Attachment 5 - Estimated Medical Service and Supplies.xlsx

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Occupational Health and Industrial Hygiene Services
Solicitation number
SP3300-12-R-0027
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Attachment 5 - Estimated Medical Service and Supplies

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Attachments #

Type of ServiceAnnual Amount
Annual Medical Surveillance Exams1000
Pre Deployment Exams60
Pre Placement70
OHP Witness Service3 hrs
Clinician Witness Service3 hrs
Hearing Tests1000
Audiogram20
Pulmonary Function Tests265
Electrocardiograms215
Agility Testing (lifting, cardio)70
Body Mass Index (BMI)1000
Fasting Blood Sugar (e.g.finger stick)200
Tuberculin Skin - Purified Protein Derivative (PPD)150
Urinalysis (UA)1000
Qualitive Urine Pregnancy Test20
Bloodborne Pathogen Evaluation (after Hours)2
Cardiac Stress25
Chest X-rays20
Chest X-rays with B Reader2
Optometric Exams30
Psychological Evaluations (testing and record review)10 hrs
Complete Blood Count (CBC)300
Comprehensive Metabolic Panel (CMP)275
Lipid Panel275
Hemoglobin A1C50
Prostate Specific Antigen (PSA)25
Thyroid Stimulating Hormone (TSH)25
Hepatitis A Titer25
Hepatitis B Titer100
Varicella Titer25
Measles/Mumps/Rubella (MMR)Titer25
Polio Titer25
G6PD (determine anti-malaria)20
ABO/RH Blood Type25
HIV Blood Test125
Quantiferon ( R ) Gold10
Blood Lead0
Zinc Protoporphyrin (Zpp)0
Cholinesterase RBC and Serum0
Serum Heavy Metals1
Influenza800
Tetanus/Diphtheria/Pertussis (TDaP)50
Hepatitis A Vaccine (two dose)20
Hepatitis A Booster20
Hepatitis B Vaccine (three dose)25
Hepatitis B Booster40
Typhoid Vaccine (two dose)20
Typhoid Booster40
Varicella Vaccine20
Diphtheria/Tetanus (DT)30
Health Screenings (e.g. annual health fair)
Cholesterol500
Blood Sugar500
PFT500
Body Fat Measurement500
Blood Pressure Screening500
Dietician1 day
Cancer Counselor1 day
Diabetes Mellitus Counselor1 day
Tuberculin Skin - Purified Protein Derivative (PPD)50

Attachment 5 SP3300-12-R-0027 Estimated Services/Supplies Provided by Contractor

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