aminotransferase (AST) (SGOT)128,369
Barbiturates27,691
Benzodiazepines27,691
Benzoylecgonine27,691
Beta-Hydroxybutyrate1,310
Beta 2 Microglobulin1,174
Bicarbonate (CO2)166,940
Bilirubin, Direct16,273
Bilirubin, Total128,747
B-type Natriuretic Peptide (BNP)12,062
Buprenorphone26,935
CALCIUM, Urine and Blood167,637
Cannabinoids26,935
CARBAMEZAPINE935
Carcinoembryonic Antigen (CEA)1,243
CHLORIDE, URINE, BLOOD and, CSF167,891
Cholesterol, Total, Blood and Fluid74,550
Complement Component 3 (C3)1,714
Complement Component 4(C4)1,751
Cortisol3,200
C-REACTIVE PROTEIN, High Sensitive11,529
Creatine Kinase (CK)13,950
CREATININE, Urine and Blood224,524
DIGOXIN1,298
Estradiol2,470
Ethanol, Urine and Blood33,069
Ferritin8,341
FOLIC ACID (Folate)5,733
Free T47,799
Follicle-Stimulating Hormone (FSH)1,966
Gamma-Glutamyl Transferase (GGT)4,225
GLUCOSE, Urine, Blood, Fluid, CSF168,340
Haptoglobin1,766
HDL Cholesterol74,386
Hepatitis A IgM2,715
Hepatitis A IgG11,113
Hepatitis B Core AB Total2,419
Hepatitis B Core IgM3,793
Hepatitis B Surface Ab20,979
Hepatitis B Surface Ag5,229
Hepatitis C Ab11,369
Hiv- 1/2 Antibody with antigen ("4th generation" HIV testing)10,106
Homocysteine2,095
Human Chorionic Gonadotropin, Beta, Quant (HCG. Beta)858
IgA3,241
IgG2,750
IgM2,687
IRON10,786
LACTIC ACID, BLOOD and CSF13,658
Lactate Dehydrogenase, Blood, Fluid, CSF (LDH)2,073
LDL Cholesterol, Direct4,920
Lipase11,918
Lithium1,334
Lutenizing Hormone (LH)1,840
Magnesium, Blood and Urine43,168
Methadone26,179
Microalbumin21,668
Opiates26,935
Oxycodone26,935
PARATHYROID HORMONE (Intra)578
PHENYTOIN, (Dilantin)993
PHOSPHORUS, Urine, Blood36,301
POTASSIUM, Urine, Blood169,831
Prealbumin1,448
Prolactin1,827
Prostate Specific Antigen (PSA)29,138
PSA, Free4,158
Protein, TOTOAL Blood, Urine and Fluid171,549
Rheumatoid Factor2,473
Salicylate2,558
SODIUM, Urine and Blood169,827
TESTOSTERONE, Total5,137
Theophylline920
Thyroid-Stimulating Hormone (TSH)65,010
TRANSFERRIN11,649
Triglycerides74,745
Troponin17,690
UREA NITROGEN, Urine and Blood168,378
URIC ACID, Urine and Blood5,972
Valproic Acid1,880
Vancomycin1,852
Vitamin B 122,373
Vit-D-25 Hydroxy Total46,956
Free T32,205
Hemoglobin A1c83,160
Procalcitonin2,759
Tacrolimus (EK506)2,999
3,380,301

4. PROPOSED INSTRUMENTS

Instruments Part/Product # Cost Prescott VISN 22

EXTENDED

COSTS

Description
CHEMISTRY
Instrument A1000 (example)(Example, please replace with actual price and item)$100,000.0000$0.0000
Instrument B2000 (example)(Example, please replace with actual price and item)$150,000.0000$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
IMMUNOCHEMISTRY$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
CENTRIFUGES$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
REFRIGERATED STORAGE$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
ALIQUOTTER$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
BULK INPUT$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
Contractor Misc$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
Installation$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
Track - Automation Line$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
Training$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000

5. SERVICE

Annual Service Cost (as outlined in SOW)PhoenixNew Mexico
Total Number of years =
5
Annual Service Cost (Example)$ 20,000.00$ 1,000.00$21,000.0000(Example, please replace with actual price)
Software License A (example)$ 10,000.00$ 10,000.00$20,000.0000(Example, please replace with actual price)
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
$0.0000
Total 5yrs$ 30,000.00Total Annual Service Cost$30,000.0000

6. OPT TESTS

Optional Tests (INFORMATIONAL PURPOSES ONLY - * Please list all controls available)PARTIAL COST OF TEST
(Cost of single test including all Reagents and Consumables Only; )Please identify what Reagents and Consumables are required to run a single test

7. Proposed Total

TermsYearly CostCPT
Base Year
Base Year 2
Base Year 3
Base Year 4
Base Year 5

Total Amount $ - 0

File details come from the government source that posted it. Updated .