Price Schedule Tool.xlsx

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Reference Laboratory Services
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75H709-BAIHS23Q-007
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12 Month Utilization.xlsx XLSX spreadsheet
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REF LAB PRICING

BIL-IHS AREA-WIDE REFERENCE LAB IDIQ Pricing Schedule
PERIOD OF PERFORMANCEBASE Ordering Period (CLIN 1)Ordering Period 1 (CLIN 2)Ordering Period 2 (CLIN 3)Ordering Period 3 (CLIN 4)Ordering Period 4 (CLIN 5)
3/1/23 - 2/29/243/1/24 - 2/28/253/1/25 - 2/28/263/1/26 - 2/28/263/1/26 - 2/28/27
BLACKFEETTOTAL AMOUNT
DescriptionUnit of IssueQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax Amount$0.00
Anatomic Pathology and Clinical Laboratory Testing Services - BFMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Anatomic Pathology and Clinical Laboratory Testing Services - HBMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Medical DirectorshipMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Technical Consultant / Technologist ReportEA4$ - 0$ - 04$ - 0$ - 04$ - 0$ - 04$ - 0$ - 04$ - 0$ - 0
Excess Charges (Rate)EA$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0
totals40$ - 040$ - 040$ - 040$ - 040$ - 0
CROWTOTAL AMOUNT
DescriptionUnit of IssueQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax Amount$0.00
Anatomic Pathology and Clinical Laboratory Testing Services - CNCHMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Anatomic Pathology and Clinical Laboratory Testing Services - PRMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Anatomic Pathology and Clinical Laboratory Testing Services - LGMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Medical DirectorshipMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Technical Consultant / Technologist ReportEA4$ - 0$ - 04$ - 0$ - 04$ - 0$ - 04$ - 0$ - 04$ - 0$ - 0
Excess Charges (Rate)EA$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0
totals52$ - 052$ - 052$ - 052$ - 052$ - 0
FORT BELKNAPTOTAL AMOUNT
DescriptionUnit of IssueQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax Amount$0.00
Anatomic Pathology and Clinical Laboratory Testing Services - FBMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Anatomic Pathology and Clinical Laboratory Testing Services - HYMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Medical DirectorshipMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Technical Consultant / Technologist ReportEA4$ - 0$ - 04$ - 0$ - 04$ - 0$ - 04$ - 0$ - 04$ - 0$ - 0
Excess Charges (Rate)EA$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0
totals40$ - 040$ - 040$ - 040$ - 040$ - 0
FORT PECKTOTAL AMOUNT
DescriptionUnit of IssueQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax Amount$0.00
Anatomic Pathology and Clinical Laboratory Testing Services - CRMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Anatomic Pathology and Clinical Laboratory Testing Services - VGMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Medical DirectorshipMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Excess Charges (Rate)EA$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0
totals36$ - 036$ - 036$ - 036$ - 036$ - 0
LITTLESHELLTOTAL AMOUNT
DescriptionUnit of IssueQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax Amount$0.00
Anatomic Pathology and Clinical Laboratory Testing Services - LSMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Medical DirectorshipMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Excess Charges (Rate)EA$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0
totals24$ - 024$ - 024$ - 024$ - 024$ - 0
NORTHERN CHEYENNETOTAL AMOUNT
DescriptionUnit of IssueQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax Amount$0.00
Anatomic Pathology and Clinical Laboratory Testing Services - NCMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Medical DirectorshipMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Excess Charges (Rate)EA$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0
totals24$ - 024$ - 024$ - 024$ - 024$ - 0
WIND RIVERTOTAL AMOUNT
DescriptionUnit of IssueQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax AmountQTYUnit PriceMax Amount$0.00
Anatomic Pathology and Clinical Laboratory Testing Services - WRMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Medical DirectorshipMO12$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 012$ - 0$ - 0
Excess Charges (Rate)EA$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0
totals24$ - 024$ - 024$ - 024$ - 024$ - 0

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