A.09.03__APPENDIX_B_-_Price_Matrix.xlsx

XLSX spreadsheet 33 KB Posted Nov 28, 2017

Attached to: Army Direct Care Medical Services Healthcare Providers locations in Europe for the Regional Health Command Europe, Installation Management Command Directorate-Europe, and the United States Air Forces in Europe
Solicitation number: W9114F-18-R-0001
Issued by: Department of the Army Medical Command

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Appendix B: Price Matrix

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W9114F-18-R-0001-0001.docx	DOCX document	Dec 19, 2017
A.09.03__APPENDIX_A_-_Compensation_Plan.xlsx	XLSX spreadsheet	Nov 28, 2017
W9114F-18-R-0001.pdf	PDF	Nov 28, 2017

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Base Year

Name of company:

Date:

Solicitation Number: W9114F-18-R-0001

ADCMS GEN III

Base Ordering Period: 15May2018-14May2019

	ITEM NO	SERVICE	ESTIMATED
QUANTITY	UNIT	UNIT
PRICE	ESTIMATED

AMOUNT

0001	LRMC
0001AA	Video Network Systems Manager	7680	Hours
0001AB	Video Network Coordinator	7680	Hours
0001AC	Optometrist	1920	Hours
0001AD	Optometry Technician	1920	Hours
0001AE	Physican Assistant (3 PTE @ 960hrs each)	2880	Hours
0001AF	Anesthesiologist	1920	Hours
0001AG	*Stand By	1000	Hours
0001AH	*Call Back	400	Hours

0005	IMCOM
0005AA	Home Visitor Project Manager	1920	Hours
0005AB	Home Visitor	34560	Hours

0009	LAKENHEATH
0009AA	Registered Nurse-OR	3840	Hours
0009AB	Registered Nurse-OB GYN	7680	Hours
0009AC	Women's Health Nurse Practitioner	1920	Hours
0009AD	Anesthesiologist - Pain Management	1920	Hours
0009AE	Pharmacy Technician	3840	Hours
0009AF	Lactation Consultant - Int'l Board Certififed	1920	Hours
0009AG	Physician Assistant - PDHR	3840	Hours
0009AH	Medical Case Manager	3840	Hours
0009AJ	Licensed Practical Nurse - Internal Medicine	1920	Hours
0009AK	Licensed Practical Nurse - Pain Management	1920	Hours
0009AL	Licensed Practical Nurse - Referral Management	1920	Hours
0009AM	Licensed Practical Nurse - Pediactics	1920	Hours
0009AN	Licensed Practical Nurse - OB GYN	1920	Hours
0009AP	Licensed Practical Nurse - Family Health	1920	Hours
0009AQ	Referral Management Clerk	3840	Hours
0009AR	Medical Administrative Technician	1920	Hours
0009AS	Surgery Technician	1920	Hours
0009AT	Physical Therapist	3840	Hours
0009AU	Physical Evaluation Board Liaison Officer	1920	Hours
0009AV	Pharmacist	1920	Hours
0009AW	Physician - Emergency Room	1920	Hours
0009AX	**Callback Hours	700	Hours
0009AY	Family Services Coordinator	1920	Hours

0013	RAMSTEIN
0013AA	International Board Certified Lactation Consultant	1920	Hours
0013AB	Registered Nurse - Case Manager	3840	Hours
0013AC	Registered Nurse - Utilization Manager	1920	Hours
0013AD	Registered Nurse - Flight Medicine	1920	Hours
0013AE	Physician - Flight Medicine	1920	Hours
0013AF	Licensed Practical Nurse-Referral Management	1920	Hours
0013AG	Health Management Technician	11520	Hours
0013AH	Physical Evaluation Board Liaison Officer	1920	Hours
0013AJ	Nurse Practitioner - PDHR	5760	Hours
0013AK	Certified Nurse - LPN/LVN	1920	Hours
0013AL	Certified RN - Medical Service Specialist	3840	Hours
0013AM	Medical Services Coordinator-Admin Support	5760	Hours

0017	SPANGDAHLEM
0017AA	Patient Liaison Services	13440	Hours
0017AB	Licensed Practical Nurse-Pediatrics	1920	Hours
0017AC	Licensed Practical Nurse-Referral Management	1920	Hours
0017AD	Physician Assistant - PDHR	1920	Hours
0017AE	Licensed Practical Nurse - PDHR	1920	Hours
0017AF	Medical Office Clerk	1920	Hours
0017AG	Licensed Vocational Nurse	1920	Hours
0017AH	Patient Liaison Officers	19200	Hours
0017AJ	Beneficiary Service Representative-KleinBrogel	1920	Hours
0017AK	Beneficiary Service Representative-Volkel	1920	Hours

0021	GEILENKIRCHEN
0021AA	Patient Liaison Services	7680	Hours

0025	BMEDDAC
0025AA	Physican Assistant ( 3 PTE @ 864 hrs each)	2592	Hours

0026 Contract Manpower Reporting (CMR) 10 Each

FOR OFFICIAL USE ONLY

Source Selection Information (See FAR 2.101 and 3.104-4)

Option Year (1)

Name of company:

Date:

Solicitation Number: W9114F-18-R-1001

ADCMS GEN III

Option Year (1) Ordering Period: 15May2019-14May2020

	ITEM NO	SERVICE	ESTIMATED
QUANTITY	UNIT	UNIT
PRICE	ESTIMATED

AMOUNT

1001	LRMC
1001AA	Video Network Systems Manager	7680	Hours
1001AB	Video Network Coordinator	7680	Hours
1001AC	Optometrist	1920	Hours
1001AD	Optometry Technician	1920	Hours
1001AE	Physican Assistant (3 PTE @ 960hrs each)	2880	Hours
1001AF	Anesthesiologist	1920	Hours
1001AG	*Stand By	1000	Hours
1001AH	*Call Back	400	Hours

1005	IMCOM
1005AA	Home Visitor Project Manager	1920	Hours
1005AB	Home Visitor	34560	Hours

1009	LAKENHEATH
1009AA	Registered Nurse-OR	3840	Hours
1009AB	Registered Nurse-OB GYN	7680	Hours
1009AC	Women's Health Nurse Practitioner	1920	Hours
1009AD	Anesthesiologist - Pain Management	1920	Hours
1009AE	Pharmacy Technician	3840	Hours
1009AF	Lactation Consultant - Int'l Board Certififed	1920	Hours
1009AG	Physician Assistant - PDHR	3840	Hours
1009AH	Medical Case Manager	3840	Hours
1009AJ	Licensed Practical Nurse - Internal Medicine	1920	Hours
1009AK	Licensed Practical Nurse - Pain Management	1920	Hours
1009AL	Licensed Practical Nurse - Referral Management	1920	Hours
1009AM	Licensed Practical Nurse - Pediactics	1920	Hours
1009AN	Licensed Practical Nurse - OB GYN	1920	Hours
1009AP	Licensed Practical Nurse - Family Health	1920	Hours
1009AQ	Referral Management Clerk	3840	Hours
1009AR	Medical Administrative Technician	1920	Hours
1009AS	Surgery Technician	1920	Hours
1009AT	Physical Therapist	3840	Hours
1009AU	Physical Evaluation Board Liaison Officer	1920	Hours
1009AV	Pharmacist	1920	Hours
1009AW	Physician - Emergency Room	1920	Hours
1009AX	**Callback Hours	700	Hours
1009AY	Family Services Coordinator	1920	Hours

1013	RAMSTEIN
1013AA	International Board Certified Lactation Consultant	1920	Hours
1013AB	Registered Nurse - Case Manager	3840	Hours
1013AC	Registered Nurse - Utilization Manager	1920	Hours
1013AD	Registered Nurse - Flight Medicine	1920	Hours
1013AE	Physician - Flight Medicine	1920	Hours
1013AF	Licensed Practical Nurse-Referral Management	1920	Hours
1013AG	Health Management Technician	11520	Hours
1013AH	Physical Evaluation Board Liaison Officer	1920	Hours
1013AJ	Nurse Practitioner - PDHR	5760	Hours
1013AK	Certified Nurse - LPN/LVN	1920	Hours
1013AL	Certified RN - Medical Service Specialist	3840	Hours
1013AM	Medical Services Coordinator-Admin Support	5760	Hours

1017	SPANGDAHLEM
1017AA	Patient Liaison Services	13440	Hours
1017AB	Licensed Practical Nurse-Pediatrics	1920	Hours
1017AC	Licensed Practical Nurse-Referral Management	1920	Hours
1017AD	Physician Assistant - PDHR	1920	Hours
1017AE	Licensed Practical Nurse - PDHR	1920	Hours
1017AF	Medical Office Clerk	1920	Hours
1017AG	Licensed Vocational Nurse	1920	Hours
1017AH	Patient Liaison Officers	19200	Hours
1017AJ	Beneficiary Service Representative-KleinBrogel	1920	Hours
1017AK	Beneficiary Service Representative-Volkel	1920	Hours

1021	GEILENKIRCHEN
1021AA	Patient Liaison Services	7680	Hours

1025	BMEDDAC
1025AA	Physican Assistant ( 3 PTE @ 864 hrs each)	2592	Hours

1026 Contract Manpower Reporting (CMR) 10 Each

Option Year (2)

Name of company:

Date:

Solicitation Number: W9114F-18-R-2001

ADCMS GEN III

Option Year (2) Ordering Period: 15May2020-14May2021

	ITEM NO	SERVICE	ESTIMATED
QUANTITY	UNIT	UNIT
PRICE	ESTIMATED

AMOUNT

2001	LRMC
2001AA	Video Network Systems Manager	7680	Hours
2001AB	Video Network Coordinator	7680	Hours
2001AC	Optometrist	1920	Hours
2001AD	Optometry Technician	1920	Hours
2001AE	Physican Assistant (3 PTE @ 960hrs each)	2880	Hours
2001AF	Anesthesiologist	1920	Hours
2001AG	*Stand By	1000	Hours
2001AH	*Call Back	400	Hours

2005	IMCOM
2005AA	Home Visitor Project Manager	1920	Hours
2005AB	Home Visitor	34560	Hours

2009	LAKENHEATH
2009AA	Registered Nurse-OR	3840	Hours
2009AB	Registered Nurse-OB GYN	7680	Hours
2009AC	Women's Health Nurse Practitioner	1920	Hours
2009AD	Anesthesiologist - Pain Management	1920	Hours
2009AE	Pharmacy Technician	3840	Hours
2009AF	Lactation Consultant - Int'l Board Certififed	1920	Hours
2009AG	Physician Assistant - PDHR	3840	Hours
2009AH	Medical Case Manager	3840	Hours
2009AJ	Licensed Practical Nurse - Internal Medicine	1920	Hours
2009AK	Licensed Practical Nurse - Pain Management	1920	Hours
2009AL	Licensed Practical Nurse - Referral Management	1920	Hours
2009AM	Licensed Practical Nurse - Pediactics	1920	Hours
2009AN	Licensed Practical Nurse - OB GYN	1920	Hours
2009AP	Licensed Practical Nurse - Family Health	1920	Hours
2009AQ	Referral Management Clerk	3840	Hours
2009AR	Medical Administrative Technician	1920	Hours
2009AS	Surgery Technician	1920	Hours
2009AT	Physical Therapist	3840	Hours
2009AU	Physical Evaluation Board Liaison Officer	1920	Hours
2009AV	Pharmacist	1920	Hours
2009AW	Physician - Emergency Room	1920	Hours
4009AX	**Callback Hours	700	Hours
2009AY	Family Services Coordinator	1920	Hours

2013	RAMSTEIN
2013AA	International Board Certified Lactation Consultant	1920	Hours
2013AB	Registered Nurse - Case Manager	3840	Hours
2013AC	Registered Nurse - Utilization Manager	1920	Hours
2013AD	Registered Nurse - Flight Medicine	1920	Hours
2013AE	Physician - Flight Medicine	1920	Hours
2013AF	Licensed Practical Nurse-Referral Management	1920	Hours
2013AG	Health Management Technician	11520	Hours
2013AH	Physical Evaluation Board Liaison Officer	1920	Hours
2013AJ	Nurse Practitioner - PDHR	5760	Hours
2013AK	Certified Nurse - LPN/LVN	1920	Hours
2013AL	Certified RN - Medical Service Specialist	3840	Hours
2013AM	Medical Services Coordinator-Admin Support	5760	Hours

2017	SPANGDAHLEM
2017AA	Patient Liaison Services	13440	Hours
2017AB	Licensed Practical Nurse-Pediatrics	1920	Hours
2017AC	Licensed Practical Nurse-Referral Management	1920	Hours
2017AD	Physician Assistant - PDHR	1920	Hours
2017AE	Licensed Practical Nurse - PDHR	1920	Hours
2017AF	Medical Office Clerk	1920	Hours
2017AG	Licensed Vocational Nurse	1920	Hours
2017AH	Patient Liaison Officers	19200	Hours
2017AJ	Beneficiary Service Representative-KleinBrogel	1920	Hours
2017AK	Beneficiary Service Representative-Volkel	1920	Hours

2021	GEILENKIRCHEN
2021AA	Patient Liaison Services	7680	Hours

2025	BMEDDAC
2025AA	Physican Assistant ( 3 PTE @ 864 hrs each)	2592	Hours

2026 Contract Manpower Reporting (CMR) 10 Each

Option Year (3)

Name of company:

Date:

Solicitation Number: W9114F-18-R-3001

ADCMS GEN III

Option Year (3) Ordering Period: 15May2021-14May2022

	ITEM NO	SERVICE	ESTIMATED
QUANTITY	UNIT	UNIT
PRICE	ESTIMATED

AMOUNT

3001	LRMC
3001AA	Video Network Systems Manager	7680	Hours
3001AB	Video Network Coordinator	7680	Hours
3001AC	Optometrist	1920	Hours
3001AD	Optometry Technician	1920	Hours
3001AE	Physican Assistant (3 PTE @ 960hrs each)	2880	Hours
3001AF	Anesthesiologist	1920	Hours
3001AG	*Stand By	1000	Hours
3001AH	*Call Back	400	Hours

3005	IMCOM
3005AA	Home Visitor Project Manager	1920	Hours
3005AB	Home Visitor	34560	Hours

3009	LAKENHEATH
3009AA	Registered Nurse-OR	3840	Hours
3009AB	Registered Nurse-OB GYN	7680	Hours
3009AC	Women's Health Nurse Practitioner	1920	Hours
3009AD	Anesthesiologist - Pain Management	1920	Hours
3009AE	Pharmacy Technician	3840	Hours
3009AF	Lactation Consultant - Int'l Board Certififed	1920	Hours
3009AG	Physician Assistant - PDHR	3840	Hours
3009AH	Medical Case Manager	3840	Hours
3009AJ	Licensed Practical Nurse - Internal Medicine	1920	Hours
3009AK	Licensed Practical Nurse - Pain Management	1920	Hours
3009AL	Licensed Practical Nurse - Referral Management	1920	Hours
3009AM	Licensed Practical Nurse - Pediactics	1920	Hours
3009AN	Licensed Practical Nurse - OB GYN	1920	Hours
3009AP	Licensed Practical Nurse - Family Health	1920	Hours
3009AQ	Referral Management Clerk	3840	Hours
3009AR	Medical Administrative Technician	1920	Hours
3009AS	Surgery Technician	1920	Hours
3009AT	Physical Therapist	3840	Hours
3009AU	Physical Evaluation Board Liaison Officer	1920	Hours
3009AV	Pharmacist	1920	Hours
3009AW	Physician - Emergency Room	1920	Hours
4009AX	**Callback Hours	700	Hours
3009AY	Family Services Coordinator	1920	Hours

3013	RAMSTEIN
3013AA	International Board Certified Lactation Consultant	1920	Hours
3013AB	Registered Nurse - Case Manager	3840	Hours
3013AC	Registered Nurse - Utilization Manager	1920	Hours
3013AD	Registered Nurse - Flight Medicine	1920	Hours
3013AE	Physician - Flight Medicine	1920	Hours
3013AF	Licensed Practical Nurse-Referral Management	1920	Hours
3013AG	Health Management Technician	11520	Hours
3013AH	Physical Evaluation Board Liaison Officer	1920	Hours
3013AJ	Nurse Practitioner - PDHR	5760	Hours
3013AK	Certified Nurse - LPN/LVN	1920	Hours
3013AL	Certified RN - Medical Service Specialist	3840	Hours
3013AM	Medical Services Coordinator-Admin Support	5760	Hours

3017	SPANGDAHLEM
3017AA	Patient Liaison Services	13440	Hours
3017AB	Licensed Practical Nurse-Pediatrics	1920	Hours
3017AC	Licensed Practical Nurse-Referral Management	1920	Hours
3017AD	Physician Assistant - PDHR	1920	Hours
3017AE	Licensed Practical Nurse - PDHR	1920	Hours
3017AF	Medical Office Clerk	1920	Hours
3017AG	Licensed Vocational Nurse	1920	Hours
3017AH	Patient Liaison Officers	19200	Hours
3017AJ	Beneficiary Service Representative-KleinBrogel	1920	Hours
3017AK	Beneficiary Service Representative-Volkel	1920	Hours

3021	GEILENKIRCHEN
3021AA	Patient Liaison Services	7680	Hours

3025	BMEDDAC
3025AA	Physican Assistant ( 3 PTE @ 864 hrs each)	2592	Hours

3026 Contract Manpower Reporting (CMR) 10 Each

Option Year (4)

Name of company:

Date:

Solicitation Number: W9114F-18-R-4001

ADCMS GEN III

Option Year (4) Ordering Period: 15May2022-14May2023

	ITEM NO	SERVICE	ESTIMATED
QUANTITY	UNIT	UNIT
PRICE	ESTIMATED

AMOUNT

4001	LRMC
4001AA	Video Network Systems Manager	7680	Hours
4001AB	Video Network Coordinator	7680	Hours
4001AC	Optometrist	1920	Hours
4001AD	Optometry Technician	1920	Hours
4001AE	Physican Assistant (3 PTE @ 960hrs each)	2880	Hours
4001AF	Anesthesiologist	1920	Hours
4001AG	*Stand By	1000	Hours
4001AH	*Call Back	400	Hours

4005	IMCOM
4005AA	Home Visitor Project Manager	1920	Hours
4005AB	Home Visitor	34560	Hours

4009	LAKENHEATH
4009AA	Registered Nurse-OR	3840	Hours
4009AB	Registered Nurse-OB GYN	7680	Hours
4009AC	Women's Health Nurse Practitioner	1920	Hours
4009AD	Anesthesiologist - Pain Management	1920	Hours
4009AE	Pharmacy Technician	3840	Hours
4009AF	Lactation Consultant - Int'l Board Certififed	1920	Hours
4009AG	Physician Assistant - PDHR	3840	Hours
4009AH	Medical Case Manager	3840	Hours
4009AJ	Licensed Practical Nurse - Internal Medicine	1920	Hours
4009AK	Licensed Practical Nurse - Pain Management	1920	Hours
4009AL	Licensed Practical Nurse - Referral Management	1920	Hours
4009AM	Licensed Practical Nurse - Pediactics	1920	Hours
4009AN	Licensed Practical Nurse - OB GYN	1920	Hours
4009AP	Licensed Practical Nurse - Family Health	1920	Hours
4009AQ	Referral Management Clerk	3840	Hours
4009AR	Medical Administrative Technician	1920	Hours
4009AS	Surgery Technician	1920	Hours
4009AT	Physical Therapist	3840	Hours
4009AU	Physical Evaluation Board Liaison Officer	1920	Hours
4009AV	Pharmacist	1920	Hours
4009AW	Physician - Emergency Room	1920	Hours
4009AX	**Callback Hours	700	Hours
4009AY	Family Services Coordinator	1920	Hours

4013	RAMSTEIN
4013AA	International Board Certified Lactation Consultant	1920	Hours
4013AB	Registered Nurse - Case Manager	3840	Hours
4013AC	Registered Nurse - Utilization Manager	1920	Hours
4013AD	Registered Nurse - Flight Medicine	1920	Hours
4013AE	Physician - Flight Medicine	1920	Hours
4013AF	Licensed Practical Nurse-Referral Management	1920	Hours
4013AG	Health Management Technician	11520	Hours
4013AH	Physical Evaluation Board Liaison Officer	1920	Hours
4013AJ	Nurse Practitioner - PDHR	5760	Hours
4013AK	Certified Nurse - LPN/LVN	1920	Hours
4013AL	Certified RN - Medical Service Specialist	3840	Hours
4013AM	Medical Services Coordinator-Admin Support	5760	Hours

4017	SPANGDAHLEM
4017AA	Patient Liaison Services	13440	Hours
4017AB	Licensed Practical Nurse-Pediatrics	1920	Hours
4017AC	Licensed Practical Nurse-Referral Management	1920	Hours
4017AD	Physician Assistant - PDHR	1920	Hours
4017AE	Licensed Practical Nurse - PDHR	1920	Hours
4017AF	Medical Office Clerk	1920	Hours
4017AG	Licensed Vocational Nurse	1920	Hours
4017AH	Patient Liaison Officers	19200	Hours
4017AJ	Beneficiary Service Representative-KleinBrogel	1920	Hours
4017AK	Beneficiary Service Representative-Volkel	1920	Hours

4021	GEILENKIRCHEN
4021AA	Patient Liaison Services	7680	Hours

4025	BMEDDAC
4025AA	Physican Assistant ( 3 PTE @ 864 hrs each)	2592	Hours

4026 Contract Manpower Reporting (CMR) 10 Each

Grand Total

Name of company:

Date:

Solicitation Number: W9114F-18-R-0001

ADCMS GEN III

Ordering Period: 15May2018 through 14May2023

PRICE SUMMARY
Total Base Year	$
Total Opt Yr (1)	$
Total Opt Yr (2)	$
Total Opt Yr (3)	$
Total Opt Yr (4)	$

Grand Total $

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