The file's text, extracted by GovTribe without its formatting.
CLIN_Breakout
| Minimum Medical Professional/Medical Administrative List | | | | | | | |
| EVENT STAFF ONLY - per day pricing with up to 250 miles roundtrip from Austin, TX (unless otherwise noted) | | | Base | Opt 1 | Opt 2 | Opt 3 | Opt 3 |
| CLIN | DESCRIPTION | Quantity | Cost | | | | | |
| Dental | | | | | | | | |
| 1 | Dentist (DR) | | | | | | | |
| 2 | Endodontist | | | | | | | |
| 3 | Oral Surgeon | | | | | | | |
| 4 | Registered Dental Assistant (RDA) | | | | | | | |
| 5 | Dental Assistant (DA) | | | | | | | |
| 6 | Radiograph Technician | | | | | | | |
| Medical | |
| 7 | Medical Event Manager |
| 8 | Medical Doctor (MD) |
| 9 | Optometrist (OP) |
| 10 | Optometry Tech (OT) |
| 11 | Ophthalmologist |
| 12 | Hearing Conservationist (HC) |
| 13 | Audiologist (AU) |
| 14 | Audiologist Technician |
| 15 | Physician Assistant (PA) |
| 16 | Nurse Practitioner (NP) |
| 17 | Registered Nurse (RN) |
| 18 | Certified Nursing Assitant |
| 19 | Licensed Practical Nurse |
| 20 | Behavioral Health Specialist (BHS) |
| 21 | Phlebotomist (PL) |
| 22 | Emergency Medical Technician (EMT) |
| 23 | Case Manager |
| Admin | |
| 24 | Event Manager (EM) |
| 25 | MEDPROS & Electronic PHA Data Entry Specialist |
| 26 | Medical Technician (MT) |
| 27 | IT Support Technician (IT) |
| SUPPLIES | | |
| CLIN | DESCRIPTION | Quantity | Cost |
| Dental | | | |
| 28 | Dental Exam Supplies | | |
| 29 | Dental Exam Supplies | | |
| 30 | Dental Exam Supplies | | |
| 31 | Dental Treatment Supplies | | |
| 32 | Dental Treatment Supplies | | |
| Medical | |
| 33 | Periodic Health Assessment Supplies per soldier |
| 34 | Expanded Medical Exam Supplies (over 40 physicals and women's health) |
| 38 | Blood Collection Supplies to perform (at a minimum) HIV, DNA, G6PD, PSA blood draws with proper collection tubes |
| 39 | Immunization Supplies to include PPD screening |
| VEHICLES and (OSHA compliant) DURABLE MEDICAL EQUIPMENT | | |
| CLIN | DESCRIPTION | Quantity | Cost |
| Den/Med | | | |
| 40 | 4-Operatory Mobile Health Practice (dental or medical) | | |
| 41 | 3-Operatory Mobile Health Practice (dental or medical) | | |
| 42 | 2-Operatory Mobile Health Practice (dental or medical) | | |
| 43 | 8-Person Mobile Hearing Practice (must include additional ISO-Booth for Individual Audiologist Exams) | | |
| Dental | |
| 44 | Portable Digital Panoramic X-ray Machine |
| 45 | Portable Digital Dental Exam Equipment (Intra-Oral Bitewing & PANO X-Ray Capability) (i.e. PLANMECA) |
| 46 | Portable Dental Treatment Equipment |
| Medical | |
| 47 | 12+ Station Mobile Data Processing Practice |
| 61 | Portable PHA Equipment |
| 62 | DOEHRA Compatible Portable Hearing Equipment |
| 53 | TITMUS Visual Acuity Screener |
| 54 | CLEA-Waived Rapid Laboratory Screenings (Lipid Profile, Hemoglobin, Blood Glucose, Total Cholesterol, Urinalysis & Urine HCG) |
| 55 | Blood Pressure, Pulse Oximetry, Height/Weight/Temperature Equipment |
| 57 | EKG Equipment |
| 58 | Optometry with Visual Refraction |
| Admin | |
| 59 | Mobile Office Trailer - Per Event (up to 30 consecutive days of service) |
| 60 | Electronic PHA Sets (minimum 12 laptops,3 printers w/internet connectivity) |
| 61 | Live Event-Soldier Tracking System |
| 62 | Satallite Internet connection (stand-alone) |
DATA ENTRY ONLY - POST EVENT (WITHIN 5 BUSINESS DAYS AFTER EVENT) - Per ServiceMember (unless otherwsie noted)
| CLIN | DESCRIPTION | Quantity | Cost |
| Dental IT | | | |
| 62 | Point of Service Live Denclass Data Entry | | |
| 63 | Point of Service Live Electronic PHA Data Entry | | |
| 64 | Point of Service e-Profile Data Entry | | |
| Medical IT | |
| 66 | Live Electronic Point of Service MEDPROS Web Data Entry (MWDE) access/entry |
| 67 | Live Electronic Point of Service DOEHRS, Audio Evaluation, & SPRINT Data Entry |
| 68 | Health Records Repository (HRR) Scan & Data Entry |
| NON-EVENT STAFFING | | |
| CLIN | DESCRIPTION | Quantity | Cost |
| 69 | Health Readiness Branch Manager - Per Day Rate (medical or dental) | | |
| 70 | Health Readiness Branch Manager - Per Month Rate (medical or dental) | | |
| 71 | Health Case Manager - Per Day Rate (medical or dental) | | |
| 72 | Health Case Manager - Per Month Rate (medical or dental) | | |
| 73 | Health Records Clerk- Per Day Rate (medical or dental) | | |
| 74 | Health Records Clerk - Per Month Rate (medical or dental) | | |
| SUPPORT SERVICE COSTS | | | |
| CLIN | DESCRIPTION | Quantity | Cost | |
| 75 | Post Event Dental & Health Case Management | PER PROCEDURE | Utilize CPT Code | * UCR will be utilized according to NDA by zip code +30% to cover additional work |
| 78 | Post Event DENCLASS entry | | | |
| 79 | Mobile Practice Mileage Rate (Applicable when site is over 250 miles roundtrip from Austin, TX) | | | |
| IMMUNIZATIONS & SERUMS | | Quantity | Cost |
| CLIN | DESCRIPTION | | |
| 108 | Hep-A | | |
| 109 | Hep-B | | |
| 110 | TWINREX (combination HEB A&B) | | |
| 111 | PPD | | |
| 112 | TDaP | | |
| 113 | Administer Influenza - (Flumist) inhalable for Soldiers under 49 and under (Immunization provided to vendor by TXARNG) | | |
| 114 | Administer Influenza - injectable for those 50 and above. (Immunization provided to vendor by TXARNG) | | |
| LABS | | |
| CLIN | DESCRIPTION | Quantity | Cost |
| 115 | PSA | | |
| 116 | G6PD | | |
| 117 | Thin Prep | | |
| 118 | Gonorrhea | | |
| 119 | Chlamydia | | |
| 120 | Pregnancy Test (Urine) | | |
| 121 | Hemoglobin (Hgb) A1C | | |
| 122 | Fasting Lipid Panel (To include TC, HDL, LDL, TRIG and calculation of Framingham Risk Percentage) | | |
| 123 | FBS | | |
| 122 | ECG-Electrocardiogram | | |
| 124 | HIV-cost to draw only. (TXARNG will provide blood tubes, labels, and shipping.) | | |
FOUO - Independent Government Estimate - Master IDIQ W912L1-18-R-0004, Base Plus 4 Option Years
