VA259-17-R-0100-A00010003.xlsx
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- AMENDMENT 9
- Solicitation number
- VA25917R0100
About this file
This document contains a price schedule for medical equipment and services to be provided under Solicitation Number VA25917R0100 from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 19. The price schedule lists line items for initial setup, preventative maintenance, monthly rentals, and contents/supplies for low-flow oxygen concentrators, high-flow oxygen concentrators, portable oxygen concentrators, portable and stationary liquid oxygen systems, portable gaseous oxygen systems, ventilator systems, suction machines, cough assist devices, and percussive vests. Estimated quantities, units of issue, and periods of performance are provided for base year, four option years, and various Healthcare Common Procedure Coding System codes. Pricing will remain firm for the base year and each option year exercised.
VA259-17-R-0100 A00010 Attachment 1, Eastern Oklahoma CLINS.xlsx
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Denver
| PRICE SCHEDULE | ||||||
| VA EASTERN OKLAHOMA HEALTH CARE SYSTEM | ||||||
| PERIOD OF PERFORMANCE: BASE YEAR APRIL 1, 2018 TO SEPTEMBER 30, 2018 | ||||||
| LINE ITEM | HCPSC CODE | DESCRIPTION OF SERVICES | ESTIMATED ANNUAL QUANTITY | UNIT OF ISSUE | UNIT PRICE | ESTIMATED TOTAL |
| 0001 | E1390 | Initial Set up of LOW FLOW Rental Concentrators less than 5 LPM : Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 5 LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 115 | Each | ||
| 0001AA | E1390 | Quarterly Preventive Maintenance of LOW FLOW Concentrators less than 5 LPM: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies. | 2,455 | Each | ||
| 0001AB | E1390 | Monthly Rental of LOW FLOW Concentrator less than 5 LPM: Monthly rental fees for Concentrators less than 5 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 7,368 | Each | ||
| 0002 | E1390 | Initial set up of Rental of HIGH FLOW Rental Concentrator more than 5 LPM: Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow < 5 LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 2 | Each | ||
| 0002AA | E1390 | Preventive Maintenance of HIGH FLOW Rental Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies. | 50 | Each | ||
| 0002AB | E1390 | Monthly Rental of HIGH FLOW Rental Concentrator: Monthly rental fees for Concentrators < 5 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 12 | Each | ||
| 0003 | E1392 | Initial Set Up of Portable Oxygen Concentrator: Contractor to deliver, set-up & ensure proper training and proper functioning of equipment. Contractor to provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies). Contractor to provide sufficient batteries to ensure patient has 12 hours battery use per day. | 150 | Each | ||
| 0003AA | E1392 | Preventive Maintenance of Portable Oxygen Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs and provide disposable supplies. | 340 | Each | ||
| 0004AB | E1392 | Monthly Rental of Portable Oxygen Concentrator: Monthly rental fees for Concentrators that are in use covering all necessary supplies, batteries and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 1,020 | Each | ||
| 0004AC | E1392 | Additional Portable Oxygen Concentrator Batteries: Contractor to provide extra batteries (number will depend on specific usage of POC, flight, travel etc.. ) | 300 | Each | ||
| 0005 | E0443 | Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, E,D,C) | 3,000 | Each | ||
| 0005AA | E0443 | Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, M6) | 2,484 | Each | ||
| 0006 | E1392 | Initial Set up of Portable Gaseous System Sizes B (M6), C, D, or E: Contractor to deliver, set-up & ensure proper training, functioning of equipment, preventive maintenance for portable system. Portable System, including various tank sizes, regulator for continuous flow, conserving device (pulse dose regulator) with durable back pack to use with smaller tank sizes for flows < 4 LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies), and oxygen tank cylinder stand capable of holding 12 cylinders. | 100 | Each | ||
| 0006AA | E1392 | Preventive Maintenance of Portable Gaseous System Sizes B (M6), C, D or E: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if necessary for regulator), and provide disposable supplies. | 1,800 | Each | ||
| 0006AB | E0431 | Monthly Rental of Portable Gaseous System Sizes B (M6), C, D, or E: Portable System, including All containers, Regulator, Flow meter and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies),and Oxygen Tank Cylinder Stands capable of holding 12 cylinders, sizes B (M6), C, D, or E. | 5,400 | Each | ||
| 0007 | E0442 | Stationary Liquid Oxygen Contents: Stationary Liquid Oxygen Contents. | 5,688 | LBS | ||
| 0008 | E0442 | Initial Set Up Of Stationary Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing. | 1 | Each | ||
| 0008AA | E0442 | Preventive Maintenance of Stationary Liquid Oxygen System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 20 | Each | ||
| 0008AB | E0434 | Monthly Rental of Stationary Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, batteries (if appropriate) cannula or mask and tubing. | 66 | Each | ||
| 0009 | E0442 | Initial Set Up Of Portable Liquid Oxygen System: Includes portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing. | 1 | Each | ||
| 0009AA | E0442 | Preventive Maintenance of Portable Liquid Oxygen System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 20 | Each | ||
| 0009AB | E0434 | Monthly Rental of Portable Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, batteries (if appropriate) cannula or mask and tubing. | 66 | Each | ||
| 0010 | E0465 | Initial set up of Rental of Ventilator System: Delivery, Set-up, training at the hospital/ veterans home as indicated by VA staff; to include family members comfort of operating machine in their home for Contractor owned Portable invasive/non-invasive Ventilator. To include back-up ventilator and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies). | 3 | Each | ||
| 0010AA | E0465 | Monthly Rental of Ventilator System: Maintenance of Contractor owned Stationary or Portable invasive/non-invasive Ventilator. With clinician follow up not to exceed 48 hours after set up. At a minimum 30 day clinician follow ups at veterans home to ensure proper functioning of all equipment, replace any needed consumable supplies, and equipment maintenance in accordance with manufacturer standards. | 18 | Each | ||
| 0010AB | E0465 | Preventive Maintenance of Ventilator System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 6 | Each | ||
| 0011 | VA120 | CRT/RRT/RN Visit: Government requested CRT/RRT/RN visit not covered by other CLINs. | 10 | Each | ||
| 0012 | E0600 | Set-up of Suction Machine: Delivery, Set-up, and Training of Suction Machine (stationary/portable). To include all necessary supplies. | 1 | Each | ||
| 0012AA | E0600 | Delivery of Suction Machine Replacement (Consumable) Supplies: Contractor to deliver the replacement of consumable supplies and equipment maintenance in accordance with manufacturer standards, and any needed filters if applicable to the Suction Machine's manufactuers guidelines, . | 12 | Each | ||
| 0012AB | E0600 | Monthly Rental of Suction Machine: Monthly rental fees for equipment and supplies | 12 | Each | ||
| 0013 | VA120 | Set-up of Cough Assist: Delivery, Set-up, and Training of cough assist device. | 1 | Each | ||
| 0013AA | VA120 | Monthly Rental of Cough Assist: Monthly rental fees for equipment and the replacement of all necessary associated supplies and equipment maintenance in accordance with manufacturer standards and replacement of any filters required to be change per Cough Assist's manufacturer's guidelines. | 12 | Each | ||
| 0014 | VA120 | Initial Set Up of Percussive Vest: Contractor to deliver, set up and train for proper use of percussive vest. | 1 | Each | ||
| 0014AA | VA120 | Monthly Rental of Percussive Vest: Monthly rental of all associated equipment fees and any equipment replacement items for Percussive Vest and equipment maintenance in accordance with manufacturer standards and any filter changes applicable to the Percussive Vest according to the manufacturer's guidelines. | 12 | Each | ||
| ESTIMATED TOTAL | ||||||
| PERIOD OF PERFORMANCE: OPTION YEAR 1 OCTOBER 1, 2018 TO SEPTEMBER 30, 2019 | ||||||
| LINE ITEM | HCPSC CODE | DESCRIPTION OF SERVICES | ESTIMATED ANNUAL QUANTITY | UNIT OF ISSUE | UNIT PRICE | ESTIMATED TOTAL |
| 0001 | E1390 | Initial Set up of LOW FLOW Rental Concentrators less than 5 LPM : Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 5 LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 230 | Each | ||
| 0001AA | E1390 | Quarterly Preventive Maintenance of LOW FLOW Concentrators less than 5 LPM: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies. | 4,910 | Each | ||
| 0001AB | E1390 | Monthly Rental of LOW FLOW Concentrator less than 5 LPM: Monthly rental fees for Concentrators less than 5 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 14,736 | Each | ||
| 0002 | E1390 | Initial set up of Rental of HIGH FLOW Rental Concentrator more than 5 LPM: Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow < 5 LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 4 | Each | ||
| 0002AA | E1390 | Preventive Maintenance of HIGH FLOW Rental Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies. | 100 | Each | ||
| 0002AB | E1390 | Monthly Rental of HIGH FLOW Rental Concentrator: Monthly rental fees for Concentrators < 5 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 24 | Each | ||
| 0003 | E1392 | Initial Set Up of Portable Oxygen Concentrator: Contractor to deliver, set-up & ensure proper training and proper functioning of equipment. Contractor to provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies). Contractor to provide sufficient batteries to ensure patient has 12 hours battery use per day. | 300 | Each | ||
| 0003AA | E1392 | Preventive Maintenance of Portable Oxygen Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs and provide disposable supplies. | 680 | Each | ||
| 0004AB | E1392 | Monthly Rental of Portable Oxygen Concentrator: Monthly rental fees for Concentrators that are in use covering all necessary supplies, batteries and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 2,040 | Each | ||
| 0004AC | E1392 | Additional Portable Oxygen Concentrator Batteries: Contractor to provide extra batteries (number will depend on specific usage of POC, flight, travel etc.. ) | 600 | Each | ||
| 0005 | E0443 | Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, E,D,C) | 3,000 | Each | ||
| 0005AA | E0443 | Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, M6) | 2,484 | Each | ||
| 0006 | E1392 | Initial Set up of Portable Gaseous System Sizes B (M6), C, D, or E: Contractor to deliver, set-up & ensure proper training, functioning of equipment, preventive maintenance for portable system. Portable System, including various tank sizes, regulator for continuous flow, conserving device (pulse dose regulator) with durable back pack to use with smaller tank sizes for flows < 4 LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies), and oxygen tank cylinder stand capable of holding 12 cylinders. | 100 | Each | ||
| 0006AA | E1392 | Preventive Maintenance of Portable Gaseous System Sizes B (M6), C, D or E: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if necessary for regulator), and provide disposable supplies. | 1,800 | Each | ||
| 0006AB | E0431 | Monthly Rental of Portable Gaseous System Sizes B (M6), C, D, or E: Portable System, including All containers, Regulator, Flow meter and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies),and Oxygen Tank Cylinder Stands capable of holding 12 cylinders, sizes B (M6), C, D, or E. | 5,400 | Each | ||
| 0007 | E0442 | Stationary Liquid Oxygen Contents: Stationary Liquid Oxygen Contents. | 11,376 | LBS | ||
| 0008 | E0442 | Initial Set Up Of Stationary Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing. | 2 | Each | ||
| 0008AA | E0442 | Preventive Maintenance of Stationary Liquid Oxygen System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 40 | Each | ||
| 0008AB | E0434 | Monthly Rental of Stationary Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, batteries (if appropriate) cannula or mask and tubing. | 132 | Each | ||
| 0009 | E0442 | Initial Set Up Of Portable Liquid Oxygen System: Includes portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing. | 2 | Each | ||
| 0009AA | E0442 | Preventive Maintenance of Portable Liquid Oxygen System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 40 | Each | ||
| 0009AB | E0434 | Monthly Rental of Portable Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, batteries (if appropriate) cannula or mask and tubing. | 132 | Each | ||
| 0010 | E0465 | Initial set up of Rental of Ventilator System: Delivery, Set-up, training at the hospital/ veterans home as indicated by VA staff; to include family members comfort of operating machine in their home for Contractor owned Portable invasive/non-invasive Ventilator. To include back-up ventilator and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies). | 6 | Each | ||
| 0010AA | E0465 | Monthly Rental of Ventilator System: Maintenance of Contractor owned Stationary or Portable invasive/non-invasive Ventilator. With clinician follow up not to exceed 48 hours after set up. At a minimum 30 day clinician follow ups at veterans home to ensure proper functioning of all equipment, replace any needed consumable supplies, and equipment maintenance in accordance with manufacturer standards. | 36 | Each | ||
| 0010AB | E0465 | Preventive Maintenance of Ventilator System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 12 | Each | ||
| 0011 | VA120 | CRT/RRT/RN Visit: Government requested CRT/RRT/RN visit not covered by other CLINs. | 20 | Each | ||
| 0012 | E0600 | Set-up of Suction Machine: Delivery, Set-up, and Training of Suction Machine (stationary/portable). To include all necessary supplies. | 2 | Each | ||
| 0012AA | E0600 | Delivery of Suction Machine Replacement (Consumable) Supplies: Contractor to deliver the replacement of consumable supplies and equipment maintenance in accordance with manufacturer standards, and any needed filters if applicable to the Suction Machine's manufactuers guidelines, . | 24 | Each | ||
| 0012AB | E0600 | Monthly Rental of Suction Machine: Monthly rental fees for equipment and supplies | 24 | Each | ||
| 0013 | VA120 | Set-up of Cough Assist: Delivery, Set-up, and Training of cough assist device. | 2 | Each | ||
| 0013AA | VA120 | Monthly Rental of Cough Assist: Monthly rental fees for equipment and the replacement of all necessary associated supplies and equipment maintenance in accordance with manufacturer standards and replacement of any filters required to be change per Cough Assist's manufacturer's guidelines. | 24 | Each | ||
| 0014 | VA120 | Initial Set Up of Percussive Vest: Contractor to deliver, set up and train for proper use of percussive vest. | 2 | Each | ||
| 0014AA | VA120 | Monthly Rental of Percussive Vest: Monthly rental of all associated equipment fees and any equipment replacement items for Percussive Vest and equipment maintenance in accordance with manufacturer standards and any filter changes applicable to the Percussive Vest according to the manufacturer's guidelines. | 24 | Each | ||
| ESTIMATED TOTAL | ||||||
| PERIOD OF PERFORMANCE: OPTION YEAR 2 OCTOBER 1, 2019 TO SEPTEMBER 30, 2020 | ||||||
| LINE ITEM | HCPSC CODE | DESCRIPTION OF SERVICES | ESTIMATED ANNUAL QUANTITY | UNIT OF ISSUE | UNIT PRICE | ESTIMATED TOTAL |
| 0001 | E1390 | Initial Set up of LOW FLOW Rental Concentrators less than 5 LPM : Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 5 LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 230 | Each | ||
| 0001AA | E1390 | Quarterly Preventive Maintenance of LOW FLOW Concentrators less than 5 LPM: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies. | 4,910 | Each | ||
| 0001AB | E1390 | Monthly Rental of LOW FLOW Concentrator less than 5 LPM: Monthly rental fees for Concentrators less than 5 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 14,736 | Each | ||
| 0002 | E1390 | Initial set up of Rental of HIGH FLOW Rental Concentrator more than 5 LPM: Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow < 5 LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 4 | Each | ||
| 0002AA | E1390 | Preventive Maintenance of HIGH FLOW Rental Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies. | 100 | Each | ||
| 0002AB | E1390 | Monthly Rental of HIGH FLOW Rental Concentrator: Monthly rental fees for Concentrators < 5 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 24 | Each | ||
| 0003 | E1392 | Initial Set Up of Portable Oxygen Concentrator: Contractor to deliver, set-up & ensure proper training and proper functioning of equipment. Contractor to provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies). Contractor to provide sufficient batteries to ensure patient has 12 hours battery use per day. | 300 | Each | ||
| 0003AA | E1392 | Preventive Maintenance of Portable Oxygen Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs and provide disposable supplies. | 680 | Each | ||
| 0004AB | E1392 | Monthly Rental of Portable Oxygen Concentrator: Monthly rental fees for Concentrators that are in use covering all necessary supplies, batteries and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 2,040 | Each | ||
| 0004AC | E1392 | Additional Portable Oxygen Concentrator Batteries: Contractor to provide extra batteries (number will depend on specific usage of POC, flight, travel etc.. ) | 600 | Each | ||
| 0005 | E0443 | Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, E,D,C) | 3,000 | Each | ||
| 0005AA | E0443 | Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, M6) | 2,484 | Each | ||
| 0006 | E1392 | Initial Set up of Portable Gaseous System Sizes B (M6), C, D, or E: Contractor to deliver, set-up & ensure proper training, functioning of equipment, preventive maintenance for portable system. Portable System, including various tank sizes, regulator for continuous flow, conserving device (pulse dose regulator) with durable back pack to use with smaller tank sizes for flows < 4 LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies), and oxygen tank cylinder stand capable of holding 12 cylinders. | 100 | Each | ||
| 0006AA | E1392 | Preventive Maintenance of Portable Gaseous System Sizes B (M6), C, D or E: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if necessary for regulator), and provide disposable supplies. | 1,800 | Each | ||
| 0006AB | E0431 | Monthly Rental of Portable Gaseous System Sizes B (M6), C, D, or E: Portable System, including All containers, Regulator, Flow meter and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies),and Oxygen Tank Cylinder Stands capable of holding 12 cylinders, sizes B (M6), C, D, or E. | 5,400 | Each | ||
| 0007 | E0442 | Stationary Liquid Oxygen Contents: Stationary Liquid Oxygen Contents. | 11,376 | LBS | ||
| 0008 | E0442 | Initial Set Up Of Stationary Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing. | 2 | Each | ||
| 0008AA | E0442 | Preventive Maintenance of Stationary Liquid Oxygen System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 40 | Each | ||
| 0008AB | E0434 | Monthly Rental of Stationary Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, batteries (if appropriate) cannula or mask and tubing. | 132 | Each | ||
| 0009 | E0442 | Initial Set Up Of Portable Liquid Oxygen System: Includes portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing. | 2 | Each | ||
| 0009AA | E0442 | Preventive Maintenance of Portable Liquid Oxygen System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 40 | Each | ||
| 0009AB | E0434 | Monthly Rental of Portable Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, batteries (if appropriate) cannula or mask and tubing. | 132 | Each | ||
| 0010 | E0465 | Initial set up of Rental of Ventilator System: Delivery, Set-up, training at the hospital/ veterans home as indicated by VA staff; to include family members comfort of operating machine in their home for Contractor owned Portable invasive/non-invasive Ventilator. To include back-up ventilator and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies). | 6 | Each | ||
| 0010AA | E0465 | Monthly Rental of Ventilator System: Maintenance of Contractor owned Stationary or Portable invasive/non-invasive Ventilator. With clinician follow up not to exceed 48 hours after set up. At a minimum 30 day clinician follow ups at veterans home to ensure proper functioning of all equipment, replace any needed consumable supplies, and equipment maintenance in accordance with manufacturer standards. | 36 | Each | ||
| 0010AB | E0465 | Preventive Maintenance of Ventilator System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 12 | Each | ||
| 0011 | VA120 | CRT/RRT/RN Visit: Government requested CRT/RRT/RN visit not covered by other CLINs. | 20 | Each | ||
| 0012 | E0600 | Set-up of Suction Machine: Delivery, Set-up, and Training of Suction Machine (stationary/portable). To include all necessary supplies. | 2 | Each | ||
| 0012AA | E0600 | Delivery of Suction Machine Replacement (Consumable) Supplies: Contractor to deliver the replacement of consumable supplies and equipment maintenance in accordance with manufacturer standards, and any needed filters if applicable to the Suction Machine's manufactuers guidelines, . | 24 | Each | ||
| 0012AB | E0600 | Monthly Rental of Suction Machine: Monthly rental fees for equipment and supplies | 24 | Each | ||
| 0013 | VA120 | Set-up of Cough Assist: Delivery, Set-up, and Training of cough assist device. | 2 | Each | ||
| 0013AA | VA120 | Monthly Rental of Cough Assist: Monthly rental fees for equipment and the replacement of all necessary associated supplies and equipment maintenance in accordance with manufacturer standards and replacement of any filters required to be change per Cough Assist's manufacturer's guidelines. | 24 | Each | ||
| 0014 | VA120 | Initial Set Up of Percussive Vest: Contractor to deliver, set up and train for proper use of percussive vest. | 2 | Each | ||
| 0014AA | VA120 | Monthly Rental of Percussive Vest: Monthly rental of all associated equipment fees and any equipment replacement items for Percussive Vest and equipment maintenance in accordance with manufacturer standards and any filter changes applicable to the Percussive Vest according to the manufacturer's guidelines. | 24 | Each | ||
| ESTIMATED TOTAL |
| PERIOD OF PERFORMANCE: OPTION YEAR 3 OCTOBER 1, 2020 TO SEPTEMBER 30, 2021 | ||||||
| LINE ITEM | HCPSC CODE | DESCRIPTION OF SERVICES | ESTIMATED ANNUAL QUANTITY | UNIT OF ISSUE | UNIT PRICE | ESTIMATED TOTAL |
| 0001 | E1390 | Initial Set up of LOW FLOW Rental Concentrators less than 5 LPM : Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 5 LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 230 | Each | ||
| 0001AA | E1390 | Quarterly Preventive Maintenance of LOW FLOW Concentrators less than 5 LPM: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies. | 4,910 | Each | ||
| 0001AB | E1390 | Monthly Rental of LOW FLOW Concentrator less than 5 LPM: Monthly rental fees for Concentrators less than 5 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 14,736 | Each | ||
| 0002 | E1390 | Initial set up of Rental of HIGH FLOW Rental Concentrator more than 5 LPM: Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow < 5 LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 4 | Each | ||
| 0002AA | E1390 | Preventive Maintenance of HIGH FLOW Rental Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies. | 100 | Each | ||
| 0002AB | E1390 | Monthly Rental of HIGH FLOW Rental Concentrator: Monthly rental fees for Concentrators < 5 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 24 | Each | ||
| 0003 | E1392 | Initial Set Up of Portable Oxygen Concentrator: Contractor to deliver, set-up & ensure proper training and proper functioning of equipment. Contractor to provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies). Contractor to provide sufficient batteries to ensure patient has 12 hours battery use per day. | 300 | Each | ||
| 0003AA | E1392 | Preventive Maintenance of Portable Oxygen Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs and provide disposable supplies. | 680 | Each | ||
| 0004AB | E1392 | Monthly Rental of Portable Oxygen Concentrator: Monthly rental fees for Concentrators that are in use covering all necessary supplies, batteries and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 2,040 | Each | ||
| 0004AC | E1392 | Additional Portable Oxygen Concentrator Batteries: Contractor to provide extra batteries (number will depend on specific usage of POC, flight, travel etc.. ) | 600 | Each | ||
| 0005 | E0443 | Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, E,D,C) | 3,000 | Each | ||
| 0005AA | E0443 | Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, M6) | 2,484 | Each | ||
| 0006 | E1392 | Initial Set up of Portable Gaseous System Sizes B (M6), C, D, or E: Contractor to deliver, set-up & ensure proper training, functioning of equipment, preventive maintenance for portable system. Portable System, including various tank sizes, regulator for continuous flow, conserving device (pulse dose regulator) with durable back pack to use with smaller tank sizes for flows < 4 LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies), and oxygen tank cylinder stand capable of holding 12 cylinders. | 100 | Each | ||
| 0006AA | E1392 | Preventive Maintenance of Portable Gaseous System Sizes B (M6), C, D or E: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if necessary for regulator), and provide disposable supplies. | 1,800 | Each | ||
| 0006AB | E0431 | Monthly Rental of Portable Gaseous System Sizes B (M6), C, D, or E: Portable System, including All containers, Regulator, Flow meter and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies),and Oxygen Tank Cylinder Stands capable of holding 12 cylinders, sizes B (M6), C, D, or E. | 5,400 | Each | ||
| 0007 | E0442 | Stationary Liquid Oxygen Contents: Stationary Liquid Oxygen Contents. | 11,376 | LBS | ||
| 0008 | E0442 | Initial Set Up Of Stationary Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing. | 2 | Each | ||
| 0008AA | E0442 | Preventive Maintenance of Stationary Liquid Oxygen System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 40 | Each | ||
| 0008AB | E0434 | Monthly Rental of Stationary Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, batteries (if appropriate) cannula or mask and tubing. | 132 | Each | ||
| 0009 | E0442 | Initial Set Up Of Portable Liquid Oxygen System: Includes portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing. | 2 | Each | ||
| 0009AA | E0442 | Preventive Maintenance of Portable Liquid Oxygen System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 40 | Each | ||
| 0009AB | E0434 | Monthly Rental of Portable Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, batteries (if appropriate) cannula or mask and tubing. | 132 | Each | ||
| 0010 | E0465 | Initial set up of Rental of Ventilator System: Delivery, Set-up, training at the hospital/ veterans home as indicated by VA staff; to include family members comfort of operating machine in their home for Contractor owned Portable invasive/non-invasive Ventilator. To include back-up ventilator and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies). | 6 | Each | ||
| 0010AA | E0465 | Monthly Rental of Ventilator System: Maintenance of Contractor owned Stationary or Portable invasive/non-invasive Ventilator. With clinician follow up not to exceed 48 hours after set up. At a minimum 30 day clinician follow ups at veterans home to ensure proper functioning of all equipment, replace any needed consumable supplies, and equipment maintenance in accordance with manufacturer standards. | 36 | Each | ||
| 0010AB | E0465 | Preventive Maintenance of Ventilator System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 12 | Each | ||
| 0011 | VA120 | CRT/RRT/RN Visit: Government requested CRT/RRT/RN visit not covered by other CLINs. | 20 | Each | ||
| 0012 | E0600 | Set-up of Suction Machine: Delivery, Set-up, and Training of Suction Machine (stationary/portable). To include all necessary supplies. | 2 | Each | ||
| 0012AA | E0600 | Delivery of Suction Machine Replacement (Consumable) Supplies: Contractor to deliver the replacement of consumable supplies and equipment maintenance in accordance with manufacturer standards, and any needed filters if applicable to the Suction Machine's manufactuers guidelines, . | 24 | Each | ||
| 0012AB | E0600 | Monthly Rental of Suction Machine: Monthly rental fees for equipment and supplies | 24 | Each | ||
| 0013 | VA120 | Set-up of Cough Assist: Delivery, Set-up, and Training of cough assist device. | 2 | Each | ||
| 0013AA | VA120 | Monthly Rental of Cough Assist: Monthly rental fees for equipment and the replacement of all necessary associated supplies and equipment maintenance in accordance with manufacturer standards and replacement of any filters required to be change per Cough Assist's manufacturer's guidelines. | 24 | Each | ||
| 0014 | VA120 | Initial Set Up of Percussive Vest: Contractor to deliver, set up and train for proper use of percussive vest. | 2 | Each | ||
| 0014AA | VA120 | Monthly Rental of Percussive Vest: Monthly rental of all associated equipment fees and any equipment replacement items for Percussive Vest and equipment maintenance in accordance with manufacturer standards and any filter changes applicable to the Percussive Vest according to the manufacturer's guidelines. | 24 | Each | ||
| ESTIMATED TOTAL |
| PERIOD OF PERFORMANCE: OPTION YEAR 4 OCTOBER 1, 2021 TO SEPTEMBER 30, 2022 | ||||||
| LINE ITEM | HCPSC CODE | DESCRIPTION OF SERVICES | ESTIMATED ANNUAL QUANTITY | UNIT OF ISSUE | UNIT PRICE | ESTIMATED TOTAL |
| 0001 | E1390 | Initial Set up of LOW FLOW Rental Concentrators less than 5 LPM : Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow > 5 LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 230 | Each | ||
| 0001AA | E1390 | Quarterly Preventive Maintenance of LOW FLOW Concentrators less than 5 LPM: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies. | 4,910 | Each | ||
| 0001AB | E1390 | Monthly Rental of LOW FLOW Concentrator less than 5 LPM: Monthly rental fees for Concentrators less than 5 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 14,736 | Each | ||
| 0002 | E1390 | Initial set up of Rental of HIGH FLOW Rental Concentrator more than 5 LPM: Contractor to deliver, set-up & ensure proper training, functioning of equipment, humidity for oxygen flow < 5 LPM, and all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 4 | Each | ||
| 0002AA | E1390 | Preventive Maintenance of HIGH FLOW Rental Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies. | 100 | Each | ||
| 0002AB | E1390 | Monthly Rental of HIGH FLOW Rental Concentrator: Monthly rental fees for Concentrators < 5 LPM that are in use covering all necessary supplies and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 24 | Each | ||
| 0003 | E1392 | Initial Set Up of Portable Oxygen Concentrator: Contractor to deliver, set-up & ensure proper training and proper functioning of equipment. Contractor to provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies). Contractor to provide sufficient batteries to ensure patient has 12 hours battery use per day. | 300 | Each | ||
| 0003AA | E1392 | Preventive Maintenance of Portable Oxygen Concentrator: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs and provide disposable supplies. | 680 | Each | ||
| 0004AB | E1392 | Monthly Rental of Portable Oxygen Concentrator: Monthly rental fees for Concentrators that are in use covering all necessary supplies, batteries and equipment as specified in the PWS (Consumable Supplies), including back-up systems. | 2,040 | Each | ||
| 0004AC | E1392 | Additional Portable Oxygen Concentrator Batteries: Contractor to provide extra batteries (number will depend on specific usage of POC, flight, travel etc.. ) | 600 | Each | ||
| 0005 | E0443 | Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, E,D,C) | 3,000 | Each | ||
| 0005AA | E0443 | Portable Gaseous Contents: Portable Gaseous Oxygen Contents (Refill cylinder sizes, M6) | 2,484 | Each | ||
| 0006 | E1392 | Initial Set up of Portable Gaseous System Sizes B (M6), C, D, or E: Contractor to deliver, set-up & ensure proper training, functioning of equipment, preventive maintenance for portable system. Portable System, including various tank sizes, regulator for continuous flow, conserving device (pulse dose regulator) with durable back pack to use with smaller tank sizes for flows < 4 LPM, provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies), and oxygen tank cylinder stand capable of holding 12 cylinders. | 100 | Each | ||
| 0006AA | E1392 | Preventive Maintenance of Portable Gaseous System Sizes B (M6), C, D or E: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if necessary for regulator), and provide disposable supplies. | 1,800 | Each | ||
| 0006AB | E0431 | Monthly Rental of Portable Gaseous System Sizes B (M6), C, D, or E: Portable System, including All containers, Regulator, Flow meter and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies),and Oxygen Tank Cylinder Stands capable of holding 12 cylinders, sizes B (M6), C, D, or E. | 5,400 | Each | ||
| 0007 | E0442 | Stationary Liquid Oxygen Contents: Stationary Liquid Oxygen Contents. | 11,376 | LBS | ||
| 0008 | E0442 | Initial Set Up Of Stationary Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing. | 2 | Each | ||
| 0008AA | E0442 | Preventive Maintenance of Stationary Liquid Oxygen System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 40 | Each | ||
| 0008AB | E0434 | Monthly Rental of Stationary Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, batteries (if appropriate) cannula or mask and tubing. | 132 | Each | ||
| 0009 | E0442 | Initial Set Up Of Portable Liquid Oxygen System: Includes portable container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, cannula or mask and tubing. | 2 | Each | ||
| 0009AA | E0442 | Preventive Maintenance of Portable Liquid Oxygen System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 40 | Each | ||
| 0009AB | E0434 | Monthly Rental of Portable Liquid Oxygen System: Includes stationary container, supply reservoir, humidifier, flowmeter, refill adapter, contents gauge, batteries (if appropriate) cannula or mask and tubing. | 132 | Each | ||
| 0010 | E0465 | Initial set up of Rental of Ventilator System: Delivery, Set-up, training at the hospital/ veterans home as indicated by VA staff; to include family members comfort of operating machine in their home for Contractor owned Portable invasive/non-invasive Ventilator. To include back-up ventilator and provide all necessary supplies and equipment as specified in the PWS (Consumable Supplies). | 6 | Each | ||
| 0010AA | E0465 | Monthly Rental of Ventilator System: Maintenance of Contractor owned Stationary or Portable invasive/non-invasive Ventilator. With clinician follow up not to exceed 48 hours after set up. At a minimum 30 day clinician follow ups at veterans home to ensure proper functioning of all equipment, replace any needed consumable supplies, and equipment maintenance in accordance with manufacturer standards. | 36 | Each | ||
| 0010AB | E0465 | Preventive Maintenance of Ventilator System: Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters, ensure battery needs (if appropriate) and provide disposable supplies. | 12 | Each | ||
| 0011 | VA120 | CRT/RRT/RN Visit: Government requested CRT/RRT/RN visit not covered by other CLINs. | 20 | Each | ||
| 0012 | E0600 | Set-up of Suction Machine: Delivery, Set-up, and Training of Suction Machine (stationary/portable). To include all necessary supplies. | 2 | Each | ||
| 0012AA | E0600 | Delivery of Suction Machine Replacement (Consumable) Supplies: Contractor to deliver the replacement of consumable supplies and equipment maintenance in accordance with manufacturer standards, and any needed filters if applicable to the Suction Machine's manufactuers guidelines, . | 24 | Each | ||
| 0012AB | E0600 | Monthly Rental of Suction Machine: Monthly rental fees for equipment and supplies | 24 | Each | ||
| 0013 | VA120 | Set-up of Cough Assist: Delivery, Set-up, and Training of cough assist device. | 2 | Each | ||
| 0013AA | VA120 | Monthly Rental of Cough Assist: Monthly rental fees for equipment and the replacement of all necessary associated supplies and equipment maintenance in accordance with manufacturer standards and replacement of any filters required to be change per Cough Assist's manufacturer's guidelines. | 24 | Each | ||
| 0014 | VA120 | Initial Set Up of Percussive Vest: Contractor to deliver, set up and train for proper use of percussive vest. | 2 | Each | ||
| 0014AA | VA120 | Monthly Rental of Percussive Vest: Monthly rental of all associated equipment fees and any equipment replacement items for Percussive Vest and equipment maintenance in accordance with manufacturer standards and any filter changes applicable to the Percussive Vest according to the manufacturer's guidelines. | 24 | Each | ||
| ESTIMATED TOTAL |
File details come from the government source that posted it. Updated .