PRICE WORKSHEET.xlsx

XLSX spreadsheet 26 KB Posted Sep 12, 2022

Attached to: Q503--Department of Veterans Affairs VA Loma Linda Healthcare System Dental Service Department Dental Laboratory Services
Solicitation number: 36C26222Q1721
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 22

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File	Type	Posted
36C26222Q1721_2.docx	DOCX document	Sep 22, 2022
WAGE DETERMINATION - SAN BERNARDINO COUNTY.pdf	PDF	Sep 12, 2022
36C26222Q1721_1.docx	DOCX document	Sep 12, 2022
36C26222Q1721.pdf	PDF	Sep 12, 2022

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Base Year

CLIN	ITEM DESCRIPTION	Unit of Measure	Annual Est. Qty	Unit Price	Extended Price
	PORCELAIN FUSED TO METAL
0001	Semi-precious metal (white) WL-1	EA	100
0002	Metal Lingual	EA	100
0003	Metal Collar Margin	EA	100
0004	Porcelain Margin	EA	20
0005	Fit to Partial	EA	5
0006	Rest Prep	EA	10
0007	Cingulum Rest Semi Precious	EA	34
0008	Porcelain Fused to White High Noble	EA	140
	IMPLANT
0009	Implant Crowns PFM (white) semi-precious	EA	56
0010	Implant Crowns PFM (White) High Noble	EA	56
0011	Implant Crowns – Full Cast High Noble	EA	14
0012	Stauman Abut. Titanium PFM Semi-Precious	EA	30
0013	Custom UCLA Abutment PFM to White High Noble	EA	10
0014	Custom UCLA Abutment PFM to W. Semi-Precious	EA	96
0015	Custom UCLA Abutment Full Cast High Noble	EA	18
	ALL PORCELAIN
0016	Distal Guide Plane Zirconia	EA	6
0017	IPS Emax – Layered	EA	35
0018	IPS Emax – Stained	EA	44
0019	IPS Emax – Inlay/Onlay – Stained	EA	14
0020	IPS Emax – Maryland Bridge	EA	2
0021	IPS Emax - Veneer	EA	10
0022	Mesial Rest Zirconia	EA	2
0023	Mesial Guide Sleeve	EA	6
0024	Full Contour Solid High Translucency Zirconia	EA	54
0025	Full Contour Solid Zirconia	EA	24
0026	Metal Occlusal Semi-Precious	EA	80
0027	Metal Occlusal White High Noble	EA	14
0028	Mesial Guide Plane Semi-Precious	EA	32
0029	Medial Rest Semi-Precious	EA	44
0030	Mesial Rest High Noble	EA	6
0031	Biocare-Implant Abutment Titanium PFM	EA	12
0032	Biocare-Abut, Titanium High Noble	EA	8
	FULL CAST CROWN
0033	Gold Crown (Plus Metal)	EA	14
0034	Full Cast High Noble Crown Over Single Stage	EA	10
0035	Full Cast White Semi-Precious	EA	14
0036	Full Cast Yellow Semi-Precious	EA	14
0037	Myerson Ema Sleep Apnea Device	EA	4
0038	Pink Porcelain Gingival Color	EA	8
0039	PMMA Temporary	EA	22
0040	Temporary Crown	EA	20
0041	Distal Guide Plane Semi-Precious	EA	56
	ATTACHMENTS (PLUS COST OF ATTACHMENT)
0042	P.D. Attachments	EA	4
0043	Distal Rest Semi-Precious	EA	14
0044	Atlantis Abutment Titanium PFM Semi-Precious	EA	2
0045	Cast Post Semi-Precious	EA	12
0046	Acrylic Stay-Plate 1-2 Teeth	EA	2
0047	Acrylic Stay-Plate 3-7 Teeth	EA	2
0048	Acrylic Stay-Plate 8 or More Teeth	EA	2
0049	Attachment Labor Removable	EA	6
0050	PFM Semi-Precious Crown Over Single Stage	EA	62
0051	PFM White High Noble Crown Over Single Stage	EA	22
	ACRYLIC
0052	Hard Night Guard Hand Wax Clear Acrylic	EA	6
0053	Diagnostic Wax-Up	EA	344
0054	Economy Denture Without Bite Block	EA	4
0055	Stent-Clear Surgical Guide	EA	20
0056	Vacuum Formed Stent of Diagnostic Wax-Up	EA	26
0057	Zirconia Custom Hand-Layered Porcelain	EA	74
TOTAL PRICE				$

Option Year One

CLIN	ITEM DESCRIPTION	Unit of Measure	Annual Est. Qty	Unit Price	Extended Price
	PORCELAIN FUSED TO METAL
0001	Semi-precious metal (white) WL-1	EA	100
0002	Metal Lingual	EA	100
0003	Metal Collar Margin	EA	100
0004	Porcelain Margin	EA	20
0005	Fit to Partial	EA	5
0006	Rest Prep	EA	10
0007	Cingulum Rest Semi Precious	EA	34
0008	Porcelain Fused to White High Noble	EA	140
	IMPLANT
0009	Implant Crowns PFM (white) semi-precious	EA	56
0010	Implant Crowns PFM (White) High Noble	EA	56
0011	Implant Crowns – Full Cast High Noble	EA	14
0012	Stauman Abut. Titanium PFM Semi-Precious	EA	30
0013	Custom UCLA Abutment PFM to White High Noble	EA	10
0014	Custom UCLA Abutment PFM to W. Semi-Precious	EA	96
0015	Custom UCLA Abutment Full Cast High Noble	EA	18
	ALL PORCELAIN
0016	Distal Guide Plane Zirconia	EA	6
0017	IPS Emax – Layered	EA	35
0018	IPS Emax – Stained	EA	44
0019	IPS Emax – Inlay/Onlay – Stained	EA	14
0020	IPS Emax – Maryland Bridge	EA	2
0021	IPS Emax - Veneer	EA	10
0022	Mesial Rest Zirconia	EA	2
0023	Mesial Guide Sleeve	EA	6
0024	Full Contour Solid High Translucency Zirconia	EA	54
0025	Full Contour Solid Zirconia	EA	24
0026	Metal Occlusal Semi-Precious	EA	80
0027	Metal Occlusal White High Noble	EA	14
0028	Mesial Guide Plane Semi-Precious	EA	32
0029	Medial Rest Semi-Precious	EA	44
0030	Mesial Rest High Noble	EA	6
0031	Biocare-Implant Abutment Titanium PFM	EA	12
0032	Biocare-Abut, Titanium High Noble	EA	8
	FULL CAST CROWN
0033	Gold Crown (Plus Metal)	EA	14
0034	Full Cast High Noble Crown Over Single Stage	EA	10
0035	Full Cast White Semi-Precious	EA	14
0036	Full Cast Yellow Semi-Precious	EA	14
0037	Myerson Ema Sleep Apnea Device	EA	4
0038	Pink Porcelain Gingival Color	EA	8
0039	PMMA Temporary	EA	22
0040	Temporary Crown	EA	20
0041	Distal Guide Plane Semi-Precious	EA	56
	ATTACHMENTS (PLUS COST OF ATTACHMENT)
0042	P.D. Attachments	EA	4
0043	Distal Rest Semi-Precious	EA	14
0044	Atlantis Abutment Titanium PFM Semi-Precious	EA	2
0045	Cast Post Semi-Precious	EA	12
0046	Acrylic Stay-Plate 1-2 Teeth	EA	2
0047	Acrylic Stay-Plate 3-7 Teeth	EA	2
0048	Acrylic Stay-Plate 8 or More Teeth	EA	2
0049	Attachment Labor Removable	EA	6
0050	PFM Semi-Precious Crown Over Single Stage	EA	62
0051	PFM White High Noble Crown Over Single Stage	EA	22
	ACRYLIC
0052	Hard Night Guard Hand Wax Clear Acrylic	EA	6
0053	Diagnostic Wax-Up	EA	344
0054	Economy Denture Without Bite Block	EA	4
0055	Stent-Clear Surgical Guide	EA	20
0056	Vacuum Formed Stent of Diagnostic Wax-Up	EA	26
0057	Zirconia Custom Hand-Layered Porcelain	EA	74
TOTAL PRICE				$

Option Year Two

CLIN	ITEM DESCRIPTION	Unit of Measure	Annual Est. Qty	Unit Price	Extended Price
	PORCELAIN FUSED TO METAL
0001	Semi-precious metal (white) WL-1	EA	100
0002	Metal Lingual	EA	100
0003	Metal Collar Margin	EA	100
0004	Porcelain Margin	EA	20
0005	Fit to Partial	EA	5
0006	Rest Prep	EA	10
0007	Cingulum Rest Semi Precious	EA	34
0008	Porcelain Fused to White High Noble	EA	140
	IMPLANT
0009	Implant Crowns PFM (white) semi-precious	EA	56
0010	Implant Crowns PFM (White) High Noble	EA	56
0011	Implant Crowns – Full Cast High Noble	EA	14
0012	Stauman Abut. Titanium PFM Semi-Precious	EA	30
0013	Custom UCLA Abutment PFM to White High Noble	EA	10
0014	Custom UCLA Abutment PFM to W. Semi-Precious	EA	96
0015	Custom UCLA Abutment Full Cast High Noble	EA	18
	ALL PORCELAIN
0016	Distal Guide Plane Zirconia	EA	6
0017	IPS Emax – Layered	EA	35
0018	IPS Emax – Stained	EA	44
0019	IPS Emax – Inlay/Onlay – Stained	EA	14
0020	IPS Emax – Maryland Bridge	EA	2
0021	IPS Emax - Veneer	EA	10
0022	Mesial Rest Zirconia	EA	2
0023	Mesial Guide Sleeve	EA	6
0024	Full Contour Solid High Translucency Zirconia	EA	54
0025	Full Contour Solid Zirconia	EA	24
0026	Metal Occlusal Semi-Precious	EA	80
0027	Metal Occlusal White High Noble	EA	14
0028	Mesial Guide Plane Semi-Precious	EA	32
0029	Medial Rest Semi-Precious	EA	44
0030	Mesial Rest High Noble	EA	6
0031	Biocare-Implant Abutment Titanium PFM	EA	12
0032	Biocare-Abut, Titanium High Noble	EA	8
	FULL CAST CROWN
0033	Gold Crown (Plus Metal)	EA	14
0034	Full Cast High Noble Crown Over Single Stage	EA	10
0035	Full Cast White Semi-Precious	EA	14
0036	Full Cast Yellow Semi-Precious	EA	14
0037	Myerson Ema Sleep Apnea Device	EA	4
0038	Pink Porcelain Gingival Color	EA	8
0039	PMMA Temporary	EA	22
0040	Temporary Crown	EA	20
0041	Distal Guide Plane Semi-Precious	EA	56
	ATTACHMENTS (PLUS COST OF ATTACHMENT)
0042	P.D. Attachments	EA	4
0043	Distal Rest Semi-Precious	EA	14
0044	Atlantis Abutment Titanium PFM Semi-Precious	EA	2
0045	Cast Post Semi-Precious	EA	12
0046	Acrylic Stay-Plate 1-2 Teeth	EA	2
0047	Acrylic Stay-Plate 3-7 Teeth	EA	2
0048	Acrylic Stay-Plate 8 or More Teeth	EA	2
0049	Attachment Labor Removable	EA	6
0050	PFM Semi-Precious Crown Over Single Stage	EA	62
0051	PFM White High Noble Crown Over Single Stage	EA	22
	ACRYLIC
0052	Hard Night Guard Hand Wax Clear Acrylic	EA	6
0053	Diagnostic Wax-Up	EA	344
0054	Economy Denture Without Bite Block	EA	4
0055	Stent-Clear Surgical Guide	EA	20
0056	Vacuum Formed Stent of Diagnostic Wax-Up	EA	26
0057	Zirconia Custom Hand-Layered Porcelain	EA	74
TOTAL PRICE				$

Option Year Three

CLIN	ITEM DESCRIPTION	Unit of Measure	Annual Est. Qty	Unit Price	Extended Price
	PORCELAIN FUSED TO METAL
0001	Semi-precious metal (white) WL-1	EA	100
0002	Metal Lingual	EA	100
0003	Metal Collar Margin	EA	100
0004	Porcelain Margin	EA	20
0005	Fit to Partial	EA	5
0006	Rest Prep	EA	10
0007	Cingulum Rest Semi Precious	EA	34
0008	Porcelain Fused to White High Noble	EA	140
	IMPLANT
0009	Implant Crowns PFM (white) semi-precious	EA	56
0010	Implant Crowns PFM (White) High Noble	EA	56
0011	Implant Crowns – Full Cast High Noble	EA	14
0012	Stauman Abut. Titanium PFM Semi-Precious	EA	30
0013	Custom UCLA Abutment PFM to White High Noble	EA	10
0014	Custom UCLA Abutment PFM to W. Semi-Precious	EA	96
0015	Custom UCLA Abutment Full Cast High Noble	EA	18
	ALL PORCELAIN
0016	Distal Guide Plane Zirconia	EA	6
0017	IPS Emax – Layered	EA	35
0018	IPS Emax – Stained	EA	44
0019	IPS Emax – Inlay/Onlay – Stained	EA	14
0020	IPS Emax – Maryland Bridge	EA	2
0021	IPS Emax - Veneer	EA	10
0022	Mesial Rest Zirconia	EA	2
0023	Mesial Guide Sleeve	EA	6
0024	Full Contour Solid High Translucency Zirconia	EA	54
0025	Full Contour Solid Zirconia	EA	24
0026	Metal Occlusal Semi-Precious	EA	80
0027	Metal Occlusal White High Noble	EA	14
0028	Mesial Guide Plane Semi-Precious	EA	32
0029	Medial Rest Semi-Precious	EA	44
0030	Mesial Rest High Noble	EA	6
0031	Biocare-Implant Abutment Titanium PFM	EA	12
0032	Biocare-Abut, Titanium High Noble	EA	8
	FULL CAST CROWN
0033	Gold Crown (Plus Metal)	EA	14
0034	Full Cast High Noble Crown Over Single Stage	EA	10
0035	Full Cast White Semi-Precious	EA	14
0036	Full Cast Yellow Semi-Precious	EA	14
0037	Myerson Ema Sleep Apnea Device	EA	4
0038	Pink Porcelain Gingival Color	EA	8
0039	PMMA Temporary	EA	22
0040	Temporary Crown	EA	20
0041	Distal Guide Plane Semi-Precious	EA	56
	ATTACHMENTS (PLUS COST OF ATTACHMENT)
0042	P.D. Attachments	EA	4
0043	Distal Rest Semi-Precious	EA	14
0044	Atlantis Abutment Titanium PFM Semi-Precious	EA	2
0045	Cast Post Semi-Precious	EA	12
0046	Acrylic Stay-Plate 1-2 Teeth	EA	2
0047	Acrylic Stay-Plate 3-7 Teeth	EA	2
0048	Acrylic Stay-Plate 8 or More Teeth	EA	2
0049	Attachment Labor Removable	EA	6
0050	PFM Semi-Precious Crown Over Single Stage	EA	62
0051	PFM White High Noble Crown Over Single Stage	EA	22
	ACRYLIC
0052	Hard Night Guard Hand Wax Clear Acrylic	EA	6
0053	Diagnostic Wax-Up	EA	344
0054	Economy Denture Without Bite Block	EA	4
0055	Stent-Clear Surgical Guide	EA	20
0056	Vacuum Formed Stent of Diagnostic Wax-Up	EA	26
0057	Zirconia Custom Hand-Layered Porcelain	EA	74
TOTAL PRICE				$

Option Year Four

CLIN	ITEM DESCRIPTION	Unit of Measure	Annual Est. Qty	Unit Price	Extended Price
	PORCELAIN FUSED TO METAL
0001	Semi-precious metal (white) WL-1	EA	100
0002	Metal Lingual	EA	100
0003	Metal Collar Margin	EA	100
0004	Porcelain Margin	EA	20
0005	Fit to Partial	EA	5
0006	Rest Prep	EA	10
0007	Cingulum Rest Semi Precious	EA	34
0008	Porcelain Fused to White High Noble	EA	140
	IMPLANT
0009	Implant Crowns PFM (white) semi-precious	EA	56
0010	Implant Crowns PFM (White) High Noble	EA	56
0011	Implant Crowns – Full Cast High Noble	EA	14
0012	Stauman Abut. Titanium PFM Semi-Precious	EA	30
0013	Custom UCLA Abutment PFM to White High Noble	EA	10
0014	Custom UCLA Abutment PFM to W. Semi-Precious	EA	96
0015	Custom UCLA Abutment Full Cast High Noble	EA	18
	ALL PORCELAIN
0016	Distal Guide Plane Zirconia	EA	6
0017	IPS Emax – Layered	EA	35
0018	IPS Emax – Stained	EA	44
0019	IPS Emax – Inlay/Onlay – Stained	EA	14
0020	IPS Emax – Maryland Bridge	EA	2
0021	IPS Emax - Veneer	EA	10
0022	Mesial Rest Zirconia	EA	2
0023	Mesial Guide Sleeve	EA	6
0024	Full Contour Solid High Translucency Zirconia	EA	54
0025	Full Contour Solid Zirconia	EA	24
0026	Metal Occlusal Semi-Precious	EA	80
0027	Metal Occlusal White High Noble	EA	14
0028	Mesial Guide Plane Semi-Precious	EA	32
0029	Medial Rest Semi-Precious	EA	44
0030	Mesial Rest High Noble	EA	6
0031	Biocare-Implant Abutment Titanium PFM	EA	12
0032	Biocare-Abut, Titanium High Noble	EA	8
	FULL CAST CROWN
0033	Gold Crown (Plus Metal)	EA	14
0034	Full Cast High Noble Crown Over Single Stage	EA	10
0035	Full Cast White Semi-Precious	EA	14
0036	Full Cast Yellow Semi-Precious	EA	14
0037	Myerson Ema Sleep Apnea Device	EA	4
0038	Pink Porcelain Gingival Color	EA	8
0039	PMMA Temporary	EA	22
0040	Temporary Crown	EA	20
0041	Distal Guide Plane Semi-Precious	EA	56
	ATTACHMENTS (PLUS COST OF ATTACHMENT)
0042	P.D. Attachments	EA	4
0043	Distal Rest Semi-Precious	EA	14
0044	Atlantis Abutment Titanium PFM Semi-Precious	EA	2
0045	Cast Post Semi-Precious	EA	12
0046	Acrylic Stay-Plate 1-2 Teeth	EA	2
0047	Acrylic Stay-Plate 3-7 Teeth	EA	2
0048	Acrylic Stay-Plate 8 or More Teeth	EA	2
0049	Attachment Labor Removable	EA	6
0050	PFM Semi-Precious Crown Over Single Stage	EA	62
0051	PFM White High Noble Crown Over Single Stage	EA	22
	ACRYLIC
0052	Hard Night Guard Hand Wax Clear Acrylic	EA	6
0053	Diagnostic Wax-Up	EA	344
0054	Economy Denture Without Bite Block	EA	4
0055	Stent-Clear Surgical Guide	EA	20
0056	Vacuum Formed Stent of Diagnostic Wax-Up	EA	26
0057	Zirconia Custom Hand-Layered Porcelain	EA	74
TOTAL PRICE				$

File details come from the government source that posted it. Updated Sep 12, 2022.