Line Item Descriptions and Price Schedule.xlsx

XLSX spreadsheet 23 KB Posted Dec 11, 2020

Attached to: 6505--Radiopharmaceuticals
Solicitation number: 36C25921Q0123
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 19

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File	Type	Posted
Questions and Answers.pdf	PDF	Dec 17, 2020
36C25921Q0123 0001.docx	DOCX document	Dec 17, 2020
Statement of Work.pdf	PDF	Dec 11, 2020
36C25921Q0123.docx	DOCX document	Dec 11, 2020

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Base Year

CLIN	Item Description	Est Qty	Unit	Unit Price	Total Price HEU	Total Price NON-HEU
0001	Tc-99m Disofenin UD (1-10 mCi)	1	Ea
0002	Tc-99m Exametazime Brain UD (1-30 mCi)	1	Ea
0003	Tc-99m Filtered SC UD (1-3 mCi)	15	Ea
0004	Tc-99m Tilmanocept (Lymphoseek) (0.5-2 mCi)	8	Ea
0005	Tc-99m Macroaggregated Albumin (MAA) (1-7 mCi)	170	Ea
0006	Tc-99m Mebrofenin UD (1-8 mCi)	70	Ea
0007	Tc-99m Medronate UD (1-25 mCi)	1	Ea
0008	Tc-99m Mertiatide UD (1-10 mCi)	30	Ea
0009	Tc-99m NaTco4 UD, per mCi (including flood/linearity calibration sources	1000	per mCi
0010	Tc-99m NaTco4 UD, 35 mCi or less	70	Ea
0011	Tc-99m Oxidronate UD (1-25 mCi)	350	Ea
0012	Tc-99m Pentetate Renal UD (1-15 mCi)	1	Ea
0013	Tc-99m Pentetate UD-aerosol ventilation (1-45 mCi)	150	Ea
0014	Tc-99m Sestamibi UD (1-35 mCi)	1800	Ea
0015	Tc-99m Sulfur Colloid UD (1-10 mCi)	100	Ea
0016	Tc-99m Tetrofosmin UD (1-35 mCi)	1	Ea
0017	Tc-99m Ceretec-labeled WBCs, unit dose (including labeling service)	4	Ea
0018	Tc-99m WBC blood collection kit (heparin &/or hetastarch)	4	Ea

0019	Ga-67 Gallium Citrate UD (per mCi)	2	per mCi
0020	I-123 NaI 200uCi capsule	150	per capsule
0021	I-123 NaiI 400 uCi capsule	1	per capsule
0022	I-123 NaI pre-cal capsule	1	per capsule
0023	I-123 Iobenguane Sulfate UD (MIBG)-"or equal"	1	Ea
0024	I-131 NaI Dx cap, 4 mCi (1-6 mCi)	10	Ea
0025	I-131 NaI Dx cap, each additional mCi	1000	per mCi
0026	In-111 Pentetreotide UD (1-6 mCi)	6	Ea
0027	In-111 Oxine-labeled WBCs, unit dose (including labeling service)	1	Ea
0028	In-111 WBC blood collection kit (heparin &/or hetastarch)	1	Ea
0029	Sr-89 Strontium Chloride (1-4 mCi)	1	Ea
0030	Tl-201 Thallous Chloride, per mCi	25	per mCi
0031	F-18 FDG UD (1-15 mCi)	423	Ea
0032	F-18 NAF UD (1-15 mCi)	1	Ea

0033	Pyrophosphate Vials	75	per vial
0034	Ultratag Vials	15	per vial

0035	Delivery Fee for Additional Daily Deliveries (exceeding 2 free deliveries/day as outlined in SOW)	60	Ea
0036	Weekday STAT Order Delivery Fee (STAT orders are delivered w/in 90 minutes of order placement)	130	Ea
0037	Pharmacist Call-out Fee (weekday after-hours 1530-0500 and weekends)	40	Ea
0038	After-hour Delivery Fee (Monday-Thursday, after-hours 1530-0500)	20	Ea
0039	Weekend Delivery Fee (Friday 1530 thgough 0500 Monday)	30	Ea

0040	Hotlab Tracking Software System (purchase price)	1	EA
0041	Hotlab Tracking Maintenance Fee (software &/or hardware)	Montlhy	EA
0042	System Maintenance and Support	Montlhy	EA

Option Year 1 CLIN Item Description Est Qty Unit Unit Price Total Price HEU Total Price NON-HEU

1001	Tc-99m Disofenin UD (1-10 mCi)	1	Ea
1002	Tc-99m Exametazime Brain UD (1-30 mCi)	1	Ea
1003	Tc-99m Filtered SC UD (1-3 mCi)	15	Ea
1004	Tc-99m Tilmanocept (Lymphoseek) (0.5-2 mCi)	8	Ea
1005	Tc-99m Macroaggregated Albumin (MAA) (1-7 mCi)	170	Ea
1006	Tc-99m Mebrofenin UD (1-8 mCi)	70	Ea
1007	Tc-99m Medronate UD (1-25 mCi)	1	Ea
1008	Tc-99m Mertiatide UD (1-10 mCi)	30	Ea
1009	Tc-99m NaTco4 UD, per mCi (including flood/linearity calibration sources	1000	per mCi
1010	Tc-99m NaTco4 UD, 35 mCi or less	70	Ea
1011	Tc-99m Oxidronate UD (1-25 mCi)	350	Ea
1012	Tc-99m Pentetate Renal UD (1-15 mCi)	1	Ea
1013	Tc-99m Pentetate UD-aerosol ventilation (1-45 mCi)	150	Ea
1014	Tc-99m Sestamibi UD (1-35 mCi)	1800	Ea
1015	Tc-99m Sulfur Colloid UD (1-10 mCi)	100	Ea
1016	Tc-99m Tetrofosmin UD (1-35 mCi)	1	Ea
1017	Tc-99m Ceretec-labeled WBCs, unit dose (including labeling service)	4	Ea
1018	Tc-99m WBC blood collection kit (heparin &/or hetastarch)	4	Ea

1019	Ga-67 Gallium Citrate UD (per mCi)	2	per mCi
1020	I-123 NaI 200uCi capsule	150	per capsule
1021	I-123 NaiI 400 uCi capsule	1	per capsule
1022	I-123 NaI pre-cal capsule	1	per capsule
1023	I-123 Iobenguane Sulfate UD (MIBG)-"or equal"	1	Ea
1024	I-131 NaI Dx cap, 4 mCi (1-6 mCi)	10	Ea
1025	I-131 NaI Dx cap, each additional mCi	1000	per mCi
1026	In-111 Pentetreotide UD (1-6 mCi)	6	Ea
1027	In-111 Oxine-labeled WBCs, unit dose (including labeling service)	1	Ea
1028	In-111 WBC blood collection kit (heparin &/or hetastarch)	1	Ea
1029	Sr-89 Strontium Chloride (1-4 mCi)	1	Ea
1030	Tl-201 Thallous Chloride, per mCi	25	per mCi
1031	F-18 FDG UD (1-15 mCi)	423	Ea
1032	F-18 NAF UD (1-15 mCi)	1	Ea

1033	Pyrophosphate Vials	75	per vial
1034	Ultratag Vials	15	per vial

1035	Delivery Fee for Additional Daily Deliveries (exceeding 2 free deliveries/day as outlined in SOW)	60	Ea
1036	Weekday STAT Order Delivery Fee (STAT orders are delivered w/in 90 minutes of order placement)	130	Ea
1037	Pharmacist Call-out Fee (weekday after-hours 1530-0500 and weekends)	40	Ea
1038	After-hour Delivery Fee (Monday-Thursday, after-hours 1530-0500)	20	Ea
1039	Weekend Delivery Fee (Friday 1530 thgough 0500 Monday)	30	Ea

1040	Hotlab Tracking Software System (purchase price)	1	EA
1041	Hotlab Tracking Maintenance Fee (software &/or hardware)	Montlhy	EA
1042	System Maintenance and Support	Montlhy	EA

Option Year 2 CLIN Item Description Est Qty Unit Unit Price Total Price HEU Total Price NON-HEU

2001	Tc-99m Disofenin UD (1-10 mCi)	1	Ea
2002	Tc-99m Exametazime Brain UD (1-30 mCi)	1	Ea
2003	Tc-99m Filtered SC UD (1-3 mCi)	15	Ea
2004	Tc-99m Tilmanocept (Lymphoseek) (0.5-2 mCi)	8	Ea
2005	Tc-99m Macroaggregated Albumin (MAA) (1-7 mCi)	170	Ea
2006	Tc-99m Mebrofenin UD (1-8 mCi)	70	Ea
2007	Tc-99m Medronate UD (1-25 mCi)	1	Ea
2008	Tc-99m Mertiatide UD (1-10 mCi)	30	Ea
2009	Tc-99m NaTco4 UD, per mCi (including flood/linearity calibration sources	1000	per mCi
2010	Tc-99m NaTco4 UD, 35 mCi or less	70	Ea
2011	Tc-99m Oxidronate UD (1-25 mCi)	350	Ea
2012	Tc-99m Pentetate Renal UD (1-15 mCi)	1	Ea
2013	Tc-99m Pentetate UD-aerosol ventilation (1-45 mCi)	150	Ea
2014	Tc-99m Sestamibi UD (1-35 mCi)	1800	Ea
2015	Tc-99m Sulfur Colloid UD (1-10 mCi)	100	Ea
2016	Tc-99m Tetrofosmin UD (1-35 mCi)	1	Ea
2017	Tc-99m Ceretec-labeled WBCs, unit dose (including labeling service)	4	Ea
2018	Tc-99m WBC blood collection kit (heparin &/or hetastarch)	4	Ea

2019	Ga-67 Gallium Citrate UD (per mCi)	2	per mCi
2020	I-123 NaI 200uCi capsule	150	per capsule
2021	I-123 NaiI 400 uCi capsule	1	per capsule
2022	I-123 NaI pre-cal capsule	1	per capsule
2023	I-123 Iobenguane Sulfate UD (MIBG)-"or equal"	1	Ea
2024	I-131 NaI Dx cap, 4 mCi (1-6 mCi)	10	Ea
2025	I-131 NaI Dx cap, each additional mCi	1000	per mCi
2026	In-111 Pentetreotide UD (1-6 mCi)	6	Ea
2027	In-111 Oxine-labeled WBCs, unit dose (including labeling service)	1	Ea
2028	In-111 WBC blood collection kit (heparin &/or hetastarch)	1	Ea
2029	Sr-89 Strontium Chloride (1-4 mCi)	1	Ea
2030	Tl-201 Thallous Chloride, per mCi	25	per mCi
2031	F-18 FDG UD (1-15 mCi)	423	Ea
2032	F-18 NAF UD (1-15 mCi)	1	Ea

2033	Pyrophosphate Vials	75	per vial
2034	Ultratag Vials	15	per vial

2035	Delivery Fee for Additional Daily Deliveries (exceeding 2 free deliveries/day as outlined in SOW)	60	Ea
2036	Weekday STAT Order Delivery Fee (STAT orders are delivered w/in 90 minutes of order placement)	130	Ea
2037	Pharmacist Call-out Fee (weekday after-hours 1530-0500 and weekends)	40	Ea
2038	After-hour Delivery Fee (Monday-Thursday, after-hours 1530-0500)	20	Ea
2039	Weekend Delivery Fee (Friday 1530 thgough 0500 Monday)	30	Ea

2040	Hotlab Tracking Software System (purchase price)	1	EA
2041	Hotlab Tracking Maintenance Fee (software &/or hardware)	Montlhy	EA
2042	System Maintenance and Support	Montlhy	EA

Option Year 3 CLIN Item Description Est Qty Unit Unit Price Total Price HEU Total Price NON-HEU

3001	Tc-99m Disofenin UD (1-10 mCi)	1	Ea
3002	Tc-99m Exametazime Brain UD (1-30 mCi)	1	Ea
3003	Tc-99m Filtered SC UD (1-3 mCi)	15	Ea
3004	Tc-99m Tilmanocept (Lymphoseek) (0.5-2 mCi)	8	Ea
3005	Tc-99m Macroaggregated Albumin (MAA) (1-7 mCi)	170	Ea
3006	Tc-99m Mebrofenin UD (1-8 mCi)	70	Ea
3007	Tc-99m Medronate UD (1-25 mCi)	1	Ea
3008	Tc-99m Mertiatide UD (1-10 mCi)	30	Ea
3009	Tc-99m NaTco4 UD, per mCi (including flood/linearity calibration sources	1000	per mCi
3010	Tc-99m NaTco4 UD, 35 mCi or less	70	Ea
3011	Tc-99m Oxidronate UD (1-25 mCi)	350	Ea
3012	Tc-99m Pentetate Renal UD (1-15 mCi)	1	Ea
3013	Tc-99m Pentetate UD-aerosol ventilation (1-45 mCi)	150	Ea
3014	Tc-99m Sestamibi UD (1-35 mCi)	1800	Ea
3015	Tc-99m Sulfur Colloid UD (1-10 mCi)	100	Ea
3016	Tc-99m Tetrofosmin UD (1-35 mCi)	1	Ea
3017	Tc-99m Ceretec-labeled WBCs, unit dose (including labeling service)	4	Ea
3018	Tc-99m WBC blood collection kit (heparin &/or hetastarch)	4	Ea

3019	Ga-67 Gallium Citrate UD (per mCi)	2	per mCi
3020	I-123 NaI 200uCi capsule	150	per capsule
3021	I-123 NaiI 400 uCi capsule	1	per capsule
3022	I-123 NaI pre-cal capsule	1	per capsule
3023	I-123 Iobenguane Sulfate UD (MIBG)-"or equal"	1	Ea
3024	I-131 NaI Dx cap, 4 mCi (1-6 mCi)	10	Ea
3025	I-131 NaI Dx cap, each additional mCi	1000	per mCi
3026	In-111 Pentetreotide UD (1-6 mCi)	6	Ea
3027	In-111 Oxine-labeled WBCs, unit dose (including labeling service)	1	Ea
3028	In-111 WBC blood collection kit (heparin &/or hetastarch)	1	Ea
3029	Sr-89 Strontium Chloride (1-4 mCi)	1	Ea
3030	Tl-201 Thallous Chloride, per mCi	25	per mCi
3031	F-18 FDG UD (1-15 mCi)	423	Ea
3032	F-18 NAF UD (1-15 mCi)	1	Ea

3033	Pyrophosphate Vials	75	per vial
3034	Ultratag Vials	15	per vial

3035	Delivery Fee for Additional Daily Deliveries (exceeding 2 free deliveries/day as outlined in SOW)	60	Ea
3036	Weekday STAT Order Delivery Fee (STAT orders are delivered w/in 90 minutes of order placement)	130	Ea
3037	Pharmacist Call-out Fee (weekday after-hours 1530-0500 and weekends)	40	Ea
3038	After-hour Delivery Fee (Monday-Thursday, after-hours 1530-0500)	20	Ea
3039	Weekend Delivery Fee (Friday 1530 thgough 0500 Monday)	30	Ea

3040	Hotlab Tracking Software System (purchase price)	1	EA
3041	Hotlab Tracking Maintenance Fee (software &/or hardware)	Montlhy	EA
3042	System Maintenance and Support	Montlhy	EA

Option Year 4 CLIN Item Description Est Qty Unit Unit Price Total Price HEU Total Price NON-HEU

4001	Tc-99m Disofenin UD (1-10 mCi)	1	Ea
4002	Tc-99m Exametazime Brain UD (1-30 mCi)	1	Ea
4003	Tc-99m Filtered SC UD (1-3 mCi)	15	Ea
4004	Tc-99m Tilmanocept (Lymphoseek) (0.5-2 mCi)	8	Ea
4005	Tc-99m Macroaggregated Albumin (MAA) (1-7 mCi)	170	Ea
4006	Tc-99m Mebrofenin UD (1-8 mCi)	70	Ea
4007	Tc-99m Medronate UD (1-25 mCi)	1	Ea
4008	Tc-99m Mertiatide UD (1-10 mCi)	30	Ea
4009	Tc-99m NaTco4 UD, per mCi (including flood/linearity calibration sources	1000	per mCi
4010	Tc-99m NaTco4 UD, 35 mCi or less	70	Ea
4011	Tc-99m Oxidronate UD (1-25 mCi)	350	Ea
4012	Tc-99m Pentetate Renal UD (1-15 mCi)	1	Ea
4013	Tc-99m Pentetate UD-aerosol ventilation (1-45 mCi)	150	Ea
4014	Tc-99m Sestamibi UD (1-35 mCi)	1800	Ea
4015	Tc-99m Sulfur Colloid UD (1-10 mCi)	100	Ea
4016	Tc-99m Tetrofosmin UD (1-35 mCi)	1	Ea
4017	Tc-99m Ceretec-labeled WBCs, unit dose (including labeling service)	4	Ea
4018	Tc-99m WBC blood collection kit (heparin &/or hetastarch)	4	Ea

4019	Ga-67 Gallium Citrate UD (per mCi)	2	per mCi
4020	I-123 NaI 200uCi capsule	150	per capsule
4021	I-123 NaiI 400 uCi capsule	1	per capsule
4022	I-123 NaI pre-cal capsule	1	per capsule
4023	I-123 Iobenguane Sulfate UD (MIBG)-"or equal"	1	Ea
4024	I-131 NaI Dx cap, 4 mCi (1-6 mCi)	10	Ea
4025	I-131 NaI Dx cap, each additional mCi	1000	per mCi
4026	In-111 Pentetreotide UD (1-6 mCi)	6	Ea
4027	In-111 Oxine-labeled WBCs, unit dose (including labeling service)	1	Ea
4028	In-111 WBC blood collection kit (heparin &/or hetastarch)	1	Ea
4029	Sr-89 Strontium Chloride (1-4 mCi)	1	Ea
4030	Tl-201 Thallous Chloride, per mCi	25	per mCi
4031	F-18 FDG UD (1-15 mCi)	423	Ea
4032	F-18 NAF UD (1-15 mCi)	1	Ea

4033	Pyrophosphate Vials	75	per vial
4034	Ultratag Vials	15	per vial

4035	Delivery Fee for Additional Daily Deliveries (exceeding 2 free deliveries/day as outlined in SOW)	60	Ea
4036	Weekday STAT Order Delivery Fee (STAT orders are delivered w/in 90 minutes of order placement)	130	Ea
4037	Pharmacist Call-out Fee (weekday after-hours 1530-0500 and weekends)	40	Ea
4038	After-hour Delivery Fee (Monday-Thursday, after-hours 1530-0500)	20	Ea
4039	Weekend Delivery Fee (Friday 1530 thgough 0500 Monday)	30	Ea

4040	Hotlab Tracking Software System (purchase price)	1	EA
4041	Hotlab Tracking Maintenance Fee (software &/or hardware)	Montlhy	EA
4042	System Maintenance and Support	Montlhy	EA

File details come from the government source that posted it. Updated Dec 11, 2020.