W912L6-23-Q-0001 Medical Lab Testing Services - Pricing Sheet.xlsx

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Aviation Medical Laboratory Testing Services
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W912L6-23-Q-0001
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Sheet1

PRICING FOR 5-YEAR ORDERING PERIOD
Test DescriptionBase YearOrdering Period 1Ordering Period 2Ordering Period 3Ordering Period 4
01Comprehensive Metabolic Panel: comprised of glucose, calcium, pre-albumin, albumin, sodium, CO2, potassium, chloride, blood urea nitrogen (BUN), creatinine, alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin
02Lipid Panel: comprised of total cholesterol, triglyceride level, HDL level, LDL level, Very low density lipoprotein (VLDL) level, ratio of total cholesterol to HDL, ratio of LDL to HDL
03CBC with differential comprised of White blood cell count, white blood cell types, red blood cell count, hematocrit, hemoglobin, red blood cell indices, platelet count, mean platelet volume
04Prostate Specific Antigen (PSA)
05Blood Typing
06Hemoglobin A 1 C
07Blood Glucose
08Free thyroxine (FT1 or FT4)
09Urine Microscope and Specific Gravity
10Stool Guaiac (fecal occult blood test)
11Sickle Cell Screen
12G6PD (Glucose-6-phosphate dehydrogenase deficiency) - malaria prophylaxis screening
13Varicella Titer
14Thyroxine (T4)
15Thyroxine (T4) Free, Direct
16Hgb Solubility
17Venipuncture
18TSH
19Ceruloplasmin
20Triiodothyronine (T3)
21PTH, Intact
22Hepatitis Panel (4)
23Eosinophil Count, Nasal
24Pap Smear 1 slide w Mat
25Pap Smear, 1 slide
26RPR Test
27Uric Acid, Serum
28Renal Panel
29Urine Culture and Sensitivity
3024 Hr Urine Calcium
3124 Hr Urine Phosphate (Phosphorus)
3224 Hr Urine Uric Acid
3324 Hr Urine Creatine
34Urine Culture, Routine
35Kidney Stone, Urine/Sa
36UA/M w/rflx Culture, R
37Sedimentation Rate-wes
38C-Reactive Protein, OU
39Hepatic Function Panel
40HIV testing
41Urine drug screen
42Blood alcohol level
Pricing will include ALL costs associated with the services listed above and in accordance with the PWS.
Note: Items that are not price, please provide an explanation for zero pricing.

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