Exhibit A.xlsx
XLSX spreadsheet 13 KB Posted
- Solicitation number
- 005-RFB-2176-2026
- Issued by
- Iowa
About this file
Exhibit A is a billing summary document related to prosthetics, orthotics, and orthopedic devices procured for the Iowa Department of Corrections from January 1, 2025 through September 17, 2025. The document itemizes services and devices provided during this period, demonstrating the types and quantities of medical equipment required by the correctional healthcare system. The products listed include ankle-foot orthoses (multiple Total Contact Casts with custom-fabricated thermoplastic materials), cervical collars, knee orthoses, lumbar and thoracolumbosacral orthoses, CAM walker boots, prosthetic sockets and components for below-knee amputees, prosthetic socks and sheaths, prosthetic shrinkkers, and various orthopedic additions and components. The services encompass device fabrication, fitting, adjustment, socket replacement, and post-operative support for transtibial prosthetic patients.
The total billed amount for the nine-month period from January 1 through September 17, 2025 is $25,534.16. This billing history reflects actual utilization patterns and device requirements within the Department of Corrections' inmate population and serves as documentation of the scope and scale of prosthetic and orthopedic services required. The variety of HCPCS codes represented indicates comprehensive medical device provision spanning orthotic devices across multiple body regions (cervical, thoracic, lumbar, knee, and ankle-foot) as well as prosthetic components for lower-extremity amputees. This historical data establishes baseline demand and pricing information relevant to the competitive procurement initiated by the Iowa Department of Administrative Services Central Procurement for ongoing prosthetics, orthotics, and orthopedic devices and related services.
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Other files
| File | Type | Posted |
|---|---|---|
| 1343462-event.pdf | ||
| RFB Solicitation Document.docx | DOCX document |
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Text version
Jan 1, 2025 - Sep 17, 2025
| Totals from 1/1/2025 to 9/17/2025 | |||||
| Code | Quantity | Code Description | Billed Amount | Device Type | DOS |
| L2106 | 1 | ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, THERMOPLASTIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED | $1,424.54 | Total Contact Cast | 4/30/25 |
| L2106 | 1 | ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, THERMOPLASTIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED | $1,424.54 | Total Contact Cast | 5/6/25 |
| L0174 | 1 | CERVICAL, COLLAR, SEMI-RIGID, THERMOPLASTIC FOAM, TWO PIECE WITH THORACIC EXTENSION, PREFABRICATED, OFF-THE-SHELF | $503.29 | Cervical Orthosis | 5/14/25 |
| L2106 | 1 | ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, THERMOPLASTIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED | $1,424.54 | Total Contact Cast | 5/15/25 |
| L1833 | 1 | KNEE ORTHOSIS, ADJUSTABLE KNEE JOINTS (UNICENTRIC OR POLYCENTRIC), POSITIONAL ORTHOSIS, RIGID SUPPORT, PREFABRICATED, OFF-THE SHELF | $733.23 | Knee Orthosis | 5/20/25 |
| L0627 | 1 | LUMBAR ORTHOSIS, SAGITTAL CONTROL, WITH RIGID ANTERIOR AND POSTERIOR PANELS, POSTERIOR EXTENDS FROM L-1 TO BELOW L-5 VERTEBRA, PRODUCES INTRACAVITARY PRESSURE TO REDUCE LOAD ON THE INTERVERTEBRAL DISCS, INCLUDES STRAPS, CLOSURES, MAY INCLUDE PADDING, SHOULDER STRAPS, PENDULOUS ABDOMEN DESIGN, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT | $742.84 | Lumbosacral Orthosis | 5/21/25 |
| L2106 | 1 | ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, THERMOPLASTIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED | $1,424.54 | Total Contact Cast | 5/21/25 |
| L4361 | 1 | WALKING BOOT, PNEUMATIC AND/OR VACUUM, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF | $467.91 | CAM Walker Boot | 5/21/25 |
| L0464 | 1 | TLSO, TRIPLANAR CONTROL, MODULAR SEGMENTED SPINAL SYSTEM, FOUR RIGID PLASTIC SHELLS, POSTERIOR EXTENDS FROM SACROCOCCYGEAL JUNCTION AND TERMINATES JUST INFERIOR TO SCAPULAR SPINE, ANTERIOR EXTENDS FROM SYMPHYSIS PUBIS TO THE STERNAL NOTCH, SOFT LINER, RESTRICTS GROSS TRUNK MOTION IN SAGITTAL, CORONAL, AND TRANVERSE PLANES, LATERAL STRENGTH IS PROVIDED BY OVERLAPPING PLASTIC AND STABILIZING CLOSURES, INCLUDES STRAPS AND CLOSURES, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT | $2,686.46 | TLSO | 5/27/25 |
| L0174 | 1 | CERVICAL, COLLAR, SEMI-RIGID, THERMOPLASTIC FOAM, TWO PIECE WITH THORACIC EXTENSION, PREFABRICATED, OFF-THE-SHELF | $503.29 | Cervical Orthosis | 5/28/25 |
| L2106 | 1 | ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, THERMOPLASTIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED | $1,424.54 | Total Contact Cast | 6/10/25 |
| L5450 | 1 | IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF NON-WEIGHT BEARING RIGID DRESSING, BELOW KNEE | $856.40 | Transtibial Post Operative | 6/20/25 |
| L8420 | 2 | PROSTHETIC SOCK, MULTIPLE PLY, BELOW KNEE, EACH | $75.54 | Transtibial Post Operative | 6/20/25 |
| L2106 | 1 | ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, THERMOPLASTIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED | $240.00 | Total Contact Cast | 7/18/25 |
| L2106 | 1 | ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, THERMOPLASTIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED | $485.40 | Total Contact Cast | 7/24/25 |
| L2106 | 1 | ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, THERMOPLASTIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED | $240.00 | Total Contact Cast | 8/7/25 |
| L8420 | 4 | PROSTHETIC SOCK, MULTIPLE PLY, BELOW KNEE, EACH | $151.08 | Consumables | 8/7/25 |
| L5700 | 1 | REPLACEMENT, SOCKET, BELOW KNEE, MOLDED TO PATIENT MODEL | $2,396.55 | Transtibial Replacement Socket | 8/7/25 |
| L5620 | 2 | ADDITION TO LOWER EXTREMITY, TEST SOCKET, BELOW KNEE | $414.66 | Transtibial Replacement Socket | 8/7/25 |
| L5629 | 1 | ADDITION TO LOWER EXTREMITY, BELOW KNEE, ACRYLIC SOCKET | $232.78 | Transtibial Replacement Socket | 8/7/25 |
| L5910 | 1 | ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ALIGNABLE SYSTEM | $265.28 | Transtibial Replacement Socket | 8/7/25 |
| L5940 | 1 | ADDITION, ENDOSKELETAL SYSTEM, BELOW KNEE, ULTRA-LIGHT MATERIAL (TITANIUM, CARBON FIBER OR EQUAL) | $487.30 | Transtibial Replacement Socket | 8/7/25 |
| L5637 | 1 | ADDITION TO LOWER EXTREMITY, BELOW KNEE, TOTAL CONTACT | $211.58 | Transtibial Replacement Socket | 8/7/25 |
| L5647 | 1 | ADDITION TO LOWER EXTREMITY, BELOW KNEE SUCTION SOCKET | $776.88 | Transtibial Replacement Socket | 8/7/25 |
| L5685 | 2 | ADDITION TO LOWER EXTREMITY PROSTHESIS, BELOW KNEE, SUSPENSION/SEALING SLEEVE, WITH OR WITHOUT VALVE, ANY MATERIAL, EACH | $211.34 | Transtibial Replacement Socket | 8/7/25 |
| L5679 | 2 | ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE, CUSTOM FABRICATED FROM EXISTING MOLD OR PREFABRICATED, SOCKET INSERT, SILICONE GEL, ELASTOMERIC OR EQUAL, NOT FOR USE WITH LOCKING MECHANISM | $1,029.16 | Transtibial Replacement Socket | 8/7/25 |
| L5645 | 1 | ADDITION TO LOWER EXTREMITY, BELOW KNEE, FLEXIBLE INNER SOCKET, EXTERNAL FRAME | $263.29 | Transtibial Replacement Socket | 8/7/25 |
| L8420 | 4 | PROSTHETIC SOCK, MULTIPLE PLY, BELOW KNEE, EACH | $63.08 | Transtibial Replacement Socket | 8/7/25 |
| L8470 | 6 | PROSTHETIC SOCK, SINGLE PLY, FITTING, BELOW KNEE, EACH | $7.56 | Transtibial Replacement Socket | 8/7/25 |
| L8400 | 6 | PROSTHETIC SHEATH, BELOW KNEE, EACH | $43.14 | Transtibial Replacement Socket | 8/7/25 |
| L8430 | 3 | PROSTHETIC SOCK, MULTIPLE PLY, ABOVE KNEE, EACH | $128.34 | Consumables | 8/12/25 |
| L8460 | 2 | PROSTHETIC SHRINKER, ABOVE KNEE, EACH | $239.96 | Consumables | 8/12/25 |
| L8480 | 3 | PROSTHETIC SOCK, SINGLE PLY, FITTING, ABOVE KNEE, EACH | $49.74 | Consumables | 8/12/25 |
| L1960 | 1 | ANKLE FOOT ORTHOSIS, POSTERIOR SOLID ANKLE, PLASTIC, CUSTOM-FABRICATED | $496.07 | Ankle Foot Orthosis | 8/13/25 |
| L2755 | 1 | ADDITION TO LOWER EXTREMITY ORTHOSIS, HIGH STRENGTH, LIGHTWEIGHT MATERIAL, ALL HYBRID LAMINATION/PREPREG COMPOSITE, PER SEGMENT, FOR CUSTOM FABRICATED ORTHOSIS ONLY | $99.26 | Ankle Foot Orthosis | 8/13/25 |
| L5450 | 1 | IMMEDIATE POST SURGICAL OR EARLY FITTING, APPLICATION OF NON-WEIGHT BEARING RIGID DRESSING, BELOW KNEE | $531.70 | transtibial removable protector | 8/15/25 |
| L5688 | 1 | ADDITION TO LOWER EXTREMITY, BELOW KNEE, WAIST BELT, WEBBING | $76.64 | transtibial removable protector | 8/15/25 |
| L8420 | 3 | PROSTHETIC SOCK, MULTIPLE PLY, BELOW KNEE, EACH | $69.81 | transtibial removable protector | 8/15/25 |
| L2106 | 1 | ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, THERMOPLASTIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED | $1,424.54 | Total Contact Cast | 8/25/25 |
| L1833 | 1 | KNEE ORTHOSIS, ADJUSTABLE KNEE JOINTS (UNICENTRIC OR POLYCENTRIC), POSITIONAL ORTHOSIS, RIGID SUPPORT, PREFABRICATED, OFF-THE SHELF | $514.37 | Knee Orthosis | 8/26/25 |
| L0174 | 1 | CERVICAL, COLLAR, SEMI-RIGID, THERMOPLASTIC FOAM, TWO PIECE WITH THORACIC EXTENSION, PREFABRICATED, OFF-THE-SHELF | $207.59 | Cervical Orthosis | 8/27/25 |
| L2106 | 1 | ANKLE FOOT ORTHOSIS, FRACTURE ORTHOSIS, TIBIAL FRACTURE CAST ORTHOSIS, THERMOPLASTIC TYPE CASTING MATERIAL, CUSTOM-FABRICATED | $485.40 | Total Contact Cast | 9/3/25 |
| $25,534.16 |
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