Attachment 1 PWS_Amendment 0001.docx

PERFORMANCE WORK STATEMENT (PWS)

August 3, 2021 Defense Finance Accounting Services (DFAS) and Defense Information System Agency (DISA) Agencies Nurse Staffing Support Services

General Information

1. GENERAL: This is a non-personnel services contract to provide clinical occupational health staffing services. Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

1.1 Description of Services/Introduction: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non- personal services necessary to perform clinical occupational health services as defined in this Performance Work Statement except for those items specified as government furnished property and services. The contractor shall perform to the standards in this contract.

1.2 Background: The Department of Defense is a world class employer seeking to hire and retain exceptional quality employees by offering a variety of programs and services. The overall intent is to ensure that the Department can meet mission goals and objectives by ensuring the safety and welfare its employees. The Defense of Defense (DoD) requires occupational medical examinations to meet the needs of employees that must meet job specific medical standards to safely perform work that is arduous, involves a high degree of sensitivity toward the public or sensitive national security concerns, or puts employees at risk of hazardous exposures while performing essential job duties. These exams may be required to meet requirements for compliance with the standards set by the Occupational Safety and Health Administration (OSHA) or other regulatory bodies in addition to medical standards developed according to 5 CFR 339. The examinations may be performed prior to employment for applicants, for periodic medical surveillance of incumbents, before return to work after an injury, or to determine an incumbent’s ongoing fitness for duty when a change in health status has caused concern about the worker’s or others’ safety.

DoD meets its nurse staffing requirements through both on-site clinics as well as contract network providers who operate out of private facilities.

1.3 Objectives:

a. Walk-in care, first aid, and emergency response

b. Provision of short-term prescriptions by licensed personnel as requested

c. Provision of diagnostic testing as prescribed by a personal physician such as blood pressure monitoring, glucose monitoring (utilizing employee provided tester and strips) and allergy immunotherapy (with employee provided medications).

d. Forensic collection for drug testing

d. Health education and training programs (e.g. nutrition, blood borne pathogens, smoking cessation, respirator fit testing)

e. Health screenings as approved by the agency (e.g. cancer, diabetes, blood pressure, vision)

f. Preventive health, medical surveillance provided in conjunction to a personal physicians requested assistance during the workday

g. Administration of immunizations as approved by the agency (e.g. Hepatitis A, Hepatitis B, Anthrax, Smallpox, Flu, etc.) contractor to provide medications/vaccines

h. Physician review, development and approval of standing orders, protocols and medical instructions as required to provide requested services Management of designated lactation space located within the clinic space to include regular cleaning of the room and any agency provided equipment.

i. Clinic staff participation in occupant emergency planning with other tenant agencies;

j. Provide subject matter expertise for all issues related to the operations of the medical clinics

k. Provide general office administration of personnel to ensure contractual requirements are met

l. Provide reports as required for number of services provided, personnel staffing, maintenance requirements and other activities related to the operation of the clinics

m. Ensure that personnel are compliant with current licensing, training and other requirements for the states where the clinic operates

n. Annual program review to assist management in identifying basic safety, health, and wellness opportunities.

o. Provide all required supplies, laboratory services and equipment for delivery of services listed above.

1.4 Scope: The contractor shall provide onsite occupational health staffing services within the continental United States (CONUS) to meet the occupational medical needs of the Department of Defense (DoD). To meet the DoD’s requirements, the contractor will:

1. Operate several clinics within the United States.

2. Provide the necessary clinical health services, supplies and equipment as required to geographically dispersed personnel through a network of clinics or licensed independent practitioners. Provide vaccination services to covered DoD personnel.

1.5 Period of Performance: The period of performance shall be for one (1), five (5) year ordering period. The Period of Performance reads as follows:

Order Period: 09 September 2021 to 08 September 2026

1.6 General Information:

1.6.1 Quality Control: The contractor shall develop and maintain an effective quality control program to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s quality control program is the means by which he assures himself that his work complies with the requirement of the contract. The Quality Control Plan (QCP) shall be delivered via electronic mail within 30 days of contract award. Amendments/changes to the QCP shall be delivered to the COR and KO within three business days following any change.

1.6.2 Quality Assurance: The government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the Government must do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

1.6.3 Recognized Holidays: The contractor is not required to perform service on holidays

Independence Day

1.6.4 Hours of Operation: The contractor is responsible for conducting business, between the WHS core hours of 8:00 AM to 4:30 PM, arriving no earlier than 6:30 AM and departing no later than 6:30 PM Monday thru Friday except Federal holidays or when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings. For other than firm fixed price contracts, the contractor will not be reimbursed when the government facility is closed for the above reasons. The Contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS when the Government facility is not closed for the above reasons. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential.

1.6.5 Place of Performance: The work to be performed under this contract will be performed in a government provided office space in Limestone, ME, Indianapolis, IN, Rome, NY, Fort Mead, MD, Cleveland, OH, Columbus, OH and Baltimore, MD. Contractor personnel may be requested to work at the Governments alternate locations during emergencies and emergency exercises. Individual Contractor personnel may be designated as essential personnel to support contingency operations at alternate Government locations during actual emergencies and emergency exercises.

1.6.6 Type of Contract: The government will award a hybrid type contract that consist of Firm-Fixed Priced (FFP) and Time-and-Material (T&M), contract line item numbers (CLINs).

1.6.7 Security Requirements: If a CAC is required, the Contractor must also have received a favorable National Agency Check with Inquiries (NACI) as well as a favorable response to a Federal Bureau of Investigation (FBI) fingerprint check.

1.6.8 Special Qualifications: Contractor personnel will be required to sign a Non-Disclosure Agreement

1.6.9 Post Award Conference/Periodic Progress Meetings: The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The contracting officer, Contracting Officers Representative (COR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the contracting officer will apprise the contractor of how the government views the contractor's performance and the contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the government.

1.6.10 Contracting Officer Representative (COR): The (COR) from each participating agency will be identified by separate letter. The COR monitors all technical aspects of the contract and assists in contract administration The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract: perform inspections necessary in connection with contract performance: maintain written and oral communications with the Contractor concerning technical aspects of the contract: issue written interpretations of technical requirements, including Government drawings, designs, specifications: monitor Contractor's performance and notifies both the Contracting Officer and Contractor of any deficiencies; coordinate availability of government furnished property, and provide site entry of Contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting order.

1.6.11 Monthly Status Reports: The contractor will submit a monthly status report to the COR containing at a minimum monthly accomplishments and risks to accomplishing tasks in the PWS.

1.6.12 Key Personnel: The personnel identified in each task section are considered essential to the work being performed under this contract. Before removing, replacing, or diverting any of the listed or specified personnel or facilities, the Contractor shall (1) notify the Contracting Officer reasonably in advance and (2) submit justification (including proposed substitutions) in sufficient detail to permit evaluation of the impact on this contract. The Contractor shall make no diversion without the Contracting Officer's written consent; provided that the Contracting Officer may ratify in writing the proposed change, and that ratification shall constitute the Contracting Officer's consent required by this document.

1.6.12.1 Area Nurse Manager

Minimum Educational Requirements: Graduation from a National League of Nursing (NLN) accredited school of nursing (Diploma, AD, or BSN).

Experience/Certification Requirements: RN licensure with CPR and AED certification and three

(3) years’ experience in Occupational Health (OH) or related experience such as public health/community health, outpatient clinic, school nursing, or physician office nursing and at least one (1) year supervisory experience. Shall have CAOHC certification for audiometry and have attended a NIOSH approved Spirometry course. Should also be proficient in performing, assessing and training in venipuncture competency.

1.6.12.2 Standing Orders/Oversight Physician

Minimum Requirements: Must be board-certified in an appropriate medical specialty (Family Medicine, Internal Medicine, Occupational Medicine, or Emergency Medicine); Unrestricted license to practice medicine. This license must be in the state where designated OHC(s) is located, when required. Resident Medical Officer (RMOs) must follow the requirements of State Practice Acts and prevailing local standards of care. Current BLS/AED certification. At least one year of experience providing direct patient care to an adult population.

1.6.13 Identification of Contractor Employees: All contract personnel attending meetings, answering Government telephones, and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed. Contractor personnel will be required to obtain, use, and display a Common Access Card in the performance of this service.

1.6.14 Contractor Travel: Contractor will be required to travel CONUS during the performance of this contract to attend meetings, conferences, etc. All travel shall occur on an “as needed” basis and requires Government approval/authorization and notification to the COR. Travel may be required outside of regular business hours. All travel requests shall be coordinated and pre-approved in writing by the Government COR prior to any trips within five (5) business days. Requests for approval of costs in excess of maximum per diem rates in accordance with the procedures contained in FAR 31.205-46(a)(3) must be submitted to the COR for final approval prior to commencement of travel. The Contractor is responsible for all travel arrangements including airline, hotel, and rental car reservations. The Contractor should estimate travel costs in accordance with FAR 31.205-46. The contract will designate a separate Contract Line Item Number (CLIN) to cover travel costs. Trip reports are required no later than 14 days at the conclusion of each trip and submitted to the COR.

1.6.15 Other Direct Costs: This category includes travel (outlined in 1.6.14), equipment and supplies required to support the PWS.

1.6.16 Organizational Conflict of Interest: Contractor and subcontractor personnel performing work under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent Organizational Conflict of Interests (OCI) as defined in FAR Subpart 9.5. The Contractor shall notify the Contracting Officer immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the Contracting Officer to avoid or mitigate any such OCI. The Contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the Contracting Officer and in the event the Contracting Officer unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the Contracting Officer may affect other remedies as he or she deems necessary, including prohibiting the Contractor from participation in subsequent contracted requirements which may be affected by the OCI.

1.6.17 Phase In/Phase Out Period: To minimize any decreases in productivity and to prevent possible negative impacts on additional services, the Contractor shall have personnel on board, during the thirty (30) day, phase in/phase out periods. During the phase in period, the Contractor shall become familiar with performance requirements in order to commence full performance of services on the contract start date.

PART 2 DEFINITIONS & ACRONYMS

2. DEFINITIONS AND ACRONYMS:

2.1. DEFINITIONS:

2.1.1 CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

2.1.2 CONTRACTING OFFICER. A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.3 CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the contracting officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.4 DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

2.1.5 DELIVERABLE. Anything that can be physically delivered, but may include non- manufactured things such as meeting minutes or reports.

2.1.6 KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.7 PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

2.1.8 QUALITY ASSURANCE. The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.9 QUALITY ASSURANCE Surveillance Plan (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.10 QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

2.1.11 SUBCONTRACTOR. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

2.1.12 WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.1.13 WORK WEEK. Monday through Friday, unless specified otherwise.

2.2 ACRONYMS:

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1. Services: The government will provide basic services to phones, desks, utilities, information technology, and general office supplies) while working in Government facilities.

3.2. Facilities: Basic facilities such as work space and its associated operating requirements (i.e., phones, desks, utilities, information technology, and general office supplies) will be provided while working in Government facilities. Tele-workers will only use government furnished equipment to remotely access the WHS network.

3.3. Equipment: The Government will provide basic medical equipment and supplies such as phones, desks, utilities, information technology, and general office and clinic supplies while working in Government facilities. Tele-workers will only use government furnished equipment to remotely access the WHS network.

CONTRACTOR FURNISHED ITEMS AND SERVICES

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1. General: The Contractor shall furnish all supplies, equipment, facilities and services required to perform work under this contract that are not listed under Section 3 of this PWS.

4.2. Secret Facility Clearance: Not Applicable

4.3. Materials: NA

4.4. Equipment: NA

SPECIFIC TASKS

5. SPECIFIC TASKS:

5.1. Basic Services: The contractor shall provide services for Clinical Occupational Health Staffing Services for various Department of Defense (DoD) 4th Estate Agencies.

5.2. Occupational Health Staffing Support Services: The contractor shall provide oversight of the performance of its vendor employees, quality of deliverables, and support the government with current and emergent requirements with Occupational Health Staffing Support Services. These activities may include, and/or any combination of, the following tasks:

5.2.1 The Contractor employees shall perform the approved Government health services including, but not limited to, initial care and treatment for on-the-job injuries and illnesses; respond to medical emergencies, preventive care, health education and screening, medical surveillance; and promote good health and fitness to eligible beneficiaries of the Government Program who present themselves to the Government centers in accordance with the provider’s qualifications and tasks. Emergency care shall be provided to anyone injured or experiencing a life-threatening medical emergency at a federal work site regardless of his/her federal employment status in accordance with the Contractor provider’s qualifications and tasks. No final diagnosis or ongoing treatment for chronic or recurrent medical conditions will be rendered. Contractor employees may be required to travel to site other than the normal commuting location to provide outreach services. Examples of nursing care activities include, but are not limited to: emergency response, administering immunizations, other injections, allergy immunotherapy, and medications; performing first aid for minor burns, cuts, bruises, and sprains; obtaining histories; and keeping records, writing reports, and maintaining supplies and equipment, and other such basic nursing activities. Venipuncture, forensic testing, vision testing, EKG, audiometry and spirometry are also frequent tasks to be completed. It is the responsibility of the Contractor to ensure all Contractor personnel complete initial Skills Competency Checklists. All professional Contractor employees, including physicians, physician assistants, nurse practitioners, registered nurses (RN), Licensed Practical Nurses/Licensed Vocational Nurses (LPN/LVN), shall possess skills in interviewing, assessment, basic computer and Microsoft application knowledge, and general management and customer service skills (as they pertain to the Government).

5.2.1.1 Staff Nurse RN Tasks: Provides services at the clinic location under the general supervision/direction of the Area Nurse Manager or the Nurse Coordinator. Enters all services in the appropriate data system.

5.2.1.2 Emergency response, including CPR, first aid or the use of the AED. Emergency response services includes responding to life-threatening emergencies by the clinic nurse equipped with emergency supplies during clinic hours of operation.

5.2.1.3 Walk-in care for minor illnesses and injuries that may be work or non-work related; Routine adult immunizations according to the guidelines from the Centers for Disease Control (CDC); including Tetanus-diphtheria (TD), Tetanus-diphtheria-acellular pertussis (Tdap), influenza, and pneumococcal (pneumonia) vaccines.

5.2.1.4 Destination specific travel information from the CDC to include RN consultation for questions about the information provided.

5.2.1.5 Care prescribed by an employee's personal physician including administration of medications, administration of allergy immunotherapy, blood pressure and glucose (blood sugar) monitoring, wound care, and periodic bedrest. (Orders for care prescribed by outside physicians are subject to oversight physician review and approval).

5.2.1.6 Health screenings including vision, blood pressure, diabetes, cholesterol, and other risk factors for heart disease.

5.2.1.7 Administration of over the counter medication for fever, minor aches/pains, etc...

5.2.1.8 Management of designated lactation space and quiet room located within the clinic space to include regular cleaning of the room and any agency provided equipment.

5.2.1.9 Clinic staff participation in occupant emergency planning with other tenant agencies.

5.2.1.10 Program review to assist management in identifying basic safety, health, and wellness opportunities.

5.2.1.11 Care to all individuals as described in this performance work statement in the event of a life-threatening emergency; however, contractors and the general public may not otherwise receive routine convenience care services unless a specific exception is granted in advance.

5.3 Area Nurse Manager Tasks: Oversees all activities of assigned clincs and is first line supervisor of all providers within his/her designated area. Provides orientation to all new providers. Manages outreach services and travel. Ensures that all clinics are staffed according to COR’s technical direction and that work schedules are modified to meet fluctuating workloads. Performs required quality improvement reviews of each assigned site within area, using the Government guidelines and Contractor QA/QI guidelines. May provide relief coverage at clinics on an infrequent basis.

5.4 Oversight Medical/physician Tasks: Provides oversight through the use of standing orders and policies/guidance/procedures is required for the aforementioned services. This oversight must also include guidance on the management of medical charts/records.

PART 6 APPLICABLE PUBLICATIONS

6. APPLICABLE PUBLICATIONS:

6.1. The Contractor must abide by all statutes, applicable regulations, publications, manuals, and federal policies, procedures.

PART 7 ATTACHMENT/TECHNICAL EXHIBIT LISTING

7. ATTACHMENT/TECHNICAL EXHIBIT LIST:

7.1. Attachment 1/Technical Exhibit 1 – Performance Requirements Summary

7.2. Attachment 2/Technical Exhibit 2 – Deliverables Schedule

7.3. Attachment 3/Technical Exhibit 3 – Estimated Workload Data

7.4. Attachment 4/Technical Exhibit 4 – Other Direct Cost Table

TECHNICAL EXHIBIT 1

Performance Requirements Summary The contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

Performance Objective (The Service required—usually a shall statement)

standard”) Method of Surveillance

PRS # 1.

Personnel Qualifications/Performance All contractor personnel possess the skills needed to perform the required tasks as specified in the PWS.

The contractor's personnel are qualified and adept at presenting clear, concise, professional work products free from political conclusions or any judgment of individual journalist(s).

PRS # 2

Key Personnel Management

COR/program review

PRS # 3

Personnel/Workload Management The contractor shall ensure that there is sufficient coverage during core business hours to support assigned requirements.

feedback

PRS # 4

Monthly Reporting

PRS # 5

Administrative Tasks

TECHNICAL EXHIBIT 2 DELIVERABLES SCHEDULE

Ref.

accepting a backfill FTE.

the preceding month

Award Reporting System (FSRS)

Annually PDF Copy to the CO & COR

TECHNICAL EXHIBIT 3 ESTIMATED WORKLOAD DATA

The data (labor categories and hours) provided below is an estimate of what it may take to perform the major categories of requirements listed in the Performance Work Statement. The Contractor is not required to propose the data listed below for the FFP CLINs, and is encouraged to use sound judgment and business practices when preparing its quote. One Full Time Equivalent (FTE) under each Firm Fixed Price CLIN is equivalent to 1872 hours on a per annum basis.

Street, Indianapolis, IN 46249

Registered Nurse 1,872 hrs

Area Nurse Coordinator

Standing Orders/Oversight Physician

TECHNICAL EXHIBIT 4 TIME & MATERIALS

OTHER SUPPLIES AND EQUIPMENT

The data provided is an estimate of what it may take to perform the requirements listed in the Performance Work Statement for Other Direct Supplies and Equipment. characteristics.

Equipment

Thermometer, Oral Axillary Mgm120

Chair, Bld Drwng Flip-Arm Uphol Gry Mgm63

Cabinet, Sharps Lock Wall 5qt (2/cs) Mgm128

Scale, Physician Dig W/ht Rod 500lb Pelstr

Wheelchair, Dda Sf 20" 350lbs

Defibrillator, Heartsine Sam Aed 350p

Table, Trtmt H-Brace Willow/nat

Stethoscope, Sprague Rappaportblk 16" Mgm01

Sphyg, Aneroid Dlx Lf Burg Lg Adlt (1/bx) Mgm01

Sphyg, Aneroid Dlx Lf Blk Adlt(1/bx) Mgm01

Blood Pressure Unit, Surebp Mobile Stand W/usb Wa

Refrigerator, Pharm Undercounter Glass Door Lt Hng 4.6cu Ft

Diagnostic Sys, Opht/oto/bp W/access

Top, Upholstered Soft Touch F/204 Exam Table Shadow 28"

Table, Exam Ritter Base Only Fixed Height 500lbs F/204 Model

Ecg, Cp150 Interpretive Wa

Spirometry Sys, Easy One Air

Simulator Bio-Acoustic Quest Ba-202

Audiometer Ra300+ W/ht Wizpc

Booth. Hearing/test Enclosure Industrial

Card, Vision Rosenbaum Near Numbers Pckt

Chart, Eye Test Snellen Lf 20'22"x11" (5/bg)

Screener, Vision V 4 Professional Titmus

Holder, Tube Bc (100/bx 10bx/cs)

Model, Sample Safe Lb-10 Foam Insulated

Centrifuge, Clia Approved 6pl

Rack Tube Cube 9pl 8-16mm

Container, Spec W/lid Str 4oz Taped (100/cs) Mgm16

Supplies

Tube, Urine Coll Plas 10ml (100/bx) Bd

Tourniquet, Lf 18"x1" (250/bx 4bx/cs) Mgm16

Bag, Spcmn Biohaz Outside Pckt6"x9" (100/pk 10pk/ Mgm79

Towelette, Castile Soap (100/bx) Prfdis

Needle, Eclipse Bld Coll 21gx11/4" (48/bx) Bd

Needle, Eclipse Bld Coll 22gx11/4" (48/bx) Bd

Cap, Vac Tube Wht 16mm (1000/bg)

Tube, Sst Plus 8.5ml (100/bx)

Tube, Sst Plus 10ml (100/bx) Bd

Tube, Vac/hemogard Plus Gold 4ml (100/bx) Bd

Tube, Vac Sst Plus Str 7.5ml (100/bx) Bd

Engerix-B, Syr Tiplok 20mcg/ml1ml Pf (10/pk) Smklph

Twinrix, Syr 720-20mg/ml 1ml (10/pk) Smklph

Havrix, Syr 1440u/ml 1ml Pf (10/pk) Smklph

Saline, Irr Sol Str 250ml (24/cs)

Compress, Hot Inst 5"x7" Lf (24/cs) Mgm16

Compress, Cold Inst 5"x7" Lf (24/cs) Mgm16

Closure, Skin Reinf Lf 1/4x3" (3/pk 50pk/bx 4bx/cs)

Bandage, Elas Slf-Clsr Prem N/s Lf 6x5yds Mgm16

Pad, Alcohol Prep Str Med (200/bx 20bx/cs)

Sponge, Gauze 8ply N/s 2"x2" (200/bx)

Albuterol Sulfate Hfa, Inh Aerosol 90mcg 8.5gm

M-M-R Ii, Sdv (10/bx) Mrkvac

Lifogen , Disp Bd/s

Vivotif Berna Vacc, Cap 2b Unit (4/bx)

Typhim Vi, Syr 25mcg/0.5ml Snofps

Diphenhydramine, Vl 50mg/ml 1ml (25/bx) 9west

Epinephrine, Amp Pf 1mg/ml 1ml1:1000 (10/bx)

Atovaquo+proguanil, Tab 250-100mg (24/bt) 9glenm

Tank, O2 Disp Cyl 30min W/masktubing & Gauge D/s Alhoxg