Attachment A Pricing Sheet.xls
XLS spreadsheet 80 KB Posted
- Attached to
- AFRH Dental Services
- Solicitation number
- 20342326Q00004
About this file
This is a pricing sheet for a Request for Quote (RFQ) for dental services at the Armed Forces Retirement Home (AFRH) in Washington, D.C. The solicitation (RFQ 20342326Q00004) is a small business set-aside for a firm fixed-price contract covering a base period from 01/01/2026 to 12/31/2026 and two optional 12-month periods through 12/31/2028. The comprehensive pricing sheet details unit prices and estimated quantities for a wide range of dental procedures, including diagnostics, preventive care, restorative services, dentures, oral surgery, endodontics, and miscellaneous treatments.
Key submission details include a deadline for questions by 10:00am ET on October 02, 2025, and proposal submissions due by 10:00am ET on October 14, 2025. Electronic quotations must be sent to purchasing@fiscal.treasury.gov and brittany.coffman@fiscal.treasury.gov. Offerors are required to have an unexpired SAM.gov registration and Unique Entity Identifier (UEI). The solicitation is issued by the Department of the Treasury Bureau of the Fiscal Service, with the pricing sheet showing zero-dollar placeholders for vendors to complete their proposed unit prices across three contract periods.
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Other files
| File | Type | Posted |
|---|---|---|
| Amend 0004 Att A Pricing Sheet.xls | XLS spreadsheet | |
| Amend 0003 RFQ 20342326Q00004.pdf | ||
| Amend 0003 Att A Pricing Sheet.xls | XLS spreadsheet | |
| RFQ 20342326Q00004 QAComplete.xlsx | XLSX spreadsheet | |
| Attachment B- Historical Procedures.pdf | ||
| RFQ 20342326Q00004.pdf |
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Text version
Base Year
| Pricing Sheet | ||||
| RFQ 20342326Q00004 AFRH Dental Services | ||||
| Base Year: POP: 01/01/2026 - 12/31/2026 | ||||
| Type- Item/Procedure | Description- Item/Procedure | Unit Price | Estimated Qty Base Period | Extended Total |
| DIAGNOSTIC | Oral Exam (Periodic/Comp./Limited) | $ - 0 | 150 | $ - 0 |
| Intraoral comprehensive series | $ - 0 | 15 | $ - 0 | |
| Intraoral periapical x-ray (1) | $ - 0 | 90 | $ - 0 | |
| Intraoral periapical (additional) | $ - 0 | 40 | $ - 0 | |
| Bitewing-1 film | $ - 0 | 15 | $ - 0 | |
| Bitewing-2 films | $ - 0 | 25 | $ - 0 | |
| Bitewing-3 films | $ - 0 | 12 | $ - 0 | |
| Bitewing-4 films | $ - 0 | 30 | $ - 0 | |
| PREVENTIVE | Adult Prophylaxis | $ - 0 | 130 | $ - 0 |
| Fluoride Treatment (Adult) | $ - 0 | 129 | $ - 0 | |
| Scaling/Full Mouth Debridement | $ - 0 | 40 | $ - 0 | |
| Scaling & Root Planning (Per Quad) | $ - 0 | 35 | $ - 0 | |
| RESTORATIVE | Composite-1 surface | $ - 0 | 25 | $ - 0 |
| Composite-2 surface | $ - 0 | 20 | $ - 0 | |
| Composite-3 surface | $ - 0 | 20 | $ - 0 | |
| Composite-4 surface | $ - 0 | 15 | $ - 0 | |
| Composite-1 surface (P) | $ - 0 | 8 | $ - 0 | |
| Composite-2 surface (P) | $ - 0 | 8 | $ - 0 | |
| Composite-3 surface (P) | $ - 0 | 12 | $ - 0 | |
| Composite-4 surface (P) | $ - 0 | 12 | $ - 0 | |
| Amalgam-1 surface | $ - 0 | 16 | $ - 0 | |
| Amalgam-2 surface | $ - 0 | 24 | $ - 0 | |
| Amalgam-3 surface | $ - 0 | 20 | $ - 0 | |
| Amalgam-4 surface | $ - 0 | 8 | $ - 0 | |
| Pin | $ - 0 | 12 | $ - 0 | |
| Core Buildup | $ - 0 | 12 | $ - 0 | |
| Post & Core | $ - 0 | 20 | $ - 0 | |
| PFM/Porcelain Crown | $ - 0 | 25 | $ - 0 | |
| Insert PFM/Porcelain Crown | $ - 0 | 30 | $ - 0 | |
| Gold Crown | $ - 0 | 12 | $ - 0 | |
| Insert Gold Crown | $ - 0 | 16 | $ - 0 | |
| Sedative Filling | $ - 0 | 20 | $ - 0 | |
| DENTURES | Complete Upper Denture | $ - 0 | 20 | $ - 0 |
| Preliminary Impression | $ - 0 | 16 | $ - 0 | |
| Final Impression | $ - 0 | 12 | $ - 0 | |
| Bite Block | $ - 0 | 16 | $ - 0 | |
| Wax Tryin | $ - 0 | 20 | $ - 0 | |
| Deliver Denture | $ - 0 | 20 | $ - 0 | |
| Complete Lower Denture | $ - 0 | $ - 0 | ||
| Preliminary Impression | $ - 0 | 12 | $ - 0 | |
| Final Impression | $ - 0 | 9 | $ - 0 | |
| Bite Block | $ - 0 | 12 | $ - 0 | |
| Wax Tryin | $ - 0 | 12 | $ - 0 | |
| Deliver Denture | $ - 0 | 12 | $ - 0 | |
| Immediate Upper Denture | $ - 0 | $ - 0 | ||
| Preliminary Impression | $ - 0 | 12 | $ - 0 | |
| Final Impression | $ - 0 | 9 | $ - 0 | |
| Bite Block | $ - 0 | 12 | $ - 0 | |
| Wax Tryin | $ - 0 | 12 | $ - 0 | |
| Deliver Denture | $ - 0 | 12 | $ - 0 | |
| Immediate Lower Denture | $ - 0 | 12 | $ - 0 | |
| Preliminary Impression | $ - 0 | 12 | $ - 0 | |
| Final Impression | $ - 0 | 9 | $ - 0 | |
| Bite Block | $ - 0 | 12 | $ - 0 | |
| Wax Tryin | $ - 0 | 12 | $ - 0 | |
| Deliver Denture | $ - 0 | 12 | $ - 0 | |
| PARTIALS | Upper Partial | $ - 0 | 12 | $ - 0 |
| Preliminary Impression | $ - 0 | 12 | $ - 0 | |
| Final Impression | $ - 0 | 9 | $ - 0 | |
| Bite Block | $ - 0 | 12 | $ - 0 | |
| Wax Tryin | $ - 0 | 12 | $ - 0 | |
| Deliver Partial | $ - 0 | 12 | $ - 0 | |
| Lower Partial | $ - 0 | $ - 0 | ||
| Preliminary Impression | $ - 0 | 8 | $ - 0 | |
| Final Impression | $ - 0 | 8 | $ - 0 | |
| Bite Block | $ - 0 | 8 | $ - 0 | |
| Wax Tryin | $ - 0 | 8 | $ - 0 | |
| Deliver Partial | $ - 0 | 8 | $ - 0 | |
| Repair/Add Clasp | $ - 0 | 8 | $ - 0 | |
| Interim Partial/Flipper-Max. | $ - 0 | 8 | $ - 0 | |
| Interim Partial/Flipper-Mand. | $ - 0 | 8 | $ - 0 | |
| Reline Upper Denture | $ - 0 | 8 | $ - 0 | |
| Reline Lower Denture | $ - 0 | 8 | $ - 0 | |
| Reline Upper Partial | $ - 0 | 8 | $ - 0 | |
| Reline Lower Partial | $ - 0 | 8 | $ - 0 | |
| Add Tooth to Partial | $ - 0 | 9 | $ - 0 | |
| Add Tooth to Denture | $ - 0 | 9 | $ - 0 | |
| Denture/Partial Repair | $ - 0 | 9 | $ - 0 | |
| ORAL SURGERY | Extraction/Single Tooth | $ - 0 | 9 | $ - 0 |
| Extraction Add'l Tooth | $ - 0 | 9 | $ - 0 | |
| Root Removal | $ - 0 | 9 | $ - 0 | |
| Surgical Extraction | $ - 0 | 9 | $ - 0 | |
| Surgical Root Removal | $ - 0 | 6 | $ - 0 | |
| ENDODONTICS | Root Canal Anterior | $ - 0 | 6 | $ - 0 |
| Root Canal Bicuspid | $ - 0 | 6 | $ - 0 | |
| Root Canal Molar | $ - 0 | 6 | $ - 0 | |
| RCT Re-Treat (Anterior) | $ - 0 | 6 | $ - 0 | |
| RCT Re-Treat (Bicuspid) | $ - 0 | 6 | $ - 0 | |
| RCT Re-Treat (Molar) | $ - 0 | 6 | $ - 0 | |
| FIXED | Bridge Abutment | $ - 0 | 6 | $ - 0 |
| PROSTHODONTICS | Bridge Pontic | $ - 0 | 6 | $ - 0 |
| Deliver Bridge Per Unit | $ - 0 | 6 | $ - 0 | |
| Recement Bridge | $ - 0 | 6 | $ - 0 | |
| Recement Crown | $ - 0 | 8 | $ - 0 | |
| MISCELLANEOUS | Consultation | $ - 0 | 12 | $ - 0 |
| Palliative | $ - 0 | 12 | $ - 0 | |
| OTHER | Nightguard | $ - 0 | 6 | $ - 0 |
| Broken Appointment Fee | $ - 0 | 12 | $ - 0 | |
| Panoramic | $ - 0 | 10 | $ - 0 | |
| Local Admin. Antibiotic Per Site | $ - 0 | 6 | $ - 0 | |
| Base Year Total: | $0.00 | |||
| Please see each of the three (3) tabs to fill in item/procedure prices. ** |
&LAttachment A
RFQ 20342326Q00004
Option Year- 1
| Pricing Sheet | ||||
| RFQ 20342325Q00027 AFRH Dental Services | ||||
| Option Year 1 POP: 01/01/2027 - 12/31/2027 | ||||
| Type- Item/Procedure | Description- Item/Procedure | Unit Price | Estimated Qty Option Period 1 | Extended Total |
| DIAGNOSTIC | Oral Exam (Periodic/Comp./Limited) | $ - 0 | 150 | $ - 0 |
| Intraoral comprehensive series | $ - 0 | 15 | $ - 0 | |
| Intraoral periapical x-ray (1) | $ - 0 | 90 | $ - 0 | |
| Intraoral periapical (additional) | $ - 0 | 40 | $ - 0 | |
| Bitewing-1 film | $ - 0 | 15 | $ - 0 | |
| Bitewing-2 films | $ - 0 | 25 | $ - 0 | |
| Bitewing-3 films | $ - 0 | 12 | $ - 0 | |
| Bitewing-4 films | $ - 0 | 30 | $ - 0 | |
| PREVENTIVE | Adult Prophylaxis | $ - 0 | 130 | $ - 0 |
| Fluoride Treatment (Adult) | $ - 0 | 129 | $ - 0 | |
| Scaling/Full Mouth Debridement | $ - 0 | 40 | $ - 0 | |
| Scaling & Root Planning (Per Quad) | $ - 0 | 35 | $ - 0 | |
| RESTORATIVE | Composite-1 surface | $ - 0 | 25 | $ - 0 |
| Composite-2 surface | $ - 0 | 20 | $ - 0 | |
| Composite-3 surface | $ - 0 | 20 | $ - 0 | |
| Composite-4 surface | $ - 0 | 15 | $ - 0 | |
| Composite-1 surface (P) | $ - 0 | 8 | $ - 0 | |
| Composite-2 surface (P) | $ - 0 | 8 | $ - 0 | |
| Composite-3 surface (P) | $ - 0 | 12 | $ - 0 | |
| Composite-4 surface (P) | $ - 0 | 12 | $ - 0 | |
| Amalgam-1 surface | $ - 0 | 16 | $ - 0 | |
| Amalgam-2 surface | $ - 0 | 24 | $ - 0 | |
| Amalgam-3 surface | $ - 0 | 20 | $ - 0 | |
| Amalgam-4 surface | $ - 0 | 8 | $ - 0 | |
| Pin | $ - 0 | 12 | $ - 0 | |
| Core Buildup | $ - 0 | 12 | $ - 0 | |
| Post & Core | $ - 0 | 20 | $ - 0 | |
| PFM/Porcelain Crown | $ - 0 | 25 | $ - 0 | |
| Insert PFM/Porcelain Crown | $ - 0 | 30 | $ - 0 | |
| Gold Crown | $ - 0 | 12 | $ - 0 | |
| Insert Gold Crown | $ - 0 | 16 | $ - 0 | |
| Sedative Filling | $ - 0 | 20 | $ - 0 | |
| DENTURES | Complete Upper Denture | $ - 0 | 20 | $ - 0 |
| Preliminary Impression | $ - 0 | 16 | $ - 0 | |
| Final Impression | $ - 0 | 12 | $ - 0 | |
| Bite Block | $ - 0 | 16 | $ - 0 | |
| Wax Tryin | $ - 0 | 20 | $ - 0 | |
| Deliver Denture | $ - 0 | 20 | $ - 0 | |
| Complete Lower Denture | $ - 0 | $ - 0 | ||
| Preliminary Impression | $ - 0 | 12 | $ - 0 | |
| Final Impression | $ - 0 | 9 | $ - 0 | |
| Bite Block | $ - 0 | 12 | $ - 0 | |
| Wax Tryin | $ - 0 | 12 | $ - 0 | |
| Deliver Denture | $ - 0 | 12 | $ - 0 | |
| Immediate Upper Denture | $ - 0 | $ - 0 | ||
| Preliminary Impression | $ - 0 | 12 | $ - 0 | |
| Final Impression | $ - 0 | 9 | $ - 0 | |
| Bite Block | $ - 0 | 12 | $ - 0 | |
| Wax Tryin | $ - 0 | 12 | $ - 0 | |
| Deliver Denture | $ - 0 | 12 | $ - 0 | |
| Immediate Lower Denture | $ - 0 | 12 | $ - 0 | |
| Preliminary Impression | $ - 0 | 12 | $ - 0 | |
| Final Impression | $ - 0 | 9 | $ - 0 | |
| Bite Block | $ - 0 | 12 | $ - 0 | |
| Wax Tryin | $ - 0 | 12 | $ - 0 | |
| Deliver Denture | $ - 0 | 12 | $ - 0 | |
| PARTIALS | Upper Partial | $ - 0 | 12 | $ - 0 |
| Preliminary Impression | $ - 0 | 12 | $ - 0 | |
| Final Impression | $ - 0 | 9 | $ - 0 | |
| Bite Block | $ - 0 | 12 | $ - 0 | |
| Wax Tryin | $ - 0 | 12 | $ - 0 | |
| Deliver Partial | $ - 0 | 12 | $ - 0 | |
| Lower Partial | $ - 0 | $ - 0 | ||
| Preliminary Impression | $ - 0 | 8 | $ - 0 | |
| Final Impression | $ - 0 | 8 | $ - 0 | |
| Bite Block | $ - 0 | 8 | $ - 0 | |
| Wax Tryin | $ - 0 | 8 | $ - 0 | |
| Deliver Partial | $ - 0 | 8 | $ - 0 | |
| Repair/Add Clasp | $ - 0 | 8 | $ - 0 | |
| Interim Partial/Flipper-Max. | $ - 0 | 8 | $ - 0 | |
| Interim Partial/Flipper-Mand. | $ - 0 | 8 | $ - 0 | |
| Reline Upper Denture | $ - 0 | 8 | $ - 0 | |
| Reline Lower Denture | $ - 0 | 8 | $ - 0 | |
| Reline Upper Partial | $ - 0 | 8 | $ - 0 | |
| Reline Lower Partial | $ - 0 | 8 | $ - 0 | |
| Add Tooth to Partial | $ - 0 | 9 | $ - 0 | |
| Add Tooth to Denture | $ - 0 | 9 | $ - 0 | |
| Denture/Partial Repair | $ - 0 | 9 | $ - 0 | |
| ORAL SURGERY | Extraction/Single Tooth | $ - 0 | 9 | $ - 0 |
| Extraction Add'l Tooth | $ - 0 | 9 | $ - 0 | |
| Root Removal | $ - 0 | 9 | $ - 0 | |
| Surgical Extraction | $ - 0 | 9 | $ - 0 | |
| Surgical Root Removal | $ - 0 | 6 | $ - 0 | |
| ENDODONTICS | Root Canal Anterior | $ - 0 | 6 | $ - 0 |
| Root Canal Bicuspid | $ - 0 | 6 | $ - 0 | |
| Root Canal Molar | $ - 0 | 6 | $ - 0 | |
| RCT Re-Treat (Anterior) | $ - 0 | 6 | $ - 0 | |
| RCT Re-Treat (Bicuspid) | $ - 0 | 6 | $ - 0 | |
| RCT Re-Treat (Molar) | $ - 0 | 6 | $ - 0 | |
| FIXED | Bridge Abutment | $ - 0 | 6 | $ - 0 |
| PROSTHODONTICS | Bridge Pontic | $ - 0 | 6 | $ - 0 |
| Deliver Bridge Per Unit | $ - 0 | 6 | $ - 0 | |
| Recement Bridge | $ - 0 | 6 | $ - 0 | |
| Recement Crown | $ - 0 | 8 | $ - 0 | |
| MISCELLANEOUS | Consultation | $ - 0 | 12 | $ - 0 |
| Palliative | $ - 0 | 12 | $ - 0 | |
| OTHER | Nightguard | $ - 0 | 6 | $ - 0 |
| Broken Appointment Fee | $ - 0 | 12 | $ - 0 | |
| Panoramic | $ - 0 | 10 | $ - 0 | |
| Local Admin. Antibiotic Per Site | $ - 0 | 6 | $ - 0 | |
| Option Period 1 Total: | $0.00 | |||
| Please see each of the three (3) tabs to fill in item/procedure prices. ** |
&LAttachment A
RFQ 20342326Q00004
Option Year- 2
| Pricing Sheet | ||||
| RFQ 20342325Q00027 AFRH Dental Services | ||||
| Option Year 2 POP: 01/01/2028 - 03/31/2028 | ||||
| Type- Item/Procedure | Description- Item/Procedure | Unit Price | Estimated Qty Option Period 2 | Extended Total |
| DIAGNOSTIC | Oral Exam (Periodic/Comp./Limited) | $ - 0 | 150 | $ - 0 |
| Intraoral comprehensive series | $ - 0 | 15 | $ - 0 | |
| Intraoral periapical x-ray (1) | $ - 0 | 90 | $ - 0 | |
| Intraoral periapical (additional) | $ - 0 | 40 | $ - 0 | |
| Bitewing-1 film | $ - 0 | 15 | $ - 0 | |
| Bitewing-2 films | $ - 0 | 25 | $ - 0 | |
| Bitewing-3 films | $ - 0 | 12 | $ - 0 | |
| Bitewing-4 films | $ - 0 | 30 | $ - 0 | |
| PREVENTIVE | Adult Prophylaxis | $ - 0 | 130 | $ - 0 |
| Fluoride Treatment (Adult) | $ - 0 | 129 | $ - 0 | |
| Scaling/Full Mouth Debridement | $ - 0 | 40 | $ - 0 | |
| Scaling & Root Planning (Per Quad) | $ - 0 | 35 | $ - 0 | |
| RESTORATIVE | Composite-1 surface | $ - 0 | 25 | $ - 0 |
| Composite-2 surface | $ - 0 | 20 | $ - 0 | |
| Composite-3 surface | $ - 0 | 20 | $ - 0 | |
| Composite-4 surface | $ - 0 | 15 | $ - 0 | |
| Composite-1 surface (P) | $ - 0 | 8 | $ - 0 | |
| Composite-2 surface (P) | $ - 0 | 8 | $ - 0 | |
| Composite-3 surface (P) | $ - 0 | 12 | $ - 0 | |
| Composite-4 surface (P) | $ - 0 | 12 | $ - 0 | |
| Amalgam-1 surface | $ - 0 | 16 | $ - 0 | |
| Amalgam-2 surface | $ - 0 | 24 | $ - 0 | |
| Amalgam-3 surface | $ - 0 | 20 | $ - 0 | |
| Amalgam-4 surface | $ - 0 | 8 | $ - 0 | |
| Pin | $ - 0 | 12 | $ - 0 | |
| Core Buildup | $ - 0 | 12 | $ - 0 | |
| Post & Core | $ - 0 | 20 | $ - 0 | |
| PFM/Porcelain Crown | $ - 0 | 25 | $ - 0 | |
| Insert PFM/Porcelain Crown | $ - 0 | 30 | $ - 0 | |
| Gold Crown | $ - 0 | 12 | $ - 0 | |
| Insert Gold Crown | $ - 0 | 16 | $ - 0 | |
| Sedative Filling | $ - 0 | 20 | $ - 0 | |
| DENTURES | Complete Upper Denture | $ - 0 | 20 | $ - 0 |
| Preliminary Impression | $ - 0 | 16 | $ - 0 | |
| Final Impression | $ - 0 | 12 | $ - 0 | |
| Bite Block | $ - 0 | 16 | $ - 0 | |
| Wax Tryin | $ - 0 | 20 | $ - 0 | |
| Deliver Denture | $ - 0 | 20 | $ - 0 | |
| Complete Lower Denture | $ - 0 | $ - 0 | ||
| Preliminary Impression | $ - 0 | 12 | $ - 0 | |
| Final Impression | $ - 0 | 9 | $ - 0 | |
| Bite Block | $ - 0 | 12 | $ - 0 | |
| Wax Tryin | $ - 0 | 12 | $ - 0 | |
| Deliver Denture | $ - 0 | 12 | $ - 0 | |
| Immediate Upper Denture | $ - 0 | $ - 0 | ||
| Preliminary Impression | $ - 0 | 12 | $ - 0 | |
| Final Impression | $ - 0 | 9 | $ - 0 | |
| Bite Block | $ - 0 | 12 | $ - 0 | |
| Wax Tryin | $ - 0 | 12 | $ - 0 | |
| Deliver Denture | $ - 0 | 12 | $ - 0 | |
| Immediate Lower Denture | $ - 0 | 12 | $ - 0 | |
| Preliminary Impression | $ - 0 | 12 | $ - 0 | |
| Final Impression | $ - 0 | 9 | $ - 0 | |
| Bite Block | $ - 0 | 12 | $ - 0 | |
| Wax Tryin | $ - 0 | 12 | $ - 0 | |
| Deliver Denture | $ - 0 | 12 | $ - 0 | |
| PARTIALS | Upper Partial | $ - 0 | 12 | $ - 0 |
| Preliminary Impression | $ - 0 | 12 | $ - 0 | |
| Final Impression | $ - 0 | 9 | $ - 0 | |
| Bite Block | $ - 0 | 12 | $ - 0 | |
| Wax Tryin | $ - 0 | 12 | $ - 0 | |
| Deliver Partial | $ - 0 | 12 | $ - 0 | |
| Lower Partial | $ - 0 | $ - 0 | ||
| Preliminary Impression | $ - 0 | 8 | $ - 0 | |
| Final Impression | $ - 0 | 8 | $ - 0 | |
| Bite Block | $ - 0 | 8 | $ - 0 | |
| Wax Tryin | $ - 0 | 8 | $ - 0 | |
| Deliver Partial | $ - 0 | 8 | $ - 0 | |
| Repair/Add Clasp | $ - 0 | 8 | $ - 0 | |
| Interim Partial/Flipper-Max. | $ - 0 | 8 | $ - 0 | |
| Interim Partial/Flipper-Mand. | $ - 0 | 8 | $ - 0 | |
| Reline Upper Denture | $ - 0 | 8 | $ - 0 | |
| Reline Lower Denture | $ - 0 | 8 | $ - 0 | |
| Reline Upper Partial | $ - 0 | 8 | $ - 0 | |
| Reline Lower Partial | $ - 0 | 8 | $ - 0 | |
| Add Tooth to Partial | $ - 0 | 9 | $ - 0 | |
| Add Tooth to Denture | $ - 0 | 9 | $ - 0 | |
| Denture/Partial Repair | $ - 0 | 9 | $ - 0 | |
| ORAL SURGERY | Extraction/Single Tooth | $ - 0 | 9 | $ - 0 |
| Extraction Add'l Tooth | $ - 0 | 9 | $ - 0 | |
| Root Removal | $ - 0 | 9 | $ - 0 | |
| Surgical Extraction | $ - 0 | 9 | $ - 0 | |
| Surgical Root Removal | $ - 0 | 6 | $ - 0 | |
| ENDODONTICS | Root Canal Anterior | $ - 0 | 6 | $ - 0 |
| Root Canal Bicuspid | $ - 0 | 6 | $ - 0 | |
| Root Canal Molar | $ - 0 | 6 | $ - 0 | |
| RCT Re-Treat (Anterior) | $ - 0 | 6 | $ - 0 | |
| RCT Re-Treat (Bicuspid) | $ - 0 | 6 | $ - 0 | |
| RCT Re-Treat (Molar) | $ - 0 | 6 | $ - 0 | |
| FIXED | Bridge Abutment | $ - 0 | 6 | $ - 0 |
| PROSTHODONTICS | Bridge Pontic | $ - 0 | 6 | $ - 0 |
| Deliver Bridge Per Unit | $ - 0 | 6 | $ - 0 | |
| Recement Bridge | $ - 0 | 6 | $ - 0 | |
| Recement Crown | $ - 0 | 8 | $ - 0 | |
| MISCELLANEOUS | Consultation | $ - 0 | 12 | $ - 0 |
| Palliative | $ - 0 | 12 | $ - 0 | |
| OTHER | Nightguard | $ - 0 | 6 | $ - 0 |
| Broken Appointment Fee | $ - 0 | 12 | $ - 0 | |
| Panoramic | $ - 0 | 10 | $ - 0 | |
| Local Admin. Antibiotic Per Site | $ - 0 | 6 | $ - 0 | |
| Option Year 2 Total: | $0.00 | |||
| Please see each of the three (3) tabs to fill in item/procedure prices. ** |
&LAttachment A
RFQ 20342326Q00004
TCV
| Base Period | $ - 0 |
| Option Period 1 | $ - 0 |
| Option Period 2 | $ - 0 |
| Total: | $ - 0 |
&LAttachment A
RFQ 20342326Q00004
File details come from the government source that posted it. Updated .