Attachment B Unit Pricing Schedule Exam-Tests Estimated Orders.pdf
PDF 234 KB Posted
- Solicitation number
- 60RRBH23R0011
- Issued by
-
Railroad Retirement Board
About this file
This document is an attachment to a federal solicitation providing an estimated unit pricing schedule for medical examinations and tests required by the Railroad Retirement Board over four option periods from October 2023 through September 2028. The attachment lists over 150 distinct examination and test line items including dermatology exams, various radiology scans and imaging, bloodwork, pulmonary function tests, and specialist consultations. Estimated annual volumes are provided for each item. Offerors are to provide fixed unit prices for each item for the base period and four option years. The solicitation seeks to establish an indefinite delivery/indefinite quantity contract to meet the Railroad Retirement Board's ongoing medical examination needs on an as-needed basis.
View the file
Other files
Show all 15
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Solicitation 60RRBH23R0011 Page 1 of 15 Attachment B – Price Schedule
Unit Pricing Schedule Base Period 10/01/2023 - 09/30/2024
Examination/Test
Number (& Sub-CLIN)
Examination/Test Name Estimated
No. Ordered Annually
Unit Price
001 Dermatologist Exam 5
Otolaryngology (ear exam) , including audiometric test with air and bone conduction pure tone studies with speech discrimination
005 Otolaryngology (ear exam), including audiometric test and an ENG or caloric test 5
Otolaryngology (ear exam), including a speech discrimination test with a hearing in noise test (HINT)
007 Ophthalmology (eye exam) 60
011 I. Q. Evaluation with psychometric testing 40
012 Neurologist Exam 10
013 Psychiatric Exam 700
014 Minnesota Multi-phasic Personality Inventory 5
016 Orthopedic Exam 650
017 Internal Medicine Exam with orthopedic involvement 950
018 Internal Medicine Exam 150
020 Serum Protein Electrophoresis 5
023 Arterial Blood Gas Studies (resting) 5
024 PT (Prothrombin Time) and INR (International Normalized Ratio) 5
026 A1C ( also known as glycated hemoglobin HbA1c) test 5
028 Hematocrit 5
030 Complete blood cell count (CBC) 10
031 Blood Panel, including HgA1c and Hemoccult -
Serum Creatinine; if not available, do BUN (blood urea nitrogen) or NPN (non-protein nitrogen)
033 Serum Albumin 5
034 Erythrocyte Sedimentation Rate 5
036 SMA Series (SMA-12, etc.) 10
037 Anti-convulsant Serum Level 5
038 Liver function studies 10
Solicitation 60RRBH23R0011 Page 2 of 15
(& Sub- CLIN)
Examination/Test Name Estimated
039 Thyroid Evaluation 5
040 Electro-encephalogram 5
041 Pulmonary Function Test, spirometry 100
042 Diffusing Capacity/Lungs (DLCO) 5
Stress (treadmill or bicycle) test with monitoring. Submit interpretation and sample tracings.
044 Rheumatoid Factor 5
045 Electrocardiogram (EKG) with interpretation, submit tracing 200
046 Doppler Ultrasound Flow Detection Tech. 5
047 Urinalysis 10
048 Antinuclear Antibody 5
052/152 Left/Right ankle joint, anteroposterior, lateral views, and oblique (x-ray)
053/153 Left/Right arm humerus, anteroposterior, lateral views, and oblique (x-ray)
055 Chest, anteroposterior and lateral (x-ray) 220
058/158 Left/Right elbow, anteroposterior, lateral views and oblique (x-ray) 10
062/162 Left/Right foot, anteroposterior, lateral views and oblique. (x-ray) 50
063/163 Left/Right forearm, anteroposterior, lateral views and oblique. (x-ray) 5
067/167 Left/Right hand, anteroposterior, lateral views and oblique. (x-ray) 30
068 Hip joints (right and left on one film) anteroposterior view (x-ray) 60
073/173 Left/Right knee joint, anteroposterior, lateral views and oblique. (x-ray) 220
075/175 Left/Right leg, tibia and fibular, anteroposterior, lateral views (x-ray) 15
079/179 Left/Right shoulder joint, anteroposterior view, internal and external rotation (x-ray)
Skull, anteroposterior, right and left lateral frontal and basal occipital (x-ray)
087 Spine, cervical, anteroposterior and lateral views odontoid (x-ray) 200
088 Spine, dorsal, anteroposterior and lateral views, 14X17 film (x-ray) 10
Solicitation 60RRBH23R0011 Page 3 of 15
Examination/Test Number
(& Sub- CLIN) Examination/Test Name Estimated No.
Ordered Annually
Unit Price
Spine, lumbo-sacral, anteroposterior and lateral views, 14X17 film (x-ray)
092/192 Left/Right thigh, femur, survey film (x-ray) 5
094/194 Left/Right wrist, anteroposterior and lateral views (x-ray) 20
101 Cardiology Specialist Exam 5
116 Orthopedic Specialist Exam 5
123 Arterial Blood Gas (exercise) 5
200 Functional Capacity Evaluation 5
300 Cervical Spine CT Scan 2
301 Lumbar Spine CT Scan 2
302 Shoulder CT Scan 2
303 Knee CT Scan 2
304 Hip CT Scan 2
305 Cervical Spine MRI without contrast 5
306 Lumbar Spine MRI without contrast 5
307 Shoulder MRI without contrast 5
308 Knee MRI without contrast 2
309 Hip MRI without contrast 2
Solicitation 60RRBH23R0011 Page 4 of 15
Option Period One 10/01/2024 - 09/30/2025
(& Sub- CLIN)
Examination/Test Name Estimated audiometric test with air and bone conduction pure tone studies with speech discrimination
005 Otolaryngology (ear exam), including audiometric test and an ENG or caloric test 5
Otolaryngology (ear exam), including a speech discrimination test with a hearing in noise test (HINT)
014 Minnesota Multi-phasic Personality Inventory 5
026 A1C ( also known as glycated hemoglobin
Serum Creatinine; if not available, do BUN (blood urea nitrogen) or NPN (non-protein nitrogen)
036 SMA Series (SMA-12, etc) 10
Solicitation 60RRBH23R0011 Page 5 of 15
Examination/Test Number
(& Sub- CLIN) Examination/Test Name
Estimated monitoring. Submit interpretation and sample tracings.
045 Electrocardiogram (EKG) with interpretation, submit tracing 200
046 Doppler Ultrasound Flow Detection Tech. 5
052/152 Left/Right ankle joint, anteroposterior, lateral views, and oblique (x-ray) 50
053/153 Left/Right arm humerus, anteroposterior, lateral views, and oblique (x-ray) 5
055 Chest, anteroposterior and lateral (x-ray) 220
058/158 Left/Right elbow, anteroposterior, lateral views and oblique (x-ray) 10
062/162 Left/Right foot, anteroposterior, lateral views and oblique. (x-ray) 50
063/163 Left/Right forearm, anteroposterior, lateral views and oblique. (x-ray) 5
067/167 Left/Right hand, anteroposterior, lateral views and oblique. (x-ray) 30
068 Hip joints (right and left on one film) anteroposterior view (x-ray) 60
073/173 Left/Right knee joint, anteroposterior, lateral views and oblique. (x-ray) 220
075/175 Left/Right leg, tibia and fibular, anteroposterior, lateral views (x-ray) 15
079/179 Left/Right shoulder joint, anteroposterior view, internal and external rotation (x-ray) 200
085 Skull, anteroposterior, right and left lateral frontal and basal occipital (x-ray) 5
087 Spine, cervical, anteroposterior and lateral views odontoid (x-ray) 200
088 Spine, dorsal, anteroposterior and lateral views, 14X17 film (x-ray) 10
Solicitation 60RRBH23R0011 Page 6 of 15
(& Sub- CLIN)
Examination/Test Name Estimated
089 Spine, lumbo-sacral, anteroposterior and lateral views, 14X17 film (x-ray) 400
092/192 Left/Right thigh, femur, survey film (x-ray) 5
094/194 Left/Right wrist, anteroposterior and lateral views (x-ray) 20
Solicitation 60RRBH23R0011 Page 7 of 15
Option Period Two 10/01/2025 - 09/30/2026
(& Sub- CLIN)
Examination/Test Name Estimated audiometric test with air and bone conduction pure tone studies with speech discrimination
005 Otolaryngology (ear exam), including audiometric test and an ENG or caloric test 5
Otolaryngology (ear exam), including a speech discrimination test with a hearing in noise test (HINT)
026 A1C ( also known as glycated hemoglobin
Serum Creatinine; if not available, do BUN (blood urea nitrogen) or NPN (non-protein nitrogen)
Solicitation 60RRBH23R0011 Page 8 of 15
Examination/Test Number
(& Sub- CLIN) Examination/Test Name
Estimated monitoring. Submit interpretation and sample tracings.
views, and oblique (x-ray) 50
053/153 Left/Right arm humerus, anteroposterior, lateral views, and oblique (x-ray) 5
055 Chest, anteroposterior and lateral (x-ray) 220
058/158 Left/Right elbow, anteroposterior, lateral views and oblique (x-ray) 10
062/162 Left/Right foot, anteroposterior, lateral views and oblique. (x-ray) 50
063/163 Left/Right forearm, anteroposterior, lateral views and oblique. (x-ray) 5
067/167 Left/Right hand, anteroposterior, lateral views and oblique. (x-ray) 30
068 Hip joints (right and left on one film) anteroposterior view (x-ray) 60
073/173 Left/Right knee joint, anteroposterior, lateral views and oblique. (x-ray) 220
075/175 Left/Right leg, tibia and fibular, anteroposterior, lateral views (x-ray) 15
079/179 Left/Right shoulder joint, anteroposterior view, internal and external rotation (x-ray) 200
085 Skull, anteroposterior, right and left lateral frontal and basal occipital (x-ray) 5
087 Spine, cervical, anteroposterior and lateral views odontoid (x-ray) 200
Solicitation 60RRBH23R0011 Page 9 of 15
(& Sub- CLIN)
Examination/Test Name Estimated lateral views, 14X17 film (x-ray) 400
092/192 Left/Right thigh, femur, survey film (x-ray) 5
094/194 Left/Right wrist, anteroposterior and lateral views (x-ray) 20
Solicitation 60RRBH23R0011 Page 10 of 15
Option Period Three 10/01/2026 - 09/30/2027
(& Sub- CLIN)
Examination/Test Name Estimated audiometric test with air and bone conduction pure tone studies with speech discrimination
005 Otolaryngology (ear exam), including audiometric test and an ENG or caloric test 5
Otolaryngology (ear exam), including a speech discrimination test with a hearing in noise test (HINT)
026 A1C ( also known as glycated hemoglobin
Serum Creatinine; if not available, do BUN (blood urea nitrogen) or NPN (non-protein nitrogen)
Solicitation 60RRBH23R0011 Page 11 of 15
Examination/Test Number
(& Sub- CLIN) Examination/Test Name
Estimated monitoring. Submit interpretation and sample tracings.
views, and oblique (x-ray) 50
053/153 Left/Right arm humerus, anteroposterior, lateral views, and oblique (x-ray) 5
055 Chest, anteroposterior and lateral (x-ray) 220
058/158 Left/Right elbow, anteroposterior, lateral views and oblique (x-ray) 10
062/162 Left/Right foot, anteroposterior, lateral views and oblique. (x-ray) 50
063/163 Left/Right forearm, anteroposterior, lateral views and oblique. (x-ray) 5
067/167 Left/Right hand, anteroposterior, lateral views and oblique. (x-ray) 30
068 Hip joints (right and left on one film) anteroposterior view (x-ray) 60
073/173 Left/Right knee joint, anteroposterior, lateral views and oblique. (x-ray) 220
075/175 Left/Right leg, tibia and fibular, anteroposterior, lateral views (x-ray) 15
079/179 Left/Right shoulder joint, anteroposterior view, internal and external rotation (x-ray) 200
085 Skull, anteroposterior, right and left lateral frontal and basal occipital (x-ray) 5
087 Spine, cervical, anteroposterior and lateral views odontoid (x-ray) 200
Solicitation 60RRBH23R0011 Page 12 of 15
(& Sub- CLIN)
Examination/Test Name Estimated lateral views, 14X17 film (x-ray) 400
092/192 Left/Right thigh, femur, survey film (x-ray) 5
094/194 Left/Right wrist, anteroposterior and lateral views (x-ray) 20
Solicitation 60RRBH23R0011 Page 13 of 15
Option Period Four 10/01/2027 - 09/30/2028
(& Sub- CLIN)
Examination/Test Name Estimated audiometric test with air and bone conduction pure tone studies with speech discrimination
005 Otolaryngology (ear exam), including audiometric test and an ENG or caloric test 5
Otolaryngology (ear exam), including a speech discrimination test with a hearing in noise test (HINT)
026 A1C ( also known as glycated hemoglobin
Serum Creatinine; if not available, do BUN (blood urea nitrogen) or NPN (non-protein nitrogen)
Solicitation 60RRBH23R0011 Page 14 of 15
Examination/Test Number
(& Sub- CLIN) Examination/Test Name
Estimated monitoring. Submit interpretation and sample tracings.
views, and oblique (x-ray) 50
053/153 Left/Right arm humerus, anteroposterior, lateral views, and oblique (x-ray) 5
055 Chest, anteroposterior and lateral (x-ray) 220
058/158 Left/Right elbow, anteroposterior, lateral views and oblique (x-ray) 10
062/162 Left/Right foot, anteroposterior, lateral views and oblique. (x-ray) 50
063/163 Left/Right forearm, anteroposterior, lateral views and oblique. (x-ray) 5
067/167 Left/Right hand, anteroposterior, lateral views and oblique. (x-ray) 30
068 Hip joints (right and left on one film) anteroposterior view (x-ray) 60
073/173 Left/Right knee joint, anteroposterior, lateral views and oblique. (x-ray) 220
075/175 Left/Right leg, tibia and fibular, anteroposterior, lateral views (x-ray) 15
079/179 Left/Right shoulder joint, anteroposterior view, internal and external rotation (x-ray) 200
085 Skull, anteroposterior, right and left lateral frontal and basal occipital (x-ray) 5
087 Spine, cervical, anteroposterior and lateral views odontoid (x-ray) 200
Solicitation 60RRBH23R0011 Page 15 of 15
(& Sub- CLIN)
Examination/Test Name Estimated lateral views, 14X17 film (x-ray) 400
092/192 Left/Right thigh, femur, survey film (x-ray) 5
094/194 Left/Right wrist, anteroposterior and lateral views (x-ray) 20
File details come from the government source that posted it. Updated .