35_TCRS_Sec_L_Exhib_L-7_Price_Prop_Tmplt_4-4-16.xlsx
XLSX spreadsheet 27 KB Posted
- Attached to
- TRICARE Claims Review Services
- Solicitation number
- HT9402-17-R-0002
- Issued by
-
Defense Health Agency
About this file
Section L Exhibit L-7
View the file
Other files
Show 40 more
Latest 50 of 87 listed here. See the rest on GovTribe.
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
Price Proposal Template
| TCRS HT9402-15-0003 | |||||||
| Section L Exhibit L-7 Price Proposal Template | |||||||
| OFFEROR: | |||||||
| Price Proposal by CLIN | |||||||
| Period | CLIN/ SLIN | CLIN Description | Unit of Issue | Quantity | Price Each | Price Total | |
| Transition-In | 0001 | Transition-in (Section C paragraph 6.3.1 Transition-in). Fixed price | LO | 1 | $0.00 | ||
| 0002 | Deliverables (DD Forms 1423-1, Contract Data Requirements List (CDRLS)) Not separately priced (NSP) | NSP | |||||
| Base total | Total | $0.00 | |||||
| Option Period 1 | 1001 | Option Year 1 Mangaged Care Support Contracts (MCSCs) Quarterly Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 19,200 | $0.00 | ||
| 1002 | Option Year 1 TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC) Quarterly Compliance Reviews (Section C paragraph 6.4). Fixed price per claim. Not to exceed quantity: | EA | 8,800 | $0.00 | |||
| 1003 | Option Year 1 TRICARE Overseas Program (TOP) Quarterly Compliance Reviews (Section C paragraph 6.4). Fixed price per claim. Not to exceed quantity: | EA | 7,500 | $0.00 | |||
| 1004 | Option Year 1 TRICARE Pharmacy Program (Tpharm) Quarterly Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 11,200 | $0.00 | |||
| 1005 | Option Year 1 Active Duty Dental Program (ADDP) Semiannual Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 2,500 | $0.00 | |||
| 1006 | Option Year 1 Mangaged Care Support Contracts (MCSCs) Annual Health Care Cost Audits (Section C paragraph 6.4.2.1) Fixed price per claim. Not to exceed quantity: | EA | 15,000 | $0.00 | |||
| 1007 | Option Year 1 Focus Studies (Section C paragraph 6.5.1 ) Fixed price per claim. Not to exceed: | EA | 15,000 | $0.00 | |||
| 1008 | Option Year 1 Medical Record Reviews (Section C paragraph 6.5.2) Fixed price per record. Not to exceed quantity: | EA | 36,000 | $0.00 | |||
| 1009 | Option Year 1 Transition-Out (Section C paragraph 6.3.2 ) FFP | LO | 1 | $0.00 | |||
| 1010 | Deliverables (DD Forms 1423-1, CDRLS) | ||||||
| Not separately priced (NSP). | NSP | ||||||
| Option Period 1 Total | $0.00 | ||||||
| Option Period 2 | 2001 | Option Year 2 Mangaged Care Support Contracts (MCSCs) Quarterly Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 19,200 | $0.00 | ||
| 2002 | Option Year 2 TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC) Quarterly Compliance Reviews (Section C paragraph 6.4). Fixed price per claim. Not to exceed quantity: | EA | 8,800 | $0.00 | |||
| 2003 | Option Year 2 TRICARE Overseas Program (TOP) Quarterly Compliance Reviews (Section C paragraph 6.4). Fixed price per claim. Not to exceed quantity: | EA | 7,500 | $0.00 | |||
| 2004 | Option Year 2 TRICARE Pharmacy Program (Tpharm) Quarterly Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 11,200 | $0.00 | |||
| 2005 | Option Year 2 Active Duty Dental Program (ADDP) Semiannual Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 2,500 | $0.00 | |||
| 2006 | Option Year 1 Mangaged Care Support Contracts (MCSCs) Annual Health Care Cost Audits (Section C paragraph 6.4.2.1) Fixed price per claim. Not to exceed quantity: | EA | 15,000 | $0.00 | |||
| 2007 | Option Year 2 Focus Studies (Section C paragraph 6.5.1 ) Fixed price per claim. Not to exceed quantity: | EA | 15,000 | $0.00 | |||
| 2008 | Option Year 2 Medical Record Reviews (Section C paragraph 6.5.2) Fixed price per record. Not to exceed: | EA | 36,000 | $0.00 | |||
| 2009 | Option Year 2 Transition-Out (Section C paragraph 6.3.2 ) FFP | LO | 1 | $0.00 | |||
| 2010 | Deliverables (DD Forms 1423-1, CDRLS) | ||||||
| Not separately priced (NSP). | NSP | ||||||
| Option Period 2 Total | $0.00 | ||||||
| Option Period 3 | 3001 | Option Year 3 Mangaged Care Support Contracts (MCSCs) Quarterly Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 19,200 | $0.00 | ||
| 3002 | Option Year 3 TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC) Quarterly Compliance Reviews (Section C paragraph 6.4). Fixed price per claim. Not to exceed quantity: | EA | 8,800 | $0.00 | |||
| 3003 | Option Year 3 TRICARE Overseas Program (TOP) Quarterly Compliance Reviews (Section C paragraph 6.4). Fixed price per claim. Not to exceed quantity: | EA | 7,500 | $0.00 | |||
| 3004 | Option Year 3 TRICARE Pharmacy Program (Tpharm) Quarterly Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 11,200 | $0.00 | |||
| 3005 | Option Year 3 Active Duty Dental Program (ADDP) Semiannual Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 2,500 | $0.00 | |||
| 3006 | Option Year 3 Mangaged Care Support Contracts (MCSCs) Annual Health Care Cost Audits (Section C paragraph 6.4.2.1) Fixed price per claim. Not to exceed quantity: | EA | 15,000 | $0.00 | |||
| 3007 | Option Year 3 Focus Studies (Section C paragraph 6.5.1 ) Fixed price per claim. Not to exceed quantity: | EA | 15,000 | $0.00 | |||
| 3008 | Option Year 3 Medical Record Reviews (Section C paragraph 6.5.2) Fixed price per record. Not to exceed quantity: | EA | 36,000 | $0.00 | |||
| 3009 | Option Year 3 Transition-Out (Section C paragraph 6.3.2 ) FFP | LO | 1 | $0.00 | |||
| 3010 | Option Year 3 Deliverables (DD Forms 1423-1, CDRLS) | ||||||
| Not separately priced (NSP). | NSP | ||||||
| Option Period 3 Total | $0.00 | ||||||
| Option Period 4 | 4001 | Option Year 4 Mangaged Care Support Contracts (MCSCs) Quarterly Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 19,200 | $0.00 | ||
| 4002 | Option Year 4 TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC) Quarterly Compliance Reviews (Section C paragraph 6.4). Fixed price per claim. Not to exceed quantity: | EA | 8,800 | $0.00 | |||
| 4003 | Option Year 4 TRICARE Overseas Program (TOP) Quarterly Compliance Reviews (Section C paragraph 6.4). Fixed price per claim. Not to exceed quantity: | EA | 7,500 | $0.00 | |||
| 4004 | Option Year 4 TRICARE Pharmacy Program (Tpharm) Quarterly Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 11,200 | $0.00 | |||
| 4005 | Option Year 4 Active Duty Dental Program (ADDP) Semiannual Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 2,500 | $0.00 | |||
| 4006 | Option Year 4 Mangaged Care Support Contracts (MCSCs) Annual Health Care Cost Audits (Section C paragraph 6.4.2.1) Fixed price per claim. Not to exceed quantity: | EA | 15,000 | $0.00 | |||
| 4007 | Option Year 4 Focus Studies (Section C paragraph 6.5.1 ) Fixed price per claim. Not to exceed quantity: | EA | 15,000 | $0.00 | |||
| 4008 | Option Year 4 Medical Record Reviews (Section C paragraph 6.5.2) Fixed price per record. Not to exceed quantity: | EA | 36,000 | $0.00 | |||
| 4009 | Option Year 4 Transition-Out (Section C paragraph 6.3.2 ) FFP | LO | 1 | $0.00 | |||
| 4010 | Option Year 4 Deliverables (DD Forms 1423-1, CDRLS) | ||||||
| Not separately priced (NSP). | NSP | ||||||
| Option Period 4 Total | $0.00 | ||||||
| Option Period 5 | 5001 | Option Year 5 Mangaged Care Support Contracts (MCSCs) Quarterly Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 19,200 | $0.00 | ||
| 5002 | Option Year 5 TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC) Quarterly Compliance Reviews (Section C paragraph 6.4). Fixed price per claim. Not to exceed quantity: | EA | 8,800 | $0.00 | |||
| 5003 | Option Year 5 TRICARE Overseas Program (TOP) Quarterly Compliance Reviews (Section C paragraph 6.4). Fixed price per claim. Not to exceed quantity: | EA | 7,500 | $0.00 | |||
| 5004 | Option Year 5 TRICARE Pharmacy Program (Tpharm) Quarterly Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 11,200 | $0.00 | |||
| 5005 | Option Year 5 Active Duty Dental Program (ADDP) Semiannual Compliance Reviews (Section C paragraph 6.4) Fixed price per claim. Not to exceed quantity: | EA | 2,500 | $0.00 | |||
| 5006 | Option Year 5 Mangaged Care Support Contracts (MCSCs) Annual Health Care Cost Audits (Section C paragraph 6.4.2.1) Fixed price per claim.Not to exceed quantity: | EA | 15,000 | $0.00 | |||
| 5007 | Option Year 5 Focus Studies (Section C paragraph 6.5.1 ) Fixed price per claim. Not to exceed quantity: | EA | 15,000 | $0.00 | |||
| 5008 | Option Year 5 Medical Record Reviews (Section C paragraph 6.5.2) Fixed price per record. Not to exceed quantity: | EA | 36,000 | $0.00 | |||
| 5009 | Option Year 5 Transition-Out (Section C paragraph 6.3.2 ) FFP | LO | 1 | $0.00 | |||
| 5010 | Option Year 5 Deliverables (DD Forms 1423-1, CDRLS) | ||||||
| Not separately priced (NSP). | NSP | ||||||
| Option Period 5 Total | $0.00 | ||||||
| Total all option years | $0.00 | ||||||
| 6 month extension of services | OY 5 x 0.5 | $0.00 | |||||
| Total Evaluated Price | $0.00 |
Section L, Exhibit L-7
TCRS HT9402-15-R-0003, Section L Exhibit L-7 Page &P of &N
Summary by CLIN, Option Yr
| TCRS HT9402-15-R-0003 | ||||||||
| Section L Exhibit L-11 Price Proposal Template | ||||||||
| OFFEROR: | ||||||||
| Totals by Option Year | Total by | |||||||
| Price Proposal by CLIN by Option Period | Base | OY 1 | OY 2 | OY 3 | OY 4 | OY 5 | CLIN | |
| 0001 | Transition-in (Section C paragraph 6.3.1 Transition-in). Fixed price | $0.00 | ||||||
| 0002 | Deliverables (DD Forms 1423-1, Contract Data Requirements List (CDRLS)) Not separately priced (NSP) | |||||||
| X001 | Mangaged Care Support Contracts (MCSCs) Quarterly Compliance Reviews (Section C paragraph 6.4) | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| X002 | TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC) Quarterly Compliance Reviews (Section C paragraph 6.4) | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| X003 | TRICARE Overseas Program (TOP) Quarterly Compliance Reviews (Section C paragraph 6.4) | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| X004 | TRICARE Pharmacy Program (Tpharm) Quarterly Compliance Reviews (Section C paragraph 6.4) | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| X005 | Active Duty Dental Program (ADDP) Semiannual Compliance Reviews (Section C paragraph 6.4) | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| X006 | Mangaged Care Support Contracts (MCSCs) Annual Health Care Cost Audits (Section C paragraph 6.4.2.1) | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| X007 | Focus Studies (Section C paragraph 6.5.1 ) | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| X008 | Medical Record Reviews (Section C paragraph 6.5.2) | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| X009 | Transition-Out (Section C paragraph 6.3.2 ) | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| X010 | Deliverables (DD Forms 1423-1, Contract Data Requirements List (CDRLS)) Not separately priced (NSP) Enter Estimated Cost on the "CDRL Cost Estimate" Worksheet | |||||||
| Total per period | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| Total all CLINs/Periods | $0.00 | |||||||
| 6-month extension of services | $0.00 | |||||||
| Total Evaluated Price | $0.00 |
CDRL Cost Estimate
| TCRS HT9402-15-R-0003 | |||||||
| Section L Exhibit L-11 Price Proposal Template | |||||||
| OFFEROR: | |||||||
| Estimated Cost for CDRLs | Base | OY 1 | OY 2 | OY 3 | OY 4 | OY 5 | |
| 0002 | Deliverables (DD Forms 1423-1, Contract Data Requirements List (CDRLS)) Not separately priced (NSP) | ||||||
| X010 | Deliverables (DD Forms 1423-1, Contract Data Requirements List (CDRLS)) Not separately priced (NSP) | ||||||
| Total Estimated Cost for CDRLs | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| Not included in the total evaluated price |
File details come from the government source that posted it. Updated .