ATTACHMENT E - REPORTING TOOL - NX EQ PHYSIOLOGIC MONITOR MODULES PULSE OXIMETRY.xlsx

This is a quarterly reporting template for tracking sales of NX EQ Physiologic Monitor Modules (Pulse Oximetry) across VA Medical Centers nationwide. The spreadsheet is designed for contractors to report quantities sold and associated revenue by facility for each quarterly period in Fiscal Year 2026. The template includes line items for up to 22 different products or configurations, with columns designated for each of the approximately 150 VA facilities organized by Veterans Integrated Service Networks (VISNs), including major medical centers such as those in New York/New Jersey, Pittsburgh, Great Lakes, and Sierra Pacific regions.

The reporting template requires contractors to input quarterly quantities sold for each line item at each facility, calculate total quarterly quantities sold across all items, and report total quarterly sales inclusive of Service Level Agreement (SLA) fees. The template also includes fields for contractor name, contract number, CLIN number, product description, contract/part number, and unit price inclusive of SLA fees. Additionally, contractors must separately report the SLA amount received (for Hines Fiscal only) and total sales amounts without the SLA figure, which is uploaded separately to Pay.gov. All monetary fields are currently populated with $0.00 as placeholders, indicating this is a blank template awaiting contractor completion for FY 2026 quarterly reporting periods.