Attachment_2-Exhibit_AA_Ordering_Period_1.pdf

Exhibit AA FA3010-16-R-0002 Attachment 2

Dated: 20 Oct 2015

LINE ITEM TEST MENU

ESTIMATED

QUANTITY UNIT PRICE TOTAL PRICE

GENERAL CHEMISTRY

AA01 Cost Per Reportable Result GLYCOCYLATED HEMAGLOBIN A1C - No Pretreatment Required 13500 $ $

AA02 Cost Per Reportable Result ALBUMIN 30150 $ $

AA03 Cost Per Reportable Result AMMONIA 167 $ $

AA04 Cost Per Reportable Result AMYLASE 550 $ $

AA05 Cost Per Reportable Result ALKALINE PHOSPHATASE 22962 $ $

AA06 Cost Per Reportable Result ALANINE AMINOTRANSFERASE (ALT) 23623 $ $

AA07 Cost Per Reportable Result ASPARTATE AMINOTRANSFERASE (AST) 23885 $ $

AA08 Cost Per Reportable Result BLOOD UREA NITOGEN 41168 $ $

AA09 Cost Per Reportable Result CALCIUM 41450 $ $

AA10 Cost Per Reportable Result CHOLESTEROL 14551 $ $

AA11 Cost Per Reportable Result CREATINE KINASE - TOTAL 4324 $ $

AA12 Cost Per Reportable Result CREATININE 50821 $ $

AA13 Cost Per Reportable Result DIRECT BILIRUBIN 3378 $ $

AA14 Cost Per Reportable Result ALCOHOL 385 $ $

AA15 Cost Per Reportable Result FERRITIN 3180 $ $

AA16 Cost Per Reportable Result GAMMA-GLUTAMYL TRANSFERASE 313 $ $

AA17 Cost Per Reportable Result GLUCOSE 41430 $ $

AA18 Cost Per Reportable Result HIGH DENSITY LYPOPROTIEN - DIRECT 14530 $ $

AA19 Cost Per Reportable Result LOW DENSITY LYPOPROTIEN - DIRECT 14545 $ $

AA20 Cost Per Reportable Result IRON (NO PRETREATMENT) 4682 $ $

AA21 Cost Per Reportable Result LACTATE 1466 $ $

AA22 Cost Per Reportable Result LACTIC DEHYDROGENASE 910 $ $

AA23 Cost Per Reportable Result LIPASE 1701 $ $

AA24 Cost Per Reportable Result MAGNESIUM 6789 $ $

AA25 Cost Per Reportable Result PHOSPHOROUS 9776 $ $

AA26 Cost Per Reportable Result PREALBUMIN 124 $ $

AA27 Cost Per Reportable Result TOTAL BILIRUBIN 23508 $ $

AA28 Cost Per Reportable Result IRON BINDING CAPACITY 4661 $ $

AA29 Cost Per Reportable Result TOTAL PROTEIN 23285 $ $

CHEMISTRY & SPECIAL CHEMISTRY TESTING KEESLER AFB, MS

Ordering Period 1: 1 Apr 2016 - 31 Mar 2017

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ESTIMATED

QUANTITY UNIT PRICE TOTAL PRICE

CHEMISTRY & SPECIAL CHEMISTRY TESTING KEESLER AFB, MS

Ordering Period 1: 1 Apr 2016 - 31 Mar 2017

AA30 Cost Per Reportable Result TRANSFERRIN 4661 $ $

AA31 Cost Per Reportable Result TRIGLYCERIDE 14568 $ $

AA32 Cost Per Reportable Result URIC ACID 1519 $ $

ELECTROLYTES

AA33 Cost Per Reportable Result SODIUM 40166 $ $

AA34 Cost Per Reportable Result POTASSIUM 40150 $ $

AA35 Cost Per Reportable Result CHLORIDE 39723 $ $

AA36 Cost Per Reportable Result CARBON DIOXIDE 38331 $ $

IMMUNOCHEMISTRY

AA37 Cost Per Reportable Result

3RD GENERATION TOTAL PROSTATE SPECIFIC ANTIGEN

(PSA) 2491 $ $

AA38 Cost Per Reportable Result 3RD GENERATION THYROID STYMULATING HORMONE (TSH) 13459 $ $

AA39 Cost Per Reportable Result ALPHA FETAL PROTIEN 184 $ $

AA40 Cost Per Reportable Result ANTI STREPTOLYSIN O (ASO) 25 $ $

AA41 Cost Per Reportable Result B12, VITAMIN 2977 $ $

AA42 Cost Per Reportable Result CA-125 ANTIGEN 96 $ $

AA43 Cost Per Reportable Result CARCINOEMBRYONIC ANTIGEN (CEA) 495 $ $

AA44 Cost Per Reportable Result CORTISOL 379 $ $

AA45 Cost Per Reportable Result TOTAL 25-HYDROXYVITAMIN D (TOTAL VITAMIN D) 6500 $ $

AA46 Cost Per Reportable Result ESTRADIOL 213 $ $

AA47 Cost Per Reportable Result FREE PSA 586 $ $

AA48 Cost Per Reportable Result FOLLICLE STIMULATING HORMONE (FSH) 560 $ $

AA49 Cost Per Reportable Result FREE THYROXINE (FT4) 4825 $ $

AA50 Cost Per Reportable Result FOLATE 2977 $ $

AA51 Cost Per Reportable Result Beta HUMAN CHORIONIC GONADOTROPIN (HCG) 809 $ $

AA52 Cost Per Reportable Result IMMUNOGLOBULIN A 280 $ $

AA53 Cost Per Reportable Result IMMUNOGLOBULIN G 280 $ $

AA54 Cost Per Reportable Result IMMUNOGLOBULIN M 280 $ $

AA55 Cost Per Reportable Result LUTEINIZING HORMONE (LH) 560 $ $

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ESTIMATED

QUANTITY UNIT PRICE TOTAL PRICE

CHEMISTRY & SPECIAL CHEMISTRY TESTING KEESLER AFB, MS

Ordering Period 1: 1 Apr 2016 - 31 Mar 2017

AA56 Cost Per Reportable Result PROGESTERONE 119 $ $

AA57 Cost Per Reportable Result PROLACTIN 1088 $ $

AA58 Cost Per Reportable Result RAPID/INTACT PARATHYROID HORMONE (PTH) 1602 $ $

AA59 Cost Per Reportable Result RHEUMATOID FACTOR (RF) 540 $ $

AA60 Cost Per Reportable Result TRIIODOTHYRONINE (FREE T3) 573 $ $

AA61 Cost Per Reportable Result TOTAL TESTOSTERONE 663 $ $

URINE DRUGS OF ABUSE

AA62 Cost Per Reportable Result AMPHETAMINE 800 $ $

AA63 Cost Per Reportable Result BARBITURATE 800 $ $

AA64 Cost Per Reportable Result BENZODIAZEPINE 800 $ $

AA65 Cost Per Reportable Result CANNOBINOID 800 $ $

AA66 Cost Per Reportable Result COCAINE 800 $ $

AA67 Cost Per Reportable Result OPIATE 800 $ $

AA68 Cost Per Reportable Result PHENCYCLIDINE 800 $ $

THERAPEUTIC DRUGS

AA69 Cost Per Reportable Result ACETAMINOPHEN 224 $ $

AA70 Cost Per Reportable Result CARBAMAZEPINE 25 $ $

AA71 Cost Per Reportable Result DIGOXIN 124 $ $

AA72 Cost Per Reportable Result GENTAMICIN 25 $ $

AA73 Cost Per Reportable Result LITHIUM 28 $ $

AA74 Cost Per Reportable Result PHENOBARBITAL 25 $ $

AA75 Cost Per Reportable Result PHENYTOIN 27 $ $

AA76 Cost Per Reportable Result SALICYLATE 209 $ $

AA77 Cost Per Reportable Result THEOPHYLLINE 25 $ $

AA78 Cost Per Reportable Result TOBRAMYCIN 25 $ $

AA79 Cost Per Reportable Result VALPORIC ACID 100 $ $

AA80 Cost Per Reportable Result VANCOMYCIN 410 $ $

URINE CHEMISTRY

AA81 Cost Per Reportable Result URINE/CSF TOTAL PROTEIN 2200 $ $

AA82 Cost Per Reportable Result MICROALBUMIN 11958 $ $

LINE ITEM TEST MENU

ESTIMATED

QUANTITY UNIT PRICE TOTAL PRICE

CHEMISTRY & SPECIAL CHEMISTRY TESTING KEESLER AFB, MS

Ordering Period 1: 1 Apr 2016 - 31 Mar 2017

CARDIAC TESTS

AA83 Cost Per Reportable Result C-REACTIVE PROTIEN High Sensitivity 1525 $ $

AA84 Cost Per Reportable Result N TERMINAL-PRO BRAIN NAUTINIC PEPTIDE 2587 $ $

AA85 Cost Per Reportable Result TROPONIN I 4000 $ $

AA86 Cost Per Reportable Result CREATINE KINASE - MUSCLE BRAIN 3890 $ $

676,500

Total Estimated

Price