Attachment A. Price Schedule.xlsx

XLSX spreadsheet 14 KB Posted

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6505--Radiopharmaceutical Tests/Supplies
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36C24121Q0160
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Attachment A. Price Schedule 02.xlsx XLSX spreadsheet
36C24121Q0160.docx DOCX document

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Sheet1

Item #Description/Part NumberQuantityBase Year Cost Per ItemBase Year Total CostYear Two Cost Per ItemYear Two Total CostYear Three Cost Per ItemYear Three Total CostYear Four Cost Per ItemYear Four Total CostYear Five Cost Per ItemYear Five Total Cost
1Tc99m Medronate UD20
2Tc99m Oxidronate220
3Tc99m Macro Aggreated Albumin UD150
4Tc99m Sulfur Colloid40
5Tc99m Filtered Sulfur Colloid (uCi) UD100
6Tc99m Pentetate UD2
7DMSA Tc99m UD5
899mTc- Heat Denatured RBCs5
9Tc99m Disofenin UD10
10Tc99m Mertiatide20
11Tc99m NaTc04 MD11000
12Sr89 Strontium Chloride Dose1
13I-123 100 uCi5
14I-123 200 uCi40
15I-123 Iobenguane Sulfate 1-10 mCi3
16I-131 DX Capsule 10-100 uCi Cap5
17I-131 DX/TX Capsule 1 -6 mCi12
18I-131 DX/TX Capsule each add'l mCi1000
19In-111 Pentetreotide UD20
20Tc99m Tetrofosmin UD2225
21Tc99m Sestamibi Generic UD25
22Tl-201Thallous Chloride mCi50
23Tc99m Exemetazime WBCs10
24In-111 Indium Oxine WBCs2
25In111Pentetate1
26Medronate Vial5
27Oxidronate Vial30
28Pentetate Vial50
29Succimer Vial5
30Macro Aggregated Albumin Vial50
31Disofenin Vial10
32Mebrofenin Vial20
33Sincalide Vial20
34Pyrophosphate Vial50
35F-18 FDG UD520
36F-18 FDG MD2000
37F-18 FDG UD Source20
38NaF - 18 (8-15 mCi)50
39Co-57 pen point marker (200 uCi)2
40Co-57 rod source (100 uCi/rod)2
41Cs-137 rod source (0.5uCi/rod)2
42Cs-137 rod source (0.1uCi/rod)2
43Co-57 syringe source ? 5mCi4
44Cs-137 disc source (10uCi/disc)2
45Ba-133 vial source (250uCi/vial2
46Co-57 Flood Sheet4
47NA-222 Button Source6
48Cs-137 vial source (200uCi/vial)2
49Na-22 line source (100uCi/source)1
50Emergency Weekday75
51Emergency Weekend and Holiday30
52Tc99m Pentetate UD80
53Tc99m Mebrofenin UD40
54Xenon (20 mCi)110
55WBC Setup25
56Hetastarch12
0000Total
0

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