ATTACHMENT_3_-_Price__List-_ATTACHMENT.pdf

Minimum Medical Professional/Medical Administrative List

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 24 Medical Event Manager

Admin 25 Event Manager (EM) 26 MEDPROS & Electronic PHA Data Entry Specialist 27 Medical Technician (MT) 28 IT Support Technician (IT)

DESCRIPTION Quantity Cost Dental 29 Dental Exam Supplies

30 Dental Exam Supplies 31 Dental Exam Supplies 32 Dental Treatment Supplies 33 Dental Treatment Supplies

Medical 34 Periodic Health Assessment Supplies 35 Periodic Health Assessment Supplies 36 Periodic Health Assessment Supplies 37 Hearing Exam Supplies 38 Expanded Medical Exam Supplies 38 Blood Colleciton supplies to perform HIV, DNA, G6PD, RPR 39 Immunization Supplies to include PPD screening

DESCRIPTION Quantity Cost Den/Med 40 5-Operatory Mobile Health Practice (dental or medical) 41 4-Operatory Mobile Health Practice (dental or medical) 42 3-Operatory Mobile Health Practice (dental or medical) 43 2-Operatory Mobile Health Practice (dental or medical) 44 1-Operatory Mobile Health Practice (dental or medical) 45 8-Person Mobile Hearing Practice (must include additional ISO-

Booth for Individual Audiologist Exams)

Dental 46 Portable Digital Panoramic X-ray Machine 47 Portable Digital Dental Exam Equipment (Intra-Oral Bitewing &

PANO X-Ray Capability) (i.e. PLANMECA)

48 Portable Dental Treatment Equipment

Medical 49 12+ Station Mobile Data Processing Practice 62 Portable PHA Equipment 63 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 & Pulmonary Function Testing Equipment 58 Optometry with Visual Refraction 59 Equipment to perform blood collectio

Admin 60 Mobile Office Trailer - Per Event (up to 30 consecutive days of service)

61 Electronic PHA Sets (minimum 13 laptops,3 printers w/internet connectivity)

62 Live Event-Soldier Tracking System

DATA ENTRY ONLY - POST EVENT (WITHIN 5 BUSINESS DAYS

AFTER EVENT) - Per ServiceMember (unless otherwsie noted)

DESCRIPTION Quantity Cost Dental IT 63 Point of Service Live Denclass Data Entry 64 Point of Service Live Electronic PHA Data Entry 65 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

DESCRIPTION Quantity

70 Health Readiness Branch Manager - Per Day Rate (medical or dental)

71 Health Readiness Branch Manager - Per Month Rate (medical or dental)

72 Health Case Manager - Per Day Rate (medical or dental) 73 Health Case Manager - Per Month Rate (medical or dental) 74 Health Records Clerk- Per Day Rate (medical or dental) 75 Health Records Clerk - Per Month Rate (medical or dental)

SUPPORT SERVICE COSTS

DESCRIPTION Quantity

76 Prescription Medication Case Management 77 Post Event Dental & Health Case Management PER

PROCEDUR

E

78 Post Event DENCLASS entry 79 Mobile Practice Mileage Rate (Applicable when site is over 250 miles roundtrip from Austin, TX) 80 Portable Health Equipment Shipping Rate (Applicable when site is over 250 miles roundtrip from Austin, TX)

81 Portable Panoramic X-ray Machine Shipping Rate (Applicable when site is over 250 miles roundtrip from Austin, TX)

IMMUNIZATIONS & SERUMS Quantity

DESCRIPTION

82 Hep-A 83 Hep-B

84 PPD

85 TB

86 TDaP

LABS Quantity

DESCRIPTION

87 PSA

88 G6PD

89 Thin Prep 90 Gonorrhea 91 Chlamydia