Copy of SCHEDULE.xlsx
XLSX spreadsheet 95 KB Posted
- Attached to
- Q301--NEW - Reference Lab Testing Federal contract opportunity
- Solicitation number
- 36C25724Q0608
About this file
This document is a combined synopsis/solicitation for commercial laboratory testing services issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 17. The solicitation number is 36C25724Q0608 and the NAICS code is 621511 ($41.5 million). The agency is seeking specialized and backup reference laboratory testing services, as detailed in the attached schedule of contract line items, quantities, and statement of work. Offers are due by July 5, 2024 at 10:00 CST and must be submitted by email. The contract has a base period of July 5, 2024 to July 4, 2025, with two 1-year option periods. The solicitation incorporates FAR 52.212-1, Instructions to Offerors-Commercial Items. Pricing is provided on a fee-basis for a variety of laboratory tests and services.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C25724Q0608 0002.pdf | ||
| 36C25724Q0608 0002_1.docx | DOCX document | |
| 36C25724Q0608 0001.pdf | ||
| 36C25724Q0608 0001_1.docx | DOCX document | |
| 36C25724Q0608_1.docx | DOCX document | |
| Copy of DELIVERY.xlsx | XLSX spreadsheet | |
| 36C25724Q0608.pdf |
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Text version
Item Information
| Item Number | Description | Contract Period | Pop Begin | Pop End | Quantity | Unit of Measure | Unit Price | Amount | PRINCIPAL NAICS CODE | PRODUCT/SERVICE CODE | UNSPSC | SIC CODE | MANUFACTURER PART NUMBER (MPN) | NATIONAL STOCK NUMBER | LOCAL STOCK NUMBER |
| 0001 | VENIPUNCTUE, CPT CODE: 36415 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0002 | FEE BASIS TESTING/SENDOUT: ELECTROLYTE PANEL, CPT CODE: 80051, TEST CODE: 2041000 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0003 | FEE BASIS/SENDOUT: COMPREHENSIVE METABOLIC PANEL, CPT CODE:80053, TEST CODE: 2041760 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0004 | FEE BASIS/SENDOUT: LIPID PANEL, QTY 100, CPT CODE: 80061, TEST CODE: 2041770 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0005 | FEE BASIS/SENDOUT: RENAL FUNCTION PANEL, CPT CODE: 80069, TEST CODE: 2070660 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0006 | FEE BASIS/SENDOUT: ACUTE HEPATITIS PANEL, CPT CODE: 80074, TEST CODE: 1093500 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0007 | FEE BASIS/SENDOUT: LIVER PROFILE - HEPATIC FUNCTION PANEL, CPT CODE: 80076 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0008 | FEE BASIS/SENDOUT: ACETAMINOPHEN, SERUM - HC DRUG ASSAY ACETAMINOPHEN, CPT CODE: 80143, TEST CODE: 2041380 | Base | 7/5/24 | 7/4/25 | 50.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0009 | FEE BASIS/SENDOUT: CARBAMAZEPINE LEVEL - ASSAY CARBAMAZEPINE TOTAL, CPT CODE: 80156, TEST CODE: 2066430 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0010 | FEE BASIS/SENDOUT: CYCLOSPORINE LEVEL - DRUG ASSAY CYCLOSPORINE, CPT CODE: 80158, TEST CODE: 2057300 | Base | 7/5/24 | 7/4/25 | 200.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0011 | FEE BASIS/SENDOUT: DIGOXIN LEVEL - ASSAY OF DIGOXIN TOTAL, CPT CODE: 80162, TEST CODE: 2056030 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0012 | FEE BASIS/SENDOUT: REPIRATORY VIRUS PCR WITH COVID - RESPIRATORY VIRUS ANTIBODY, CPT CODE: 86756, TEST CODE: 12320002211 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0013 | FEE BASIS/SENDOUT: ASSAY OF GENTAMICIN, CPT CODE: 80170 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0014 | FEE BASIS/SENDOUT: LITHIUM LEVEL - ASSAY OF LITHIUM, CPT CODE: 80178, TEST CODE: 2062740 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0015 | FEE BASIS/SENDOUT: SALICYLATE SERUM - HC DRUG ASSAY SALICYLATE, CPT CODE: 80179, TEST CODE: 2041390 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0016 | FEE BASIS/SENDOUT: PHENOBARBITAL - ASSAY OF PHENOBARBITAL, CPT CODE: 80184, TEST CODE: 2041350 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0017 | FEE BASIS/SENDOUT: PHENYTOIN (DILANTIN) LEVEL - ASSAY OF PHENYTOIN TOTAL, CPT CODE: 80185, TEST CODE: 2041340 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0018 | FEE BASIS/SENDOUT: RAPAMYCIN (SIROLIMUS/RAPAMUNE) LEVEL - ASSAY OF SIROLIMUS, CPT CODE: 80195, TEST CODE: 2166620 | Base | 7/5/24 | 7/4/25 | 80.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0019 | FEE BASIS/SENDOUT: PROGRAF (TACROLIMUS) LEVEL - ASSAY OF TACROLIMUS, CPT CODE: 80197, TEST CODE: 2057330 | Base | 7/5/24 | 7/4/25 | 300.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0020 | FEE BASIS/SENDOUT: THEOPHYLINE - ASSAY OF THEOPHYLINE, CPT CODE: 80198, TEST CODE: 90265 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0021 | FEE BASIS/SENDOUT: ASSAY OF TOBRAMYCINE, CPT CODE: 80200 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0022 | FEE BASIS/SENDOUT: VANCOMYCIN LEVEL (RANDOM) - ASSAY OF VANCOMYCIN, CPT CODE: 80202, TEST CODE: 2047820 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0023 | FEE BASIS/SENDOUT: VANCOMYCIN LEVEL (PEAK) - ASSAY OF VANCOMYCIN, CPT CODE: 80202, TEST CODE: 2047810 | Base | 7/5/24 | 7/4/25 | 50.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0024 | FEE BASIS/SENDOUT: VANCOMYCIN LEVEL (TROUGH), CPT CODE: 80202, TEST CODE: 2047800 | Base | 7/5/24 | 7/4/25 | 50.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0025 | FEE BASIS/SENDOUT: DRUG ASSAY INFLIXIMAB, CPT CODE: 80230 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0026 | FEE BASIS/SENDOUT: DRUG ABUSE SCREEN URINE - DRUG TEST PRSMV CHEM ANLYZR, CPT CODE: 80307, TEST CODE: 2067690 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0027 | FEE BASIS/SENDOUT: ALCOHOL SERUM - HC DEFINITIVE DRUG TESTING PROCEDURES: ALCOHOLS, CPT CODE: 80320, TEST CODE: 2041370 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0028 | FEE BASIS/SENDOUT: URINALYSIS - URINALYSIS AUTO W/SCOPE, CPT CODE | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0029 | FEE BASIS/SENDOUT: HPA-1 GENOTYPING, CPT CODE: 81105 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0030 | FEE BASIS/SENDOUT: HPA-2 GENOTYPING, CPT CODE: 81106 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0031 | FEE BASIS/SENDOUT: HPA-3 GENOTYPING, CPT CODE: 81107 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0032 | FEE BASIS/SENDOUT: HPA-4 GENOTYPING, CPT CODE: 81108 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0033 | FEE BASIS/SENDOUT: HPA-5 GENOTYPING, CPT CODE: 81109 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0034 | FEE BASIS/SENDOUT: HPA-6 GENOTYPING, CPT CODE: 81110 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0035 | FEE BASIS/SENDOUT: HPA-9 GENOTYPING, CPT CODE: 81111 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0036 | FEE BASIS/SENDOUT: HPA-15 GENOTYPING, CPT CODE: 81112 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0037 | FEE BASIS/SENDOUT: HBB FULL GENE SEQUENCE, CPT CODE: 81364 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0038 | FEE BASIS/SENDOUT: HLA TRANSPLANT WORKUP LIVER - HLA I & II TYPING IR, CPT CODE: 81370, TEST CODE: TXLIV | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0039 | FEE BASIS/SENDOUT: HLA I & II TYPING VERIFY IR, CPT CODE: 81371 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0040 | FEE BASIS/SENDOUT: HLA TRANSPLANT DONOR WORKUP - HLA I TYPING COMPLETE IR, CPT CODE: 81372, TEST CODE: DONXM | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0041 | FEE BASIS/SENDOUT: CARBAMAZEPINE HYPERSENSITIVITY - HLA I TYPING 1 LOCUS IR, CPT CODE: 81373, TEST CODE: CARB | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0042 | FEE BASIS/SENDOUT: HLA DISEASE ASSOCIATION - HLA I TYPING 1 ANTIGEN IR, CPT CODE: 81374 TEST CODE: DISAS | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0043 | FEE BASIS/SENDOUT: HLA II TYPING AG EQUIV IR, CPT CODE: 81375 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0044 | FEE BASIS/SENDOUT: HLA CELIAC DISEASE - HLA II TYPING 1 LOCUS IR, CPT CODE: 81376, TEST CODE: CELIA | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0045 | FEE BASIS/SENDOUT: HLA II TYPING 1 AG EQUIV IR, CPT CODE: 81377 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0046 | FEE BASIS/SENDOUT: HLA I & II TYPING 1 HR, CPT CODE: 81378 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0047 | FEE BASIS/SENDOUT: HLA TRANSPLANT WORK UP KIDNEY/LUNG - HLA I TYPING COMPLETE HR, HLA I TYPING 1 LOCUS HR, CPT CODE: 81379/81380, TEST CODE: TXKIL | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0048 | FEE BASIS/SENDOUT: HLA I TYPING 1 ALLELE HR, CPT CODE: 81381 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0049 | FEE BASIS/SENDOUT: HLA RHEUMATOID ARTHRITIS, HLA II TYPING 1 LOC HR, CPT CODE: 81382, TEST CODE: RHART | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0050 | FEE BASIS/SENDOUT: HLA II TYPING 1 ALLELE HR, CPT CODE: 81383 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0051 | FEE BASIS/SENDOUT: THYGESON KERATITIS - PRESENCE ABSENCES HLA DR17, TEST CODE: THYGE | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0052 | FEE BASIS/SENDOUT: BEHCETS DISEASE - PRESENCE ABSENCES HLA B*51, TEST CODE: BECHE | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0053 | FEE BASIS/SENDOUT: BETA-HYDROXYBUTYRATE ACID - ACETONE ASSAY, CPT CODE: 82010, TEST CODE: 2070290 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0054 | FEE BASIS/SENDOUT: Alpha-fetoprotein serum, CPT CODE: 82105 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0055 | FEE BASIS/SENDOUT: Ammonia, Plasma - Assay of ammonia, TEST CODE: 2041320, CPT CODE:82140 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0056 | FEE BASIS/SENDOUT: Amylase, Serum - Assay of amylase, TEST CODE: 2041140, CPT CODE: 82150 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0057 | FEE BASIS/SENDOUT: Amylase, Random Urine - Assay of amylase, TEST CODE: UAMYR | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0058 | FEE BASIS/SENDOUT: Bilirubin Total TEST CODE: 2041180, CPT CODE: 82247 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0059 | FEE BASIS/SENDOUT: Bilirubin Direct Serum - Bilirubin direct, TEST CODE: 2041190, CPT CODE: 82248 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0060 | FEE BASIS/SENDOUT: Occult Blood, Fecal - Occult blood feces TEST CODE: 2060080, CPT CODE: 82270 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0061 | FEE BASIS/SENDOUT: Occult Blood Gastric - Occult blood other sources, TEST CODE: 2070590, CPT CODE: 82271 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0062 | FEE BASIS/SENDOUT: Vitamin D 25-hydroxy, TEST CODE: 2158600 CPT CODE: 82306 | Base | 7/5/24 | 7/4/25 | 300.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0063 | FEE BASIS/SENDOUT: Calcium Serum - Assay of calcium, TEST CODE: 2041080, CPT CODE: 82310 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0064 | FEE BASIS/SENOUT: Carbon Dioxide Total Serum - Assay blood carbon dioxide TEST CODE: 2041040, CPT CODE: 82374 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0065 | FEE BASIS/SENDOUT: Creatine Kinase Serum - Assay of ck (cpk) TEST CODE: 2041150, CPT CODE: 82550 | Base | 7/5/24 | 7/4/25 | 150.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0066 | FEE BASIS/SENDOUT: CK MB Profile - Creatine mb fraction, TEST CODE: 2056020, CPT CODE: 82553 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0067 | FEE BASIS/SENDOUT: Creatinine Serum - Assay of creatinine TEST CODE: 2041070, CPT CODE: 82565 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0068 | FEE BASIS/SENDOUT: Creatinine, Random Urine - Assay of urine creatinine, TEST CODE: UCRER CPT CODE: 82570 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0069 | FEE BASIS/SENDOUT: Glucose CSF - Glucose other fluid, TEST CODE: 2043050, CPT CODE: 82945 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0070 | FEE BASIS/SENDOUT: Glucose Serum - Assay glucose blood quant TEST CODE: 2041050, CPT CODE: 82947 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0071 | FEE BASIS/SENDOUT: B-Type Natriuretic Peptide - Immunoassy Analyte Quant - B-Type TEST CODE: 2070080, CPT CODE: 83520 | Base | 7/5/24 | 7/4/25 | 500.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0072 | FEE BASIS/SENDOUT: Hemoglobin Electrophoresis, TEST CODE: 2055030, CPT CODE: 83020 | Base | 7/5/24 | 7/4/25 | 50.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0073 | FEE BASIS/SENDOUT: Lactic Acid, Plasma - Assay of lactic acid, TEST CODE: 2041310, CPT CODE: 83605 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0074 | FEE BASIS/SENDOUT: Magnesium, Serum - Assay of magnesium, TEST CODE: 2041100, CPT CODE: 83735 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0075 | FEE BASIS/SENDOUT: B-Type Natriuretic Peptide - Assay of natriuretic peptide , TEST CODE: 2070080, CPT CODE: 83880 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0076 | FEE BASIS/SENDOUT: Osmolality Serum - Assay of blood osmolality TEST CODE: 2060040, CPT CODE: 83930 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0077 | FEE BASIS/SENDOUT: Osmolality Urine - Assay of urine osmolality, TEST CODE: 2060050, CPT CODE: 83935 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0078 | FEE BASIS/SENDOUT: Alkaline Phosphatase - Assay alkaline phosphatase, TEST CODE: 2041210, CPT CODE: 84075 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0079 | FEE BASIS/SENDOUT: Phosphorus, Serum - Assay of phosphorus, TEST CODE: 2041090, CPT CODE: 84100 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0080 | FEE BASIS/SENDOUT: Potassium, Serum - Assay of serum potassium, TEST CODE: 2041020, CPT CODE: 84132 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0081 | FEE BASIS/SENDOUT: Potassium, Random Urine - Assay of urine potassium, TEST CODE: UKR, CPT CODE: 84133 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0082 | FEE BASIS/SENDOUT: Procalcitonin - Procalcitonin (pct), TEST CODE: 1232050728, CPT CODE: 84145 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0083 | FEE BASIS/SENDOUT: Myelin Basic Protein, CSF - Assay of protein other, TEST CODE: 80515, CPT CODE: 84157 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0084 | FEE BASIS/SENDOUT: Sodium, Serum - Assay of serum sodium, TEST CODE: 2041010, CPT CODE: 84295 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0085 | FEE BASIS/SENDOUT: Sodium, Random Urine - Assay of urine sodium, TEST CODE: UNAR, CPT CODE: 84300 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0086 | FEE BASIS/SENDOUT: AST/SGOT Serum - Transferase (ast) (sgot) TEST CODE: 2041160, CPT CODE: 84450 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0087 | FEE BASIS/SENDOUT: Troponin I, High Sensitiviy - Assay of troponin quant TEST CODE: 2055280 CPT CODE: 84484 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0088 | FEE BASIS/SENDOUT: Blood Urea Nitrogen(BUN)Serum - Assay of urea nitrogen, TEST CODE: 2041060 CPT CODE: 84520 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0089 | FEE BASIS/SENDOUT: Bleeding time test, CPT CODE: 85002 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0090 | FEE BASIS/SENDOUT: Hematocrit, TEST CODE: 1520040, CPT CODE: 85014 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0091 | FEE BASIS/SENDOUT: Hemoglobin, TEST CODE: 1520035, CPT CODE: 85018 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0092 | FEE BASIS/SENDOUT: Complete Blood Count with Diff - Complete cbc w/auto diff wbc TEST CODE: 1520020, CPT CODE: 85025 | Base | 7/5/24 | 7/4/25 | 300.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0093 | FEE BASIS/SENDOUT: Complete Blood Count - Complete cbc automated TEST CODE: 1521030, CPT CODE: 85027 | Base | 7/5/24 | 7/4/25 | 400.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0094 | FEE BASIS/SENDOUT: Citrated Platelet Count - Automated platelet count, TEST CODE: CPLT, CPT CODE: 85049 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0095 | FEE BASIS/SENDOUT: Blood clot retraction, CPT CODE: 85170 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0096 | FEE BASIS/SENDOUT: Factor II Activity - Clot factor ii prothrom spec, TEST CODE: 18250020, CPT CODE: 85210 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0097 | FEE BASIS/SENDOUT: AGH 1 Stage-Factor 8 Activity - Clot factor viii ahg 1 stage, TEST CODE: 1825080, CPT CODE: 85240 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0098 | FEE BASIS/SENDOUT: Clot factor viii reltd antgn, CPT CODE: 85244 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0099 | FEE BASIS/SENDOUT: Rist Cofactor Assay - Clot factor viii vw ristoctn, TEST CODE: 1826180, CPT CODE: 85245 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0100 | FEE BASIS/SENDOUT: Von Willebrand Factor Propeptide Antigen - Clot factor viii vw antigen, TEST CODE: B5200, CPT CODE: 85246 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0101 | FEE BASIS/SENDOUT: Von Willebrand Factor Collagen Binding - HC Von Willebrand Factor Quant Multimer, TEST CODE: B5190, CPT CODE: 85247 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0102 | FEE BASIS/SENDOUT: Factor IX Activity - Clot factor ix ptc/chrstmas, TEST CODE: 1825110, CPT CODE: 85250 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0103 | FEE BASIS/SENDOUT: Factor X Activity - Clot factor x stuart-power TEST CODE: 1825130, CPT CODE: 85260 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0104 | FEE BASIS/SENDOUT: Factor XI Activity - Clot factor xi pta, TEST CODE: 1825150, CPT CODE: 85270 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0105 | FEE BASIS/SENDOUT: Factor XI Assay - Clot factor xii hageman TEST CODE: 1825170, CPT CODE: 85280 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0106 | FEE BASIS/SENDOUT: Factor XIII Screen - Clot factor xiii fibrin scrn, TEST CODE: 1825190 CPT CODE: 85291 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0107 | FEE BASIS/SENDOUT: Antithrombin III Activity - Antithrombin iii activity, TEST CODE: 1823130, CPT CODE: 85300 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0108 | FEE BASIS/SENDOUT: Antithrombin iii antigen, CPT CODE: 85301 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0109 | FEE BASIS/SENDOUT: Clot inhibit prot c antigen, CPT CODE: 85302 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0110 | FEE BASIS/SENDOUT: Protein C Activity - Clot inhibit prot c activity, TEST CODE: 1823210, CPT CODE: 85303 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0111 | FEE BASIS/SENDOUT: Clot inhibit prot s total, CPT CODE: 85305 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0112 | FEE BASIS/SENDOUT: Clot inhibit prot s free, CPT CODE: 85306 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0113 | FEE BASIS/SENDOUT: Assay activated protein c, CPT CODE: 85307 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0114 | FEE BASIS/SENDOUT: Factor inhibitor test, CPT CODE: 85335 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0115 | FEE BASIS/SENDOUT: Thrombomodulin, CPT CODE: 85337 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0116 | FEE BASIS/SENDOUT: Coagulation time activated, CPT CODE: 85347 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0117 | FEE BASIS/SENDOUT: D-Dimer - Fibrin degradation quant, TEST CODE: 1823150, CPT CODE: 85379 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0118 | FEE BASIS/SENDOUT: Fibrinogen Level - Fibrinogen activity, TEST CODE: 1823030, CPT CODE: 85384 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0119 | FEE BASIS/SENDOUT: Fibrinolysins screen i&r, CPT CODE: 85390 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0120 | FEE BASIS/SENDOUT: ADAMTS13 Evaluation - HC ADAMS 13 activity, TEST CODE: B5000, CPT CODE: 85397 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0121 | FEE BASIS/SENDOUT: Heparin Unfractionated Assay - Heparin assay, TEST CODE: 1826090, CPT CODE: 85520 | Base | 7/5/24 | 7/4/25 | 50.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0122 | FEE BASIS/SENDOUT: Heparin LMW Assay - Heparin assay, TEST CODE: 1826100, CPT CODE: 85520 | Base | 7/5/24 | 7/4/25 | 50.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0123 | FEE BASIS/SENDOUT: Blood Platelet Aggregation-PFA 100 Collagen/EPIN - Blood platelet aggregation, CPT CODE: 85576 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0124 | FEE BASIS/SENDOUT: Anti-Phospholipid AB Eval - Phospholipid pltlt neutraliz, TEST CODE: 1823610, CPT CODE: 85597 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0125 | FEE BASIS/SENDOUT: Hexagnal phosph pltlt neutrl, CPT CODE: 85598 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0126 | FEE BASIS/SENDOUT: Prothrombin time, CPT CODE: 85610 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0127 | FEE BASIS/SENDOUT: Russell viper venom diluted, CPT CODE: 85613 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0128 | FEE BASIS/SENDOUT: Thrombin Time - Thrombin time plasma, TEST CODE: 1823060, CPT CODE: 85670 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0129 | FEE BASIS/SENDOUT: Partial Thromboplastin - Thromboplastin time partial, TEST CODE: 1823020, CPT CODE: 85730 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0130 | FEE BASIS/SENDOUT: Platelet antibodies-Heparin-induced Platelet Antibody - Platelet antibodies, CPT CODE: 86022 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0131 | FEE BASIS/SENDOUT: Hepatitis B Core Antibody Total - Hep b core antibody total, TEST CODE: 1093100, CPT CODE: 86704 | Base | 7/5/24 | 7/4/25 | 50.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0132 | FEE BASIS/SENDOUT: Hepatitis B Core IgM - Hep b core antibody igm, TEST CODE: 1093120, CPT CODE: 86705 | Base | 7/5/24 | 7/4/25 | 50.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0133 | FEE BASIS/SENDOUT: Hepatitis B Surface Antibody - Hep b surface antibody, TEST CODE: 1093050 CPT CODE: 86706 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0134 | FEE BASIS/SENDOUT: Hepatitis A Antibody Total - Hepatitis a antibody, TEST CODE: 1093375 CPT CODE: 86708 | Base | 7/5/24 | 7/4/25 | 50.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0135 | FEE BASIS/SENDOUT: Hepatitis A IgM - Hepatitis a igm antibody, TEST CODE: 1093350, CPT CODE: 86709 | Base | 7/5/24 | 7/4/25 | 50.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0136 | FEE BASIS/SENDOUT: Mumps Antibody IgG - Mumps antibody, TEST CODE: 1230100066, CPT CODE: 86735 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0137 | FEE BASIS/SENDOUT: Rubella Antibody IgG - Rubella antibody, TEST CODE: 1094021, CPT CODE: 86762 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0138 | FEE BASIS/SENDOUT: Measles(Rubeola)Antigody IgG - Rubeola antibody, TEST CODE: 1232050747, CPT CODE: 86765 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0139 | FEE BASIS/SENDOUT: Varicella Zoster IgG - Varicella-zoster antibody, TEST CODE: 1094101, CPT CODE: 86787 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0140 | FEE BASIS/SENDOUT: Hepatitis C Antibody - Hepatitis c ab test, TEST CODE: 1093200, CPT CODE: 86803 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0141 | FEE BASIS/SENDOUT: Hla typing a b or c, CPT CODE: 86812 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0142 | FEE BASIS/SENDOUT: Hla typing a b or c, CPT CODE: 86813 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0143 | FEE BASIS/SENDOUT: Hla typing dr/dq, CPT CODE: 86816 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0144 | FEE BASIS/SENDOUT: Hla typing dr/dq, CPT CODE: 86817 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0145 | FEE BASIS/SENDOUT: Syphillis Screen - Treponema pallidum, TEST CODE: 1090005, CPT CODE: 86780 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0146 | FEE BASIS/SENDOUT: Lymphocyte culture mixed, CPT CODE: 86821 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0147 | FEE BASIS/SENDOUT: HLA Donor Crossmatch - Hla x-math non-cytotoxic, TEST CODE: DONXM, CPT CODE: 86825 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0148 | FEE BASIS/SENDOUT: Hla x-match noncytotoxc addl, CPT CODE: 86826 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0149 | FEE BASIS/SENDOUT: Hla class i&ii antibody qual, CPT CODE: 86828 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0150 | FEE BASIS/SENDOUT: Hla class i/ii antibody qual, CPT CODE: 86829 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0151 | FEE BASIS/SENDOUT: Hla class i phenotype qual, CPT CODE: 86830 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0152 | FEE BASIS/SENDOUT: Hla class ii phenotype qual, CPT CODE: 86831 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0153 | FEE BASIS/SENDOUT: HLA Antibody - Hla class i high defin qual, TEST CODE: SAB, CPT CODE: 86832 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0154 | FEE BASIS/SENDOUT: Hla class ii high defin qual, CPT CODE: 86833 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0155 | FEE BASIS/SENDOUT: Hla class i semiquant panel, CPT CODE: 86834 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0156 | FEE BASIS/SENDOUT: Hla class ii semiquant panel, CPT CODE: 86835 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0157 | FEE BASIS/SENDOUT: Platelets, Transfusion - Blood product/irradiation, TEST CODE: BBPIRP CPT CODE: 86945 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0158 | FEE BASIS/SENDOUT: Culture othr specimn aerobic, CPT CODE: 87070 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0159 | FEE BASIS/SENDOUT: Culture aerobic quant other, CPT CODE: 87071 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0160 | FEE BASIS/SENDOUT: Culture bacteria anaerobic, CPT CODE: 87073 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0161 | FEE BASIS/SENDOUT: Culture anaerobe ident each, CPT CODE: 87076 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0162 | FEE BASIS/SENDOUT: Culture aerobic identify, CPT CODE: 87077 | Base | 7/5/24 | 7/4/25 | 60.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0163 | FEE BASIS/SENDOUT: Fungus isolation culture, CPT CODE: 87102 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0164 | FEE BASIS/SENDOUT: Mycobacteria culture, CPT CODE: 87116 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0165 | FEE BASIS/SENDOUT: Mycobacteric identification, CPT CODE: 87118 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0166 | FEE BASIS/SENDOUT: Culture type immunofluoresc, CPT CODE: 87140 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0167 | FEE BASIS/SENDOUT: Culture type immunologic, CPT CODE: 87147 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0168 | FEE BASIS/SENDOUT: Microbe susceptible diffuse, CPT CODE: 87181 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0169 | FEE BASIS/SENDOUT: Microbe susceptible disk, CPT CODE: 87184 | Base | 7/5/24 | 7/4/25 | 40.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0170 | FEE BASIS/SENDOUT: Microbe susceptible mic, CPT CODE: 87186 | Base | 7/5/24 | 7/4/25 | 25.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0171 | FEE BASIS/SENDOUT: Herpes Simplex Virus 1& 2 PCR - Herpes simplex 1 ag if 2 ag if, TEST CODE: 1230101546, CPT CODES: 87273/87274 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0172 | FEE BASIS/SENDOUT: Varicella Zoster IgG - Varicella zoster ag if, TEST CODE: 1094101, CPT CODE: 87290 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0173 | FEE BASIS/SENDOUT: Hepatitis B Surface Antigen - Hepatitis b surface ag ia TEST CODE: 1093010, CPT CODE: 87340 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0174 | FEE BASIS/SENDOUT: Human Immunodeficiency Virus(HIV)Antigen/Antibody Combo - Hiv-1 ag w/hiv-1 & hiv-2 ab, TEST CODE: HIVG4, CPT CODE: 87839 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0175 | FEE BASIS/SENDOUT: Meningitis/Encephalitis PCR - Cns dna amp probe type 12-25, TEST CODE: MEPCR, CPT CODE: 87483 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0176 | FEE BASIS/SENDOUT: CMV(Cytomegalovirus) Quantitative PCR, Blood - Cytomeg dna quant, TEST CODE: 34060603, CPT CODE: 87497 | Base | 7/5/24 | 7/4/25 | 160.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0177 | FEE BASIS/SENDOUT: BK Virus Quantitative PCR Plama - Detect agent nos dna quant, TEST CODE: 123205073301, CPT CODE: 87799 | Base | 7/5/24 | 7/4/25 | 250.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0178 | FEE BASIS/SENDOUT: Resp virus 3-5 targets. CPT CODE: 87631 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0179 | FEE BASIS/SENDOUT: Resp virus 6-11 targets, CPT CODE: 87632 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0180 | FEE BASIS/SENDOUT: Respiratory Virus PCR with COVID - Resp virus 12-25 targets, TEST CODE: 12320002211, CPT CODE: 87633/U0004 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0181 | FEE BASIS/SENDOUT: Cell cryopreserve/storage, CPT CODE: 88240 | Base | 7/5/24 | 7/4/25 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0182 | FEE BASIS/SENDOUT: HC Electron Microscopy, CPT CODE: 88348 | Base | 7/5/24 | 7/4/25 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0183 | FEE BASIS/SENDOUT: Covid-19 lab test non-cdc, CPT CODE: U0002 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0184 | FEE BASIS/SENDOUT: SARS-CoV-2(COVID19) by molecular detection(TMAT or PCR) including COVID PUI and COVID Screen - Cov-19 amp prb hgh thruput TEST CODE: COV 19, CPT CODE: U0003 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0185 | FEE BASIS/SENDOUT: Platelet Reactivity for Plavix, TEST CODE: 1826241, CPT CODE: 85576 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0186 | FEE BASIS/SENDOUT: Platele Reactiviy for Asprin, CPT CODE: 85576 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0187 | FEE BASIS/SENDOUT: Heparin Induced Platelet Antibody - TEST CODE: HITAB, CPT CODE: 86022 | Base | 7/5/24 | 7/4/25 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0188 | FEE BASIS/SENDOUT: AT1R, CPT CODE: 83520/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0189 | FEE BASIS/SENDOUT: Include: Specimen prep, adsorb, CPT CODE: 86849x2 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0190 | FEE BASIS/SENDOUT: FPRA, CPT CODE: 86828 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0191 | FEE BASIS/SENDOUT: Include: Specimen Prep, CPT CODE: 86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0192 | FEE BASIS/SENDOUT: Monthly Serum Storage, CPT CODE: 99001 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0193 | FEE BASIS/SENDOUT: Include: Specimen Prep, CPT CODE: 86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0194 | FEE BASIS/SENDOUT: SAB Class I, CPT CODE: 86832 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0195 | FEE BASIS/SENDOUT: Include: EDTA, Adsorb, Speciment Prep, CPT CODE: 86849x3 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0196 | FEE BASIS/SENDOUT: SAB Class II, CPT CODE: 86833 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0197 | FEE BASIS/SENDOUT: Include: EDTA, Adsorb, Specimen Prep, CPT CODE: 86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0198 | FEE BASIS/SENDOUT: Luminex PRA Class I, CPT CODE: 86830 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0199 | FEE BASIS/SENDOUT: Include: EDTA, Adsorb, Specimen Prep, CPT CODE: 86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0200 | FEE BASIS/SENDOUT: Luminex PRA Class II, CPT CODE: 86831 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0201 | FEE BASIS/SENDOUT: Include: EDTA, ADSORB, Specimen Prep, CPT CODE: 86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0202 | FEE BASIS/SENDOUT: RECXM, CPT CODE: 86825/86826 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0203 | FEE BASIS/SENDOUT: Include: Specimen prep, Specimen Treatment, CPT CODE: 86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0204 | FEE BASIS/SENDOUT: Real Time PCR Include Extraction no CPT Code, CPT CODE: 81370/81376x3/81382x2 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0205 | FEE BASIS/SENDOUT: pellet (specimen prep), CPT CODE: 86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0206 | FEE BASIS/SENDOUT: NGS Include Extraction no CPT Code, CPT CODE: 81379x2/81382x11 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0207 | FEE BASIS/SENDOUT: pellet (specimen prep), CPT CODE: 86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0208 | FEE BASIS/SENDOUT: SSO complete Include extraction no CPT Code, CPT CODE: 81370/81382 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0209 | FEE BASIS/SENDOUT: pellet (specimen prep), CPT CODE: 86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0210 | FEE BASIS/SENDOUT: SSOA, CPT CODE: 81380/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0211 | FEE BASIS/SENDOUT: SSOB, CPT CODE: 81380/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0212 | FEE BASIS/SENDOUT: SSOC, CPT CODES: 81380/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0213 | FEE BASIS/SENDOUT: SSODPA1, CPT CODE: 81832/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0214 | FEE BASIS/SENDOUT: SSODPB1, CPT CODE: 81832/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0215 | FEE BASIS/SENDOUT: SSODQA1, CPT CODE: 81832/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0216 | FEE BASIS/SENDOUT: SSODQB1, CPT CODE: 81832/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0217 | FEE BASIS/SENDOUT: SSODRB1, CPT CODE: 81832/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0218 | FEE BASIS/SENDOUT: SSODRB3,4,5, CPT CODE: 81832/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0219 | FEE BASIS/SENDOUT: SSO1(A,B,C), CPT CODE: 81382/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0220 | FEE BASIS/SENDOUT: SSO2 (DRB1/3/4/5,DQA1,DQB1,DPA1,DPB1), CPT CODE: 81382/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0221 | FEE BASIS/SENDOUT: SSP HIGH RESOLUTION A TYPING, CPT CODE: 81380/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0222 | FEE BASIS/SENDOUT: SSP HIGH RESOLUTION B TYPING, CPT CODE: 81380/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0223 | FEE BASIS/SENDOUT: SSP HIGH RESOLUTION C TYPING, CPT CODE: 81380/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0224 | FEE BASIS/SENDOUT: SSP HIGH RESOLUTION DRB1/3/4/5 TYPING, CPT CODE: 81382/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0225 | FEE BASIS/SENDOUT: SSP HIGH RESOLUTION DPA1 TYPING, CPT CODE: 81382/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0226 | FEE BASIS/SENDOUT: SSP HIGH RESOLUTION DPB1 TYPING, CPT CODE: 81382/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0227 | FEE BASIS/SENDOUT: SSP HIGH RESOLUTION DQA1 TYPING, CPT CODE: 81382/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 0228 | FEE BASIS/SENDOUT: SSP HIGH RESOLUTION DQB1 TYPING, CPT CODE: 81382/86849 | Base | 7/5/24 | 7/4/25 | 5.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1001 | VENIPUNCTUE, CPT CODE: 36415 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1002 | FEE BASIS TESTING/SENDOUT: ELECTROLYTE PANEL, CPT CODE: 80051, TEST CODE: 2041000 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1003 | FEE BASIS/SENDOUT: COMPREHENSIVE METABOLIC PANEL, CPT CODE:80053, TEST CODE: 2041760 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1004 | FEE BASIS/SENDOUT: LIPID PANEL, QTY 100, CPT CODE: 80061, TEST CODE: 2041770 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1005 | FEE BASIS/SENDOUT: RENAL FUNCTION PANEL, CPT CODE: 80069, TEST CODE: 2070660 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1006 | FEE BASIS/SENDOUT: ACUTE HEPATITIS PANEL, CPT CODE: 80074, TEST CODE: 1093500 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1007 | FEE BASIS/SENDOUT: LIVER PROFILE - HEPATIC FUNCTION PANEL, CPT CODE: 80076 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1008 | FEE BASIS/SENDOUT: ACETAMINOPHEN, SERUM - HC DRUG ASSAY ACETAMINOPHEN, CPT CODE: 80143, TEST CODE: 2041380 | Option 1 | 7/5/25 | 7/4/26 | 50.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1009 | FEE BASIS/SENDOUT: CARBAMAZEPINE LEVEL - ASSAY CARBAMAZEPINE TOTAL, CPT CODE: 80156, TEST CODE: 2066430 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1010 | FEE BASIS/SENDOUT: CYCLOSPORINE LEVEL - DRUG ASSAY CYCLOSPORINE, CPT CODE: 80158, TEST CODE: 2057300 | Option 1 | 7/5/25 | 7/4/26 | 200.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1011 | FEE BASIS/SENDOUT: DIGOXIN LEVEL - ASSAY OF DIGOXIN TOTAL, CPT CODE: 80162, TEST CODE: 2056030 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1012 | FEE BASIS/SENDOUT: REPIRATORY VIRUS PCR WITH COVID - RESPIRATORY VIRUS ANTIBODY, CPT CODE: 86756, TEST CODE: 12320002211 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1013 | FEE BASIS/SENDOUT: ASSAY OF GENTAMICIN, CPT CODE: 80170 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1014 | FEE BASIS/SENDOUT: LITHIUM LEVEL - ASSAY OF LITHIUM, CPT CODE: 80178, TEST CODE: 2062740 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1015 | FEE BASIS/SENDOUT: SALICYLATE SERUM - HC DRUG ASSAY SALICYLATE, CPT CODE: 80179, TEST CODE: 2041390 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1016 | FEE BASIS/SENDOUT: PHENOBARBITAL - ASSAY OF PHENOBARBITAL, CPT CODE: 80184, TEST CODE: 2041350 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1017 | FEE BASIS/SENDOUT: PHENYTOIN (DILANTIN) LEVEL - ASSAY OF PHENYTOIN TOTAL, CPT CODE: 80185, TEST CODE: 2041340 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1018 | FEE BASIS/SENDOUT: RAPAMYCIN (SIROLIMUS/RAPAMUNE) LEVEL - ASSAY OF SIROLIMUS, CPT CODE: 80195, TEST CODE: 2166620 | Option 1 | 7/5/25 | 7/4/26 | 80.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1019 | FEE BASIS/SENDOUT: PROGRAF (TACROLIMUS) LEVEL - ASSAY OF TACROLIMUS, CPT CODE: 80197, TEST CODE: 2057330 | Option 1 | 7/5/25 | 7/4/26 | 300.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1020 | FEE BASIS/SENDOUT: THEOPHYLINE - ASSAY OF THEOPHYLINE, CPT CODE: 80198, TEST CODE: 90265 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1021 | FEE BASIS/SENDOUT: ASSAY OF TOBRAMYCINE, CPT CODE: 80200 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1022 | FEE BASIS/SENDOUT: VANCOMYCIN LEVEL (RANDOM) - ASSAY OF VANCOMYCIN, CPT CODE: 80202, TEST CODE: 2047820 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1023 | FEE BASIS/SENDOUT: VANCOMYCIN LEVEL (PEAK) - ASSAY OF VANCOMYCIN, CPT CODE: 80202, TEST CODE: 2047810 | Option 1 | 7/5/25 | 7/4/26 | 50.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1024 | FEE BASIS/SENDOUT: VANCOMYCIN LEVEL (TROUGH), CPT CODE: 80202, TEST CODE: 2047800 | Option 1 | 7/5/25 | 7/4/26 | 50.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1025 | FEE BASIS/SENDOUT: DRUG ASSAY INFLIXIMAB, CPT CODE: 80230 | Option 1 | 7/5/25 | 7/4/26 | 10.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1026 | FEE BASIS/SENDOUT: DRUG ABUSE SCREEN URINE - DRUG TEST PRSMV CHEM ANLYZR, CPT CODE: 80307, TEST CODE: 2067690 | Option 1 | 7/5/25 | 7/4/26 | 100.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD | |||||
| 1027 | FEE BASIS/SENDOUT: ALCOHOL SERUM - HC DEFINITIVE DRUG TESTING PROCEDURES: ALCOHOLS, CPT CODE: 80320, TEST CODE: 2041370 | Option 1 | 7/5/25 | 7/4/26 | 20.00 | EA | 621511 - Medical Laboratories | Q301 - Medical - Laboratory Testing | TBD | TBD |
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