Lab_RFP_BAIHS.xls.xlsx

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ANATOMICAL PATHOLOGY AND CLINICAL LABORATORY TESTING SERVICES
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RFP-244-17-0008-REL
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Section J, Attachment A - Itemized Pricelist

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RFP-244-17-0008-REL.Lab_Testing_Services.doc DOC document
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HHS_Subcontracting_Plan.pdf PDF
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BASE YR

ITEM NOHCPCDescriptionEST. QTYUnitUnit Bid PriceTotal Amount
B.1.180048Basic metabolic panel; Calcium, CO2, Chloride,Creatinine, Glucose, Potassium, Urea Nitrogren,10ea$ - 0
B.1.280050General Health Panel includes; Comprehensive metabolic panel (80053), Hemogram, platelet count, auto diff (85025), TSH (84443).50ea$ - 0
B.1.380051Electrolyte panel; Na, K, Cl, CO25ea$ - 0
B.1.480053Comprehen metabolic panel; Albumin, T-Bili, Calcium, CO2, Chloride, Glucose, Alkaline Phospatase, Potassium, T-Protein, ALT, AST, BUN,50ea$ - 0
B.1.580061Lipid panel; Cholesterol (82465), HDL (83718), Triglyceride (84478)2000ea$ - 0
B.1.680069Renal function panel; Albumin (82040), Calcium (82310), CO2 (82374), Chloride (82435), Creatinine (82565), Glucose (82947), Phosphate (84100), Potassium (84132), Sodium (84295), Bun (84520)25ea$ - 0
B.1.7Arthritis panel; ANA (86038), Rheumatoid factor (86431), Uric Acid (84550)375ea$ - 0
B.1.880074Acute hepatitis panel; Hepatitis A antibody IgM (86709), Hepatitis B core anitbody IgM (86705), Hepatitis B surface antigen (87340), Hepatitis C antibody (86803)900ea$ - 0
B.1.980076Hepatic function panel; Albumin (82040), T-bil (82247), direct Bili (82248), Alkaline Phosphatase (84075), T-protein (84155), ALT (84460), AST (84450)10ea$ - 0
B.1.1080090Torch antibody panel; Antibody CMV (86644), Antibody herpes simplex (86694), Antibody rubella (86762), Antibody toxoplasma (86777)5ea$ - 0
B.1.1180100Drug screen; Amphetamines, Barbiturate, Benzodiazepines, Cocaine + metabolites, Marijuana (THC), Methadone, Methaqualone, Opiate, Phencyclidine (PCP), Propoxyphene1656ea$ - 0
B.1.1280100Drug Screen meconium75ea$ - 0
B.1.1380101Drug screen, single350ea$ - 0
B.1.1480102Drug confirmation (HPLC)100ea$ - 0
B.1.1580152Assay of amitriptyline5ea$ - 0
B.1.1680154Assay of benzodiazepines; confirm GC/MS5ea$ - 0
B.1.1780156Assay, carbamazepine, total75ea$ - 0
B.1.1880157Assay, carbamazepine, free5ea$ - 0
B.1.1980158Assay of cyclosporine68ea$ - 0
B.1.2080197FK 506300ea$ - 0
B.1.2180160Assay of desipramine10ea$ - 0
B.1.2280162Assay of digoxin50ea$ - 0
B.1.2380164Assay, dipropylacetic acid3ea$ - 0
B.1.2480166Assay of doxepin3ea$ - 0
B.1.2580168Assay of ethosuximide3ea$ - 0
B.1.2680170Assay of gentamicin5ea$ - 0
B.1.2780174Assay of imipramine5ea$ - 0
B.1.2880178Assay of lithium50ea$ - 0
B.1.2980182Assay of nortriptyline5ea$ - 0
B.1.3080184Assay of phenobarbital35ea$ - 0
B.1.3180185Assay of phenytoin, total100ea$ - 0
B.1.3280186Assay of phenytoin, free2ea$ - 0
B.1.3380196Assay of salicylate5ea$ - 0
B.1.3480198Assay of theophylline50ea$ - 0
B.1.3580202Assay of vancomycin75ea$ - 0
B.1.3680299Quantitative assay, drug10ea$ - 0
B.1.3780400Acth stimulation panel10ea$ - 0
B.1.3880500Clinical pathology consultation; limited, without review of patient's history and medical records10ea$ - 0
B.1.3980502Clinical pathology consultation; comprehensive, for a complex diagnostic problem, with review of patient's history and medical records5ea$ - 0
B.1.4082003Assay of acetaminophen10ea$ - 0
B.1.4182009Test for acetone/ketones5ea$ - 0
B.1.4282010Acetone assay5ea$ - 0
B.1.4382013Acetylcholinesterase assay5ea$ - 0
B.1.4482017Acylcarnitines, quant3ea$ - 0
B.1.4582040Assay of serum albumin5ea$ - 0
B.1.4682042Assay of urine albumin5ea$ - 0
B.1.4782043Microalbumin, quantitative, random100ea$ - 0
B.1.48Microalb/crea ratio; 82043, 82570850ea$ - 0
B.1.4982055Assay of ethanol20ea$ - 0
B.1.5082085Assay of aldolase15ea$ - 0
B.1.5182088Assay of aldosterone5ea$ - 0
B.1.5282105Alpha-fetoprotein, serum40ea$ - 0
B.1.5382106Alpha-fetoprotein, amniotic3ea$ - 0
B.1.5482127Amino acid, single qual3ea$ - 0
B.1.5582145Assay of amphetamines50ea$ - 0
B.1.5682150Assay of amylase2ea$ - 0
B.1.5782157Assay of androstenedione5ea$ - 0
B.1.5882160Assay of androsterone5ea$ - 0
B.1.5982163Assay of angiotensin II3ea$ - 0
B.1.6082164Angiotensin I enzyme test3ea$ - 0
B.1.6182172Assay of apolipoprotein3ea$ - 0
B.1.6282205Assay of barbiturates15ea$ - 0
B.1.6382340Assay of calcium in urine5ea$ - 0
B.1.6482355Calculus (stone) analysis5ea$ - 0
B.1.6582360Calculus (stone) assay5ea$ - 0
B.1.6682365Calculus (stone) assay5ea$ - 0
B.1.6782376Test for carbon monoxide5ea$ - 0
B.1.6882378Carcinoembryonic antigen100ea$ - 0
B.1.6982379Assay of carnitine10ea$ - 0
B.1.7082380Assay of carotene3ea$ - 0
B.1.7182382Assay, urine catecholamines10ea$ - 0
B.1.7282383Assay, blood catecholamines10ea$ - 0
B.1.7382480Assay, serum cholinesterase5ea$ - 0
B.1.7482520Assay of cocaine10ea$ - 0
B.1.7582530Cortisol, free10ea$ - 0
B.1.7682533Total cortisol50ea$ - 0
B.1.7782540Assay of creatine3ea$ - 0
B.1.7882565Assay of creatinine5ea$ - 0
B.1.7982570Assay of urine creatinine50ea$ - 0
B.1.8082575Creatinine clearance test50ea$ - 0
B.1.8182607Vitamin B-12150ea$ - 0
B.1.8282668Assay of erythropoietin10ea$ - 0
B.1.8382670Assay of estradiol20ea$ - 0
B.1.8482710Fats/lipids, feces, quant3ea$ - 0
B.1.8582715Assay of fecal fat3ea$ - 0
B.1.8682728Assay of ferritin400ea$ - 0
B.1.8782746Blood folic acid serum15ea$ - 0
B.1.8882747Assay of folic acid, rbc10ea$ - 0
B.1.8982787Igg 1, 2, 3 or 4, each sub classes35ea$ - 0
B.1.9082951Glucose tolerance test (GTT)5ea$ - 0
B.1.9182977Assay of GGT75ea$ - 0
B.1.9283001Gonadotropin (FSH)100ea$ - 0
B.1.9383002Gonadotropin (LH)125ea$ - 0
B.1.94LH/FSH; 83002,83001150ea$ - 0
B.1.9583003Assay, growth hormone (hgh)5ea$ - 0
B.1.9683010Assay of haptoglobin, quant5ea$ - 0
B.1.9783013H pylori analysis (Breath Test)5ea$ - 0
B.1.9886677H pylori AB800ea$ - 0
B.1.9987338H pylori AG, S50ea$ - 0
B.1.10083015Heavy metal screen15ea$ - 0
B.1.10183020Hemoglobin electrophoresis5ea$ - 0
B.1.10283036Glycated hemoglobin test; A1c1500ea$ - 0
B.1.10383090Assay of homocystine25ea$ - 0
B.1.10483491Assay of corticosteroids5ea$ - 0
B.1.10583497Assay of 5-hiaa5ea$ - 0
B.1.10683520Fetal lung maturity Surfactant5ea$ - 0
B.1.10783525Assay of insulin; total165ea$ - 0
B.1.10883527Assay of insulin; free5ea$ - 0
B.1.10983528Assay of intrinsic factor5ea$ - 0
B.1.11083540Assay of iron75ea$ - 0
B.1.111Iron binding test; 83540,83550500ea$ - 0
B.1.11283586Assay 17- ketosteroids25ea$ - 0
B.1.11383605Assay of lactic acid5ea$ - 0
B.1.11483655Assay of lead25ea$ - 0
B.1.115L/s ratio, PG fetal lung profile (83667, 84081)5ea$ - 0
B.1.11683715Assay of blood lipoproteins; electrophoretic25ea$ - 0
B.1.11783721Assay of blood lipoprotein;direct LDL100ea$ - 0
B.1.11883735Assay of magnesium125ea$ - 0
B.1.11983835Assay of metanephrines5ea$ - 0
B.1.12083840Assay of methadone45ea$ - 0
B.1.12183872Assay synovial fluid mucin5ea$ - 0
B.1.12283873Assay of csf protein3ea$ - 0
B.1.12383874Assay of myoglobin5ea$ - 0
B.1.12483918Organic acids, total, quant15ea$ - 0
B.1.12583919Organic acids, qual, each5ea$ - 0
B.1.12683921Organic acid, single, quant5ea$ - 0
B.1.12780102Assay of opiates400ea$ - 0
B.1.12883930Assay of blood osmolality10ea$ - 0
B.1.12983935Assay of urine osmolality10ea$ - 0
B.1.13083970Assay of parathyroid hormone25ea$ - 0
B.1.131PTH C-terminal; 83970, 8231010ea$ - 0
B.1.132PTH Intact whole molecule;83970,82310200ea$ - 0
B.1.13383992Assay for phencyclidine5ea$ - 0
B.1.13484066Assay prostate phosphatase5ea$ - 0
B.1.13584075Assay alkaline phosphatase10ea$ - 0
B.1.136Alk phos is0, heat stable;84075, 8407850ea$ - 0
B.1.13784081Amniotic fluid enzyme test, PG3ea$ - 0
B.1.13884100Assay of phosphorus100ea$ - 0
B.1.13984105Assay of urine phosphorus3ea$ - 0
B.1.14084110Assay of porphobilinogen20ea$ - 0
B.1.14184120Assay of urine porphyrins10ea$ - 0
B.1.14284126Assay of feces porphyrins5ea$ - 0
B.1.14384132Assay of serum potassium5ea$ - 0
B.1.14484133Assay of urine potassium5ea$ - 0
B.1.14584134Assay of prealbumin45ea$ - 0
B.1.14684144Assay of progesterone20ea$ - 0
B.1.14784146Assay of prolactin200ea$ - 0
B.1.148Psa battery, PSA(84153), Free PSA(84154) %100ea$ - 0
B.1.14984153Assay of psa, total800ea$ - 0
B.1.15084154Assay of psa, free100ea$ - 0
B.1.15184155Assay of protein10ea$ - 0
B.1.152Serum electrophoresis: (84165, 84155)100ea$ - 0
B.1.153Urine electrophoesis (84165, 84155)50ea$ - 0
B.1.15484202Assay RBC protoporphyrin10ea$ - 0
B.1.15582671Assay of estrogen25ea$ - 0
B.1.15684244Assay of renin10ea$ - 0
B.1.15784300Assay of urine sodium10ea$ - 0
B.1.15884402Assay of testosterone35ea$ - 0
B.1.15984403Assay of total testosterone25ea$ - 0
B.1.16084430Assay of thiocyanate3ea$ - 0
B.1.16186800Assay of thyroglobulin15ea$ - 0
B.1.16284436Assay of total thyroxine150ea$ - 0
B.1.16384439Assay of free thyroxine500ea$ - 0
B.1.16484443Assay thyroid stim hormone2300ea$ - 0
B.1.16584445Assay of tsi15ea$ - 0
B.1.16684450Transferase (AST) (SGOT)25ea$ - 0
B.1.16784460Alanine amino (ALT) (SGPT)25ea$ - 0
B.1.16884466Assay of transferrin25ea$ - 0
B.1.16984478Assay of triglycerides25ea$ - 0
B.1.17084481Free assay (FT-3)40ea$ - 0
B.1.17184484Assay of troponin, quant2ea$ - 0
B.1.17284520Assay of urea nitrogen2ea$ - 0
B.1.17384550Assay of blood/uric acid75ea$ - 0
B.1.17484585Assay of urine vma10ea$ - 0
B.1.17584681Assay of c-peptide25ea$ - 0
B.1.17684702Chorionic gonadotropin test; quant5ea$ - 0
B.1.17785025Automated hemogram10ea$ - 0
B.1.17885027Automated hemogram10ea$ - 0
B.1.17985210Blood clot factor II test3ea$ - 0
B.1.18085220Blood clot factor V test3ea$ - 0
B.1.18185230Blood clot factor VII test3ea$ - 0
B.1.18285240Blood clot factor VIII test3ea$ - 0
B.1.18385250Blood clot factor IX test3ea$ - 0
B.1.18485260Blood clot factor X test3ea$ - 0
B.1.18585270Blood clot factor XI test3ea$ - 0
B.1.18685280Blood clot factor XII test3ea$ - 0
B.1.18785290Blood clot factor XIII test3ea$ - 0
B.1.18885301Antithrombin III test10ea$ - 0
B.1.189Protein C + S activity; 85303,8530615ea$ - 0
B.1.19085303Blood clot inhibitor test; protein C activity10ea$ - 0
B.1.19185305Blood clot inhibitor assay; protein S total10ea$ - 0
B.1.19285306Blood clot inhibitor test; protein S free10ea$ - 0
B.1.19385384Fibrinogen test5ea$ - 0
B.1.19485379D-Dimer10ea$ - 0
B.1.19585460Hemoglobin, fetal ; Kleihauer3ea$ - 0
B.1.19685651Rbc sed rate, nonautomated3ea$ - 0
B.1.19785670Thrombin time, plasma3ea$ - 0
B.1.19885730Thromboplastin time, partial5ea$ - 0
B.1.19986000Agglutinins, febrile15ea$ - 0
B.1.20086001Allergen specific igg100ea$ - 0
B.1.20186003Allergen specific IgE, Multi-Allergen100ea$ - 0
B.1.20286005Allergen specific IgE100ea$ - 0
B.1.20386022Platelet antibodies15ea$ - 0
B.1.20486038Antinuclear antibodies900ea$ - 0
B.1.20586060Antistreptolysin o, titer3ea$ - 0
B.1.20686140C-reactive protein300ea$ - 0
B.1.20786157Cold agglutinin, screen5ea$ - 0
B.1.20886160Complement, antigen C330ea$ - 0
B.1.20986160Complement, antigen C426ea$ - 0
B.1.21086162Complement, total (CH50)20ea$ - 0
B.1.21186225DNA antibody3ea$ - 0
B.1.21286235Sjorgen's Syndrome (SS-A) Antibody3ea$ - 0
B.1.21386235Sjorgen's Syndrome (SS-A, SS-B) Antibody3ea$ - 0
B.1.21486235Sjorgen's Syndrome (SS-B) Antibody3ea$ - 0
B.1.21586235Smith Antibody (Anti-Sm)3ea$ - 0
B.1.21686235Nuclear antigen antibody3ea$ - 0
B.1.21786255Smooth Muscle Antibody Screen3ea$ - 0
B.1.21886277Growth hormone antibody5ea$ - 0
B.1.21986300Immunoassay, tumor ca 15-35ea$ - 0
B.1.22086301Immunoassay, tumor, ca 19-925ea$ - 0
B.1.22186304Immunoassay, tumor ca 12575ea$ - 0
B.1.22283525Insulin assay200ea$ - 0
B.1.22386337Insulin antibodies3ea$ - 0
B.1.22486340Intrinsic factor antibody3ea$ - 0
B.1.22586359T cells, total count30ea$ - 0
B.1.22686360T cell, absolute count/ratio30ea$ - 0
B.1.22786361T cell, absolute count; CD4 count30ea$ - 0
B.1.22886431Rheumatoid factor test900ea$ - 0
B.1.22986431Rheumatoid factor, quant25ea$ - 0
B.1.23086592Blood serology, qualitative; VDRL, RPR900ea$ - 0
B.1.23186617Lyme disease antibody; Western blot15ea$ - 0
B.1.23286618Lyme disease antibody15ea$ - 0
B.1.23386644CMV antibody15ea$ - 0
B.1.23486645CMV antibody, IgM15ea$ - 0
B.1.23586665EBV to viral capsid antigen15ea$ - 0
B.1.23687798EBV by PCR10ea$ - 0
B.1.23786665EBV, IGG + IGM10ea$ - 0
B.1.23886668Francisella tularensis15ea$ - 0
B.1.23986692Hepatitis, delta agent25ea$ - 0
B.1.24086694Herpes simplex test5ea$ - 0
B.1.24186695Herpes simplex test; type 15ea$ - 0
B.1.24286696Herpes simplex type 2; type 25ea$ - 0
B.1.24386704Hep b core antibody, total75ea$ - 0
B.1.24487340Hep B surface AG115ea$ - 0
B.1.24586705Hep b core antibody, igm75ea$ - 0
B.1.24686706Hep b surface antibody100ea$ - 0
B.1.24786707Hep be antibody15ea$ - 0
B.1.24886708Hep a antibody, total25ea$ - 0
B.1.24986709Hep a antibody, igm25ea$ - 0
B.1.25087902HCV Genotype by PCR75ea$ - 0
B.1.25187522HCV RNA BDNA15ea$ - 0
B.1.25286710Influenza virus antibody3ea$ - 0
B.1.25386762Rubella antibody145ea$ - 0
B.1.25486765Rubeola antibody25ea$ - 0
B.1.25586800Thyroglobulin antibody10ea$ - 0
B.1.25686803Hepatitis c ab test331ea$ - 0
B.1.25786804Hep c ab test, confirm25ea$ - 0
B.1.25886880Coombs test; direct3ea$ - 0
B.1.25986885Coombs test; indirect3ea$ - 0
B.1.26086886Coombs test; indirect titer3ea$ - 0
B.1.26186900Blood typing, ABO150ea$ - 0
B.1.26286901Blood typing, Rh D150ea$ - 0
B.1.26386903Blood typing, antigen screen10ea$ - 0
B.1.26486904Blood typing, patient serum10ea$ - 0
B.1.26586905Blood typing, RBC antigens10ea$ - 0
B.1.26686906Blood typing, Rh phenotype5ea$ - 0
B.1.26787077Culture aerobic identify50ea$ - 0
B.1.26887101Skin fungi culture5ea$ - 0
B.1.26987102Fungus isolation culture5ea$ - 0
B.1.27087109Mycoplasma5ea$ - 0
B.1.27187110Chlamydia culture10ea$ - 0
B.1.27287177Ova and parasites smears5ea$ - 0
B.1.27387252Viral culture5ea$ - 0
B.1.27487265Pertussis ag, if5ea$ - 0
B.1.27587275Influenza b, ag, if3ea$ - 0
B.1.27687280Respiratory syncytial ag, if3ea$ - 0
B.1.27787335E coli 0157 ag, eia3ea$ - 0
B.1.27887340Hepatitis b surface ag, eia3ea$ - 0
B.1.27987350Hepatitis be ag, eia3ea$ - 0
B.1.28087380Hepatitis delta ag, eia3ea$ - 0
B.1.28187420Resp syncytial ag, eia3ea$ - 0
B.1.28287491Chlamydia/GC-Urine, dna, LCR5ea$ - 0
B.1.283Chlamydia/GC by aptima;87491,87591520ea$ - 0
B.1.28486645CMV AB , IGM5ea$ - 0
B.1.28586644CMV AB, IGG5ea$ - 0
B.1.28687496CMV by PCR5ea$ - 0
B.1.28787516Hepatitis b , dna, amp probe3ea$ - 0
B.1.28887517Hepatitis b , dna, quant3ea$ - 0
B.1.28986804Hep C by RIBA24ea$ - 0
B.1.290Chromosome analysis amniotic fluid: (88280, 88269, 88291, 88235)5ea$ - 0
B.1.291Chromosome analysis products of conception; (88262. 88291, 88233)5ea$ - 0
B.1.292Chromosome analysis for congenital disorders; (88262,88291,88230)5ea$ - 0
B.1.293Cytopathology smears; conventional method, non-cervical/ vaginal25ea$ - 0
B.1.294Cytopathology liquid/thin prep method, non cervical/vaginal25ea$ - 0
B.1.29587621HPV DNA Probe high and low risk200ea$ - 0
B.1.296Cytopathology smears; conventional method, cervical or vaginal100ea$ - 0
B.1.297Cytopathology liquid/thin prep method, cervical or vaginal5000ea$ - 0
B.1.29888300Level I - Surgical pathology, gross examination only50ea$ - 0
B.1.29988302Level II - Surgical pathology, gross and microscopic examination, Appendix Incidental, Fallopian tube-sterilization, Finger/Toes-amutation traumatic, Foreskin-newborn, Hernia sac-any location, Hydorcele sac, Nerve, Skin-plastic repair, Sympathetic ganglion, Testis-castration75ea$ - 0
B.1.30088304Level III; Abortion-induced, Abscess, Anus-Tag, Appendix-other than incidental, Bartholin's Gland Cyst, Bone Fragments, Bursa/Sunovial Cyst, Carpal Tunnel Tissue, Cartilage-shavings, Conjunctiva-bipsy/pterygium, Cornea, Fissure/Fistula, Foreskin other than newborn, Gallbladder, Ganglion Cyst, Hematoma, Hemrrhoids, Joint-loose body, Meniscus, Mucocele-salivary, Neuroma-Morton's/Traumatic, Pilondial Cyst/Sinus, Polyps-inflamatory-Nasal/Sinusodal, Skin-Cyst/Tag/Debridement, Soft tissue debridement, Soft tissue-lipoma, Speramtocele, Tendon/Tendon sheath, Thrombus or Embolus, Tonsil and/or Adenoids, Vaicocel, Vas Defferns-other than sterilization, Vien-varicosity100ea$ - 0
B.1.30188305Level IV; Abortion-Spontaneous/Missed, Bone Marrow-biopsy, Breast-biopsy not requiring microscopic evaluation of surgical margins, Cervix-biopsy, Colon-biopsy, Endocervix-Currettins/biopsy, Endometrium-Curettings/biopsy, Extremity-amputation-traumatic, Fallopian Tube-biopsy, Fallopian tube-ectopic pregnancy, Joint-resection, Lympn node biopsy, Masal mucosa biopsy, Nasopharynx/Oropharynx biopsy, Odontogenic/dental cyst, Ovary wtih or without tube-non-neoplastic, Pacenta-other than 3rd trimester, Polyp-Cervical/Endometrial, Polyp colorectal, Prostrate-needle biopsy, Skin other than cyst/tag/debridement/plastic repair, Tongue biopsy, Tonsil biopsy, Uterus, with or without tubes and ovaries for prolapse, Vagina biopsy1500ea$ - 0
B.1.30288307Level V; Surgical pathology, gross and microscopic examination, Breast excisoin of lision requiring microscopic evaluation of surgical margins, cervix conization, Extremity aputation-non traumatic, Ovary with or without tube-neoplasic, Placenta 3rd trimester, Sentinel lymph node, Soft tissue mass biopsy/simple excision, Uterus with or without tubes and ovariaes other than neoplastic/prolapse125ea$ - 0
B.1.30388309Level VI; Surgical pathology, gross and microscopic examination, Uterus with or without tubes and ovaries-neoplastic20ea$ - 0
B.1.30489060Exam,synovial fluid crystals5ea$ - 0
B.1.30589125Specimen fat stain5ea$ - 0
B.1.30689190Nasal smear for eosinophils10ea$ - 0
B.1.307Prenatal Risk; (82105),(84702), (82577)400ea$ - 0
B.1.308Prenat Risk;(82105),(84702),(82677),(86336)150ea$ - 0
Total32,374$ - 0
Discount rate
Discount rate of client fee schedule for Billings Area Indian Health Service; please attach current fee schedule and enter discount rate in box to right

Base Year Billings Area Lab RFP 2017

&P

YR_1_OPT

ITEM NOHCPCDescriptionEST. QTYUnitUnit Bid PriceTotal Amount
B.2.180048Basic metabolic panel; Calcium, CO2, Chloride,Creatinine, Glucose, Potassium, Urea Nitrogren,11ea$ - 0
B.2.280050General Health Panel includes; Comprehensive metabolic panel (80053), Hemogram, platelet count, auto diff (85025), TSH (84443).53ea$ - 0
B.2.380051Electrolyte panel; Na, K, Cl, CO26ea$ - 0
B.2.480053Comprehen metabolic panel; Albumin, T-Bili, Calcium, CO2, Chloride, Glucose, Alkaline Phospatase, Potassium, T-Protein, ALT, AST, BUN,53ea$ - 0
B.2.580061Lipid panel; Cholesterol (82465), HDL (83718), Triglyceride (84478)2100ea$ - 0
B.2.680069Renal function panel; Albumin (82040), Calcium (82310), CO2 (82374), Chloride (82435), Creatinine (82565), Glucose (82947), Phosphate (84100), Potassium (84132), Sodium (84295), Bun (84520)26ea$ - 0
B.2.7Arthritis panel; ANA (86038), Rheumatoid factor (86431), Uric Acid (84550)395ea$ - 0
B.2.880074Acute hepatitis panel; Hepatitis A antibody IgM (86709), Hepatitis B core anitbody IgM (86705), Hepatitis B surface antigen (87340), Hepatitis C antibody (86803)950ea$ - 0
B.2.980076Hepatic function panel; Albumin (82040), T-bil (82247), direct Bili (82248), Alkaline Phosphatase (84075), T-protein (84155), ALT (84460), AST (84450)11ea$ - 0
B.2.1080090Torch antibody panel; Antibody CMV (86644), Antibody herpes simplex (86694), Antibody rubella (86762), Antibody toxoplasma (86777)6ea$ - 0
B.2.1180100Drug screen; Amphetamines, Barbiturate, Benzodiazepines, Cocaine + metabolites, Marijuana (THC), Methadone, Methaqualone, Opiate, Phencyclidine (PCP), Propoxyphene1740ea$ - 0
B.2.1280100Drug Screen meconium80ea$ - 0
B.2.1380101Drug screen, single370ea$ - 0
B.2.1480102Drug confirmation (HPLC)105ea$ - 0
B.2.1580152Assay of amitriptyline6ea$ - 0
B.2.1680154Assay of benzodiazepines; confirm GC/MS6ea$ - 0
B.2.1780156Assay, carbamazepine, total80ea$ - 0
B.2.1880157Assay, carbamazepine, free6ea$ - 0
B.2.1980158Assay of cyclosporine71ea$ - 0
B.2.2080197FK 506315ea$ - 0
B.2.2180160Assay of desipramine11ea$ - 0
B.2.2280162Assay of digoxin53ea$ - 0
B.2.2380164Assay, dipropylacetic acid4ea$ - 0
B.2.2480166Assay of doxepin4ea$ - 0
B.2.2580168Assay of ethosuximide4ea$ - 0
B.2.2680170Assay of gentamicin6ea$ - 0
B.2.2780174Assay of imipramine6ea$ - 0
B.2.2880178Assay of lithium53ea$ - 0
B.2.2980182Assay of nortriptyline6ea$ - 0
B.2.3080184Assay of phenobarbital37ea$ - 0
B.2.3180185Assay of phenytoin, total105ea$ - 0
B.2.3280186Assay of phenytoin, free3ea$ - 0
B.2.3380196Assay of salicylate6ea$ - 0
B.2.3480198Assay of theophylline53ea$ - 0
B.2.3580202Assay of vancomycin80ea$ - 0
B.2.3680299Quantitative assay, drug11ea$ - 0
B.2.3780400Acth stimulation panel11ea$ - 0
B.2.3880500Clinical pathology consultation; limited, without review of patient's history and medical records11ea$ - 0
B.2.3980502Clinical pathology consultation; comprehensive, for a complex diagnostic problem, with review of patient's history and medical records6ea$ - 0
B.2.4082003Assay of acetaminophen11ea$ - 0
B.2.4182009Test for acetone/ketones6ea$ - 0
B.2.4282010Acetone assay6ea$ - 0
B.2.4382013Acetylcholinesterase assay6ea$ - 0
B.2.4482017Acylcarnitines, quant4ea$ - 0
B.2.4582040Assay of serum albumin6ea$ - 0
B.2.4682042Assay of urine albumin6ea$ - 0
B.2.4782043Microalbumin, quantitative, random105ea$ - 0
B.2.48Microalb/crea ratio; 82043, 82570895ea$ - 0
B.2.4982055Assay of ethanol21ea$ - 0
B.2.5082085Assay of aldolase16ea$ - 0
B.2.5182088Assay of aldosterone6ea$ - 0
B.2.5282105Alpha-fetoprotein, serum42ea$ - 0
B.2.5382106Alpha-fetoprotein, amniotic4ea$ - 0
B.2.5482127Amino acid, single qual4ea$ - 0
B.2.5582145Assay of amphetamines53ea$ - 0
B.2.5682150Assay of amylase3ea$ - 0
B.2.5782157Assay of androstenedione6ea$ - 0
B.2.5882160Assay of androsterone6ea$ - 0
B.2.5982163Assay of angiotensin II4ea$ - 0
B.2.6082164Angiotensin I enzyme test4ea$ - 0
B.2.6182172Assay of apolipoprotein4ea$ - 0
B.2.6282205Assay of barbiturates16ea$ - 0
B.2.6382340Assay of calcium in urine6ea$ - 0
B.2.6482355Calculus (stone) analysis6ea$ - 0
B.2.6582360Calculus (stone) assay6ea$ - 0
B.2.6682365Calculus (stone) assay6ea$ - 0
B.2.6782376Test for carbon monoxide6ea$ - 0
B.2.6882378Carcinoembryonic antigen105ea$ - 0
B.2.6982379Assay of carnitine11ea$ - 0
B.2.7082380Assay of carotene4ea$ - 0
B.2.7182382Assay, urine catecholamines11ea$ - 0
B.2.7282383Assay, blood catecholamines11ea$ - 0
B.2.7382480Assay, serum cholinesterase6ea$ - 0
B.2.7482520Assay of cocaine11ea$ - 0
B.2.7582530Cortisol, free11ea$ - 0
B.2.7682533Total cortisol53ea$ - 0
B.2.7782540Assay of creatine4ea$ - 0
B.2.7882565Assay of creatinine6ea$ - 0
B.2.7982570Assay of urine creatinine53ea$ - 0
B.2.8082575Creatinine clearance test53ea$ - 0
B.2.8182607Vitamin B-12158ea$ - 0
B.2.8282668Assay of erythropoietin11ea$ - 0
B.2.8382670Assay of estradiol21ea$ - 0
B.2.8482710Fats/lipids, feces, quant4ea$ - 0
B.2.8582715Assay of fecal fat4ea$ - 0
B.2.8682728Assay of ferritin420ea$ - 0
B.2.8782746Blood folic acid serum16ea$ - 0
B.2.8882747Assay of folic acid, rbc11ea$ - 0
B.2.8982787Igg 1, 2, 3 or 4, each sub classes37ea$ - 0
B.2.9082951Glucose tolerance test (GTT)6ea$ - 0
B.2.9182977Assay of GGT80ea$ - 0
B.2.9283001Gonadotropin (FSH)105ea$ - 0
B.2.9383002Gonadotropin (LH)131ea$ - 0
B.2.94LH/FSH; 83002,83001158ea$ - 0
B.2.9583003Assay, growth hormone (hgh)6ea$ - 0
B.2.9683010Assay of haptoglobin, quant6ea$ - 0
B.2.9783013H pylori analysis (Breath Test)6ea$ - 0
B.2.9886677H pylori AB840ea$ - 0
B.2.9987338H pylori AG, S53ea$ - 0
B.2.10083015Heavy metal screen16ea$ - 0
B.2.10183020Hemoglobin electrophoresis6ea$ - 0
B.2.10283036Glycated hemoglobin test; A1c1575ea$ - 0
B.2.10383090Assay of homocystine27ea$ - 0
B.2.10483491Assay of corticosteroids6ea$ - 0
B.2.10583497Assay of 5-hiaa6ea$ - 0
B.2.10683520Fetal lung maturity Surfactant6ea$ - 0
B.2.10783525Assay of insulin; total173ea$ - 0
B.2.10883527Assay of insulin; free6ea$ - 0
B.2.10983528Assay of intrinsic factor6ea$ - 0
B.2.11083540Assay of iron79ea$ - 0
B.2.111Iron binding test; 83540,83550525ea$ - 0
B.2.11283586Assay 17- ketosteroids27ea$ - 0
B.2.11383605Assay of lactic acid6ea$ - 0
B.2.11483655Assay of lead27ea$ - 0
B.2.115L/s ratio, PG fetal lung profile (83667, 84081)6ea$ - 0
B.2.11683715Assay of blood lipoproteins; electrophoretic27ea$ - 0
B.2.11783721Assay of blood lipoprotein;direct LDL105ea$ - 0
B.2.11883735Assay of magnesium131ea$ - 0
B.2.11983835Assay of metanephrines6ea$ - 0
B.2.12083840Assay of methadone47ea$ - 0
B.2.12183872Assay synovial fluid mucin6ea$ - 0
B.2.12283873Assay of csf protein4ea$ - 0
B.2.12383874Assay of myoglobin6ea$ - 0
B.2.12483918Organic acids, total, quant16ea$ - 0
B.2.12583919Organic acids, qual, each6ea$ - 0
B.2.12683921Organic acid, single, quant6ea$ - 0
B.2.12780102Assay of opiates420ea$ - 0
B.2.12883930Assay of blood osmolality11ea$ - 0
B.2.12983935Assay of urine osmolality11ea$ - 0
B.2.13083970Assay of parathyroid hormone27ea$ - 0
B.2.131PTH C-terminal; 83970, 8231011ea$ - 0
B.2.132PTH Intact whole molecule;83970,82310210ea$ - 0
B.2.13383992Assay for phencyclidine6ea$ - 0
B.2.13484066Assay prostate phosphatase6ea$ - 0
B.2.13584075Assay alkaline phosphatase11ea$ - 0
B.2.136Alk phos is0, heat stable;84075, 8407853ea$ - 0
B.2.13784081Amniotic fluid enzyme test, PG4ea$ - 0
B.2.13884100Assay of phosphorus105ea$ - 0
B.2.13984105Assay of urine phosphorus4ea$ - 0
B.2.14084110Assay of porphobilinogen21ea$ - 0
B.2.14184120Assay of urine porphyrins11ea$ - 0
B.2.14284126Assay of feces porphyrins6ea$ - 0
B.2.14384132Assay of serum potassium6ea$ - 0
B.2.14484133Assay of urine potassium6ea$ - 0
B.2.14584134Assay of prealbumin47ea$ - 0
B.2.14684144Assay of progesterone21ea$ - 0
B.2.14784146Assay of prolactin210ea$ - 0
B.2.148Psa battery, PSA(84153), Free PSA(84154) %105ea$ - 0
B.2.14984153Assay of psa, total840ea$ - 0
B.2.15084154Assay of psa, free105ea$ - 0
B.2.15184155Assay of protein11ea$ - 0
B.2.152Serum electrophoresis: (84165, 84155)105ea$ - 0
B.2.153Urine electrophoesis (84165, 84155)53ea$ - 0
B.2.15484202Assay RBC protoporphyrin11ea$ - 0
B.2.15582671Assay of estrogen27ea$ - 0
B.2.15684244Assay of renin11ea$ - 0
B.2.15784300Assay of urine sodium11ea$ - 0
B.2.15884402Assay of testosterone37ea$ - 0
B.2.15984403Assay of total testosterone27ea$ - 0
B.2.16084430Assay of thiocyanate4ea$ - 0
B.2.16186800Assay of thyroglobulin16ea$ - 0
B.2.16284436Assay of total thyroxine158ea$ - 0
B.2.16384439Assay of free thyroxine525ea$ - 0
B.2.16484443Assay thyroid stim hormone2415ea$ - 0
B.2.16584445Assay of tsi16ea$ - 0
B.2.16684450Transferase (AST) (SGOT)27ea$ - 0
B.2.16784460Alanine amino (ALT) (SGPT)27ea$ - 0
B.2.16884466Assay of transferrin27ea$ - 0
B.2.16984478Assay of triglycerides27ea$ - 0
B.2.17084481Free assay (FT-3)42ea$ - 0
B.2.17184484Assay of troponin, quant3ea$ - 0
B.2.17284520Assay of urea nitrogen3ea$ - 0
B.2.17384550Assay of blood/uric acid79ea$ - 0
B.2.17484585Assay of urine vma11ea$ - 0
B.2.17584681Assay of c-peptide27ea$ - 0
B.2.17684702Chorionic gonadotropin test; quant6ea$ - 0
B.2.17785025Automated hemogram11ea$ - 0
B.2.17885027Automated hemogram11ea$ - 0
B.2.17985210Blood clot factor II test4ea$ - 0
B.2.18085220Blood clot factor V test4ea$ - 0
B.2.18185230Blood clot factor VII test4ea$ - 0
B.2.18285240Blood clot factor VIII test4ea$ - 0
B.2.18385250Blood clot factor IX test4ea$ - 0
B.2.18485260Blood clot factor X test4ea$ - 0
B.2.18585270Blood clot factor XI test4ea$ - 0
B.2.18685280Blood clot factor XII test4ea$ - 0
B.2.18785290Blood clot factor XIII test4ea$ - 0
B.2.18885301Antithrombin III test11ea$ - 0
B.2.189Protein C + S activity; 85303,8530616ea$ - 0
B.2.19085303Blood clot inhibitor test; protein C activity11ea$ - 0
B.2.19185305Blood clot inhibitor assay; protein S total11ea$ - 0
B.2.19285306Blood clot inhibitor test; protein S free11ea$ - 0
B.2.19385384Fibrinogen test6ea$ - 0
B.2.19485379D-Dimer11ea$ - 0
B.2.19585460Hemoglobin, fetal ; Kleihauer4ea$ - 0
B.2.19685651Rbc sed rate, nonautomated4ea$ - 0
B.2.19785670Thrombin time, plasma4ea$ - 0
B.2.19885730Thromboplastin time, partial6ea$ - 0
B.2.19986000Agglutinins, febrile16ea$ - 0
B.2.20086001Allergen specific igg105ea$ - 0
B.2.20186003Allergen specific IgE, Multi-Allergen105ea$ - 0
B.2.20286005Allergen specific IgE105ea$ - 0
B.2.20386022Platelet antibodies16ea$ - 0
B.2.20486038Antinuclear antibodies945ea$ - 0
B.2.20586060Antistreptolysin o, titer4ea$ - 0
B.2.20686140C-reactive protein315ea$ - 0
B.2.20786157Cold agglutinin, screen6ea$ - 0
B.2.20886160Complement, antigen C332ea$ - 0
B.2.20986160Complement, antigen C427ea$ - 0
B.2.21086162Complement, total (CH50)21ea$ - 0
B.2.21186225DNA antibody4ea$ - 0
B.2.21286235Sjorgen's Syndrome (SS-A) Antibody4ea$ - 0
B.2.21386235Sjorgen's Syndrome (SS-A, SS-B) Antibody4ea$ - 0
B.2.21486235Sjorgen's Syndrome (SS-B) Antibody4ea$ - 0
B.2.21586235Smith Antibody (Anti-Sm)4ea$ - 0
B.2.21686235Nuclear antigen antibody4ea$ - 0
B.2.21786255Smooth Muscle Antibody Screen4ea$ - 0
B.2.21886277Growth hormone antibody6ea$ - 0
B.2.21986300Immunoassay, tumor ca 15-36ea$ - 0
B.2.22086301Immunoassay, tumor, ca 19-926ea$ - 0
B.2.22186304Immunoassay, tumor ca 12580ea$ - 0
B.2.22283525Insulin assay210ea$ - 0
B.2.22386337Insulin antibodies4ea$ - 0
B.2.22486340Intrinsic factor antibody4ea$ - 0
B.2.22586359T cells, total count32ea$ - 0
B.2.22686360T cell, absolute count/ratio32ea$ - 0
B.2.22786361T cell, absolute count; CD4 count32ea$ - 0
B.2.22886431Rheumatoid factor test945ea$ - 0
B.2.22986431Rheumatoid factor, quant27ea$ - 0
B.2.23086592Blood serology, qualitative; VDRL, RPR945ea$ - 0
B.2.23186617Lyme disease antibody; Western blot16ea$ - 0
B.2.23286618Lyme disease antibody16ea$ - 0
B.2.23386644CMV antibody16ea$ - 0
B.2.23486645CMV antibody, IgM16ea$ - 0
B.2.23586665EBV to viral capsid antigen16ea$ - 0
B.2.23687798EBV by PCR11ea$ - 0
B.2.23786665EBV, IGG + IGM11ea$ - 0
B.2.23886668Francisella tularensis16ea$ - 0
B.2.23986692Hepatitis, delta agent27ea$ - 0
B.2.24086694Herpes simplex test6ea$ - 0
B.2.24186695Herpes simplex test; type 16ea$ - 0
B.2.24286696Herpes simplex type 2; type 26ea$ - 0
B.2.24386704Hep b core antibody, total80ea$ - 0
B.2.24487340Hep B surface AG125ea$ - 0
B.2.24586705Hep b core antibody, igm80ea$ - 0
B.2.24686706Hep b surface antibody105ea$ - 0
B.2.24786707Hep be antibody16ea$ - 0
B.2.24886708Hep a antibody, total27ea$ - 0
B.2.24986709Hep a antibody, igm27ea$ - 0
B.2.25087902HCV Genotype by PCR80ea$ - 0
B.2.25187522HCV RNA BDNA16ea$ - 0
B.2.25286710Influenza virus antibody4ea$ - 0
B.2.25386762Rubella antibody155ea$ - 0
B.2.25486765Rubeola antibody27ea$ - 0
B.2.25586800Thyroglobulin antibody11ea$ - 0
B.2.25686803Hepatitis c ab test350ea$ - 0
B.2.25786804Hep c ab test, confirm27ea$ - 0
B.2.25886880Coombs test; direct4ea$ - 0
B.2.25986885Coombs test; indirect4ea$ - 0
B.2.26086886Coombs test; indirect titer4ea$ - 0
B.2.26186900Blood typing, ABO160ea$ - 0
B.2.26286901Blood typing, Rh D160ea$ - 0
B.2.26386903Blood typing, antigen screen11ea$ - 0
B.2.26486904Blood typing, patient serum11ea$ - 0
B.2.26586905Blood typing, RBC antigens11ea$ - 0
B.2.26686906Blood typing, Rh phenotype6ea$ - 0
B.2.26787077Culture aerobic identify53ea$ - 0
B.2.26887101Skin fungi culture6ea$ - 0
B.2.26987102Fungus isolation culture6ea$ - 0
B.2.27087109Mycoplasma6ea$ - 0
B.2.27187110Chlamydia culture11ea$ - 0
B.2.27287177Ova and parasites smears6ea$ - 0
B.2.27387252Viral culture6ea$ - 0
B.2.27487265Pertussis ag, if6ea$ - 0
B.2.27587275Influenza b, ag, if4ea$ - 0
B.2.27687280Respiratory syncytial ag, if4ea$ - 0
B.2.27787335E coli 0157 ag, eia4ea$ - 0
B.2.27887340Hepatitis b surface ag, eia4ea$ - 0
B.2.27987350Hepatitis be ag, eia4ea$ - 0
B.2.28087380Hepatitis delta ag, eia4ea$ - 0
B.2.28187420Resp syncytial ag, eia4ea$ - 0
B.2.28287491Chlamydia/GC-Urine, dna, LCR6ea$ - 0
B.2.283Chlamydia/GC by aptima;87491,87591545ea$ - 0
B.2.28486645CMV AB , IGM6ea$ - 0
B.2.28586644CMV AB, IGG6ea$ - 0
B.2.28687496CMV by PCR6ea$ - 0
B.2.28787516Hepatitis b , dna, amp probe4ea$ - 0
B.2.28887517Hepatitis b , dna, quant4ea$ - 0
B.2.28986804Hep C by RIBA26ea$ - 0
B.2.290Chromosome analysis amniotic fluid: (88280, 88269, 88291, 88235)6ea$ - 0
B.2.291Chromosome analysis products of conception; (88262. 88291, 88233)6ea$ - 0
B.2.292Chromosome analysis for congenital disorders; (88262,88291,88230)6ea$ - 0
B.2.293Cytopathology smears; conventional method, non-cervical/ vaginal27ea$ - 0
B.2.294Cytopathology liquid/thin prep method, non cervical/vaginal27ea$ - 0
B.2.29587621HPV DNA Probe high and low risk210ea$ - 0
B.2.296Cytopathology smears; conventional method, cervical or vaginal105ea$ - 0
B.2.297Cytopathology liquid/thin prep method, cervical or vaginal5250ea$ - 0
B.2.29888300Level I - Surgical pathology, gross examination only60ea$ - 0
B.2.29988302Level II - Surgical pathology, gross and microscopic examination, Appendix Incidental, Fallopian tube-sterilization, Finger/Toes-amutation traumatic, Foreskin-newborn, Hernia sac-any location, Hydorcele sac, Nerve, Skin-plastic repair, Sympathetic ganglion, Testis-castration85ea$ - 0
B.2.30088304Level III; Abortion-induced, Abscess, Anus-Tag, Appendix-other than incidental, Bartholin's Gland Cyst, Bone Fragments, Bursa/Sunovial Cyst, Carpal Tunnel Tissue, Cartilage-shavings, Conjunctiva-bipsy/pterygium, Cornea, Fissure/Fistula, Foreskin other than newborn, Gallbladder, Ganglion Cyst, Hematoma, Hemrrhoids, Joint-loose body, Meniscus, Mucocele-salivary, Neuroma-Morton's/Traumatic, Pilondial Cyst/Sinus, Polyps-inflamatory-Nasal/Sinusodal, Skin-Cyst/Tag/Debridement, Soft tissue debridement, Soft tissue-lipoma, Speramtocele, Tendon/Tendon sheath, Thrombus or Embolus, Tonsil and/or Adenoids, Vaicocel, Vas Defferns-other than sterilization, Vien-varicosity110ea$ - 0
B.2.30188305Level IV; Abortion-Spontaneous/Missed, Bone Marrow-biopsy, Breast-biopsy not requiring microscopic evaluation of surgical margins, Cervix-biopsy, Colon-biopsy, Endocervix-Currettins/biopsy, Endometrium-Curettings/biopsy, Extremity-amputation-traumatic, Fallopian Tube-biopsy, Fallopian tube-ectopic pregnancy, Joint-resection, Lympn node biopsy, Masal mucosa biopsy, Nasopharynx/Oropharynx biopsy, Odontogenic/dental cyst, Ovary wtih or without tube-non-neoplastic, Pacenta-other than 3rd trimester, Polyp-Cervical/Endometrial, Polyp colorectal, Prostrate-needle biopsy, Skin other than cyst/tag/debridement/plastic repair, Tongue biopsy, Tonsil biopsy, Uterus, with or without tubes and ovaries for prolapse, Vagina biopsy1600ea$ - 0
B.2.30288307Level V; Surgical pathology, gross and microscopic examination, Breast excisoin of lision requiring microscopic evaluation of surgical margins, cervix conization, Extremity aputation-non traumatic, Ovary with or without tube-neoplasic, Placenta 3rd trimester, Sentinel lymph node, Soft tissue mass biopsy/simple excision, Uterus with or without tubes and ovariaes other than neoplastic/prolapse135ea$ - 0
B.2.30388309Level VI; Surgical pathology, gross and microscopic examination, Uterus with or without tubes and ovaries-neoplastic21ea$ - 0
B.2.30489060Exam,synovial fluid crystals6ea$ - 0
B.2.30589125Specimen fat stain6ea$ - 0
B.2.30689190Nasal smear for eosinophils11ea$ - 0
B.2.307Prenatal Risk; (82105),(84702), (82577)420ea$ - 0
B.2.308Prenat Risk;(82105),(84702),(82677),(86336)165ea$ - 0
Total34,234$ - 0
Discount rate
Discount rate of client fee schedule for Billings Area Indian Health Service; please attach current fee schedule and enter discount rate in box to right

Option Year One Billings Area Lab RFP-2017

&P

YR_2_OPT

ITEM NOHCPCDescriptionEST. QTYUnitUnit Bid PriceTotal Amount
B.3.180048Basic metabolic panel; Calcium, CO2, Chloride,Creatinine, Glucose, Potassium, Urea Nitrogren,12ea$ - 0
B.3.280050General Health Panel includes; Comprehensive metabolic panel (80053), Hemogram, platelet count, auto diff (85025), TSH (84443).56ea$ - 0
B.3.380051Electrolyte panel; Na, K, Cl, CO27ea$ - 0
B.3.480053Comprehen metabolic panel; Albumin, T-Bili, Calcium, CO2, Chloride, Glucose, Alkaline Phospatase, Potassium, T-Protein, ALT, AST, BUN,56ea$ - 0
B.3.580061Lipid panel; Cholesterol (82465), HDL (83718), Triglyceride (84478)2200ea$ - 0
B.3.680069Renal function panel; Albumin (82040), Calcium (82310), CO2 (82374), Chloride (82435), Creatinine (82565), Glucose (82947), Phosphate (84100), Potassium (84132), Sodium (84295), Bun (84520)27ea$ - 0
B.3.7Arthritis panel; ANA (86038), Rheumatoid factor (86431), Uric Acid (84550)415ea$ - 0
B.3.880074Acute hepatitis panel; Hepatitis A antibody IgM (86709), Hepatitis B core anitbody IgM (86705), Hepatitis B surface antigen (87340), Hepatitis C antibody (86803)1000ea$ - 0
B.3.980076Hepatic function panel; Albumin (82040), T-bil (82247), direct Bili (82248), Alkaline Phosphatase (84075), T-protein (84155), ALT (84460), AST (84450)12ea$ - 0
B.3.1080090Torch antibody panel; Antibody CMV (86644), Antibody herpes simplex (86694), Antibody rubella (86762), Antibody toxoplasma (86777)7ea$ - 0
B.3.1180100Drug screen; Amphetamines, Barbiturate, Benzodiazepines, Cocaine + metabolites, Marijuana (THC), Methadone, Methaqualone, Opiate, Phencyclidine (PCP), Propoxyphene1825ea$ - 0
B.3.1280100Drug Screen meconium85ea$ - 0
B.3.1380101Drug screen, single390ea$ - 0
B.3.1480102Drug confirmation (HPLC)110ea$ - 0
B.3.1580152Assay of amitriptyline7ea$ - 0
B.3.1680154Assay of benzodiazepines; confirm GC/MS7ea$ - 0
B.3.1780156Assay, carbamazepine, total85ea$ - 0
B.3.1880157Assay, carbamazepine, free7ea$ - 0
B.3.1980158Assay of cyclosporine74ea$ - 0
B.3.2080197FK 506330ea$ - 0
B.3.2180160Assay of desipramine12ea$ - 0
B.3.2280162Assay of digoxin56ea$ - 0
B.3.2380164Assay, dipropylacetic acid5ea$ - 0
B.3.2480166Assay of doxepin5ea$ - 0
B.3.2580168Assay of ethosuximide5ea$ - 0
B.3.2680170Assay of gentamicin7ea$ - 0
B.3.2780174Assay of imipramine7ea$ - 0
B.3.2880178Assay of lithium56ea$ - 0
B.3.2980182Assay of nortriptyline7ea$ - 0
B.3.3080184Assay of phenobarbital39ea$ - 0
B.3.3180185Assay of phenytoin, total110ea$ - 0
B.3.3280186Assay of phenytoin, free4ea$ - 0
B.3.3380196Assay of salicylate7ea$ - 0
B.3.3480198Assay of theophylline56ea$ - 0
B.3.3580202Assay of vancomycin85ea$ - 0
B.3.3680299Quantitative assay, drug12ea$ - 0
B.3.3780400Acth stimulation panel12ea$ - 0
B.3.3880500Clinical pathology consultation; limited, without review of patient's history and medical records12ea$ - 0
B.3.3980502Clinical pathology consultation; comprehensive, for a complex diagnostic problem, with review of patient's history and medical records7ea$ - 0
B.3.4082003Assay of acetaminophen12ea$ - 0
B.3.4182009Test for acetone/ketones7ea$ - 0
B.3.4282010Acetone assay7ea$ - 0
B.3.4382013Acetylcholinesterase assay7ea$ - 0
B.3.4482017Acylcarnitines, quant5ea$ - 0
B.3.4582040Assay of serum albumin7ea$ - 0
B.3.4682042Assay of urine albumin7ea$ - 0
B.3.4782043Microalbumin, quantitative, random110ea$ - 0
B.3.48Microalb/crea ratio; 82043, 82570940ea$ - 0
B.3.4982055Assay of ethanol22ea$ - 0
B.3.5082085Assay of aldolase17ea$ - 0
B.3.5182088Assay of aldosterone7ea$ - 0
B.3.5282105Alpha-fetoprotein, serum44ea$ - 0
B.3.5382106Alpha-fetoprotein, amniotic5ea$ - 0
B.3.5482127Amino acid, single qual5ea$ - 0
B.3.5582145Assay of amphetamines56ea$ - 0
B.3.5682150Assay of amylase4ea$ - 0
B.3.5782157Assay of androstenedione7ea$ - 0
B.3.5882160Assay of androsterone7ea$ - 0
B.3.5982163Assay of angiotensin II5ea$ - 0
B.3.6082164Angiotensin I enzyme test5ea$ - 0
B.3.6182172Assay of apolipoprotein5ea$ - 0
B.3.6282205Assay of barbiturates17ea$ - 0
B.3.6382340Assay of calcium in urine7ea$ - 0
B.3.6482355Calculus (stone) analysis7ea$ - 0
B.3.6582360Calculus (stone) assay7ea$ - 0
B.3.6682365Calculus (stone) assay7ea$ - 0
B.3.6782376Test for carbon monoxide7ea$ - 0
B.3.6882378Carcinoembryonic antigen110ea$ - 0
B.3.6982379Assay of carnitine12ea$ - 0
B.3.7082380Assay of carotene5ea$ - 0
B.3.7182382Assay, urine catecholamines12ea$ - 0
B.3.7282383Assay, blood catecholamines12ea$ - 0
B.3.7382480Assay, serum cholinesterase7ea$ - 0
B.3.7482520Assay of cocaine12ea$ - 0
B.3.7582530Cortisol, free12ea$ - 0
B.3.7682533Total cortisol56ea$ - 0
B.3.7782540Assay of creatine5ea$ - 0
B.3.7882565Assay of creatinine7ea$ - 0
B.3.7982570Assay of urine creatinine56ea$ - 0
B.3.8082575Creatinine clearance test56ea$ - 0
B.3.8182607Vitamin B-12164ea$ - 0
B.3.8282668Assay of erythropoietin12ea$ - 0
B.3.8382670Assay of estradiol22ea$ - 0
B.3.8482710Fats/lipids, feces, quant5ea$ - 0
B.3.8582715Assay of fecal fat5ea$ - 0
B.3.8682728Assay of ferritin440ea$ - 0
B.3.8782746Blood folic acid serum17ea$ - 0
B.3.8882747Assay of folic acid, rbc12ea$ - 0
B.3.8982787Igg 1, 2, 3 or 4, each sub classes39ea$ - 0
B.3.9082951Glucose tolerance test (GTT)7ea$ - 0
B.3.9182977Assay of GGT85ea$ - 0
B.3.9283001Gonadotropin (FSH)110ea$ - 0
B.3.9383002Gonadotropin (LH)137ea$ - 0
B.3.94LH/FSH; 83002,83001164ea$ - 0
B.3.9583003Assay, growth hormone (hgh)7ea$ - 0
B.3.9683010Assay of haptoglobin, quant7ea$ - 0
B.3.9783013H pylori analysis (Breath Test)7ea$ - 0
B.3.9886677H pylori AB880ea$ - 0
B.3.9987338H pylori AG, S56ea$ - 0
B.3.10083015Heavy metal screen17ea$ - 0
B.3.10183020Hemoglobin electrophoresis7ea$ - 0
B.3.10283036Glycated hemoglobin test; A1c1650ea$ - 0
B.3.10383090Assay of homocystine29ea$ - 0
B.3.10483491Assay of corticosteroids7ea$ - 0
B.3.10583497Assay of 5-hiaa7ea$ - 0
B.3.10683520Fetal lung maturity Surfactant7ea$ - 0
B.3.10783525Assay of insulin; total181ea$ - 0
B.3.10883527Assay of insulin; free7ea$ - 0
B.3.10983528Assay of intrinsic factor7ea$ - 0
B.3.11083540Assay of iron83ea$ - 0
B.3.111Iron binding test; 83540,83550550ea$ - 0
B.3.11283586Assay 17- ketosteroids29ea$ - 0
B.3.11383605Assay of lactic acid7ea$ - 0
B.3.11483655Assay of lead29ea$ - 0
B.3.115L/s ratio, PG fetal lung profile (83667, 84081)7ea$ - 0
B.3.11683715Assay of blood lipoproteins; electrophoretic29ea$ - 0
B.3.11783721Assay of blood lipoprotein;direct LDL110ea$ - 0
B.3.11883735Assay of magnesium137ea$ - 0
B.3.11983835Assay of metanephrines7ea$ - 0
B.3.12083840Assay of methadone49ea$ - 0
B.3.12183872Assay synovial fluid mucin7ea$ - 0
B.3.12283873Assay of csf protein5ea$ - 0
B.3.12383874Assay of myoglobin7ea$ - 0
B.3.12483918Organic acids, total, quant17ea$ - 0
B.3.12583919Organic acids, qual, each7ea$ - 0
B.3.12683921Organic acid, single, quant7ea$ - 0
B.3.12780102Assay of opiates440ea$ - 0
B.3.12883930Assay of blood osmolality12ea$ - 0
B.3.12983935Assay of urine osmolality12ea$ - 0
B.3.13083970Assay of parathyroid hormone29ea$ - 0
B.3.131PTH C-terminal; 83970, 8231012ea$ - 0
B.3.132PTH Intact whole molecule;83970,82310220ea$ - 0
B.3.13383992Assay for phencyclidine7ea$ - 0
B.3.13484066Assay prostate phosphatase7ea$ - 0
B.3.13584075Assay alkaline phosphatase12ea$ - 0
B.3.136Alk phos is0, heat stable;84075, 8407856ea$ - 0
B.3.13784081Amniotic fluid enzyme test, PG5ea$ - 0
B.3.13884100Assay of phosphorus110ea$ - 0
B.3.13984105Assay of urine phosphorus5ea$ - 0
B.3.14084110Assay of porphobilinogen22ea$ - 0
B.3.14184120Assay of urine porphyrins12ea$ - 0
B.3.14284126Assay of feces porphyrins7ea$ - 0
B.3.14384132Assay of serum potassium7ea$ - 0
B.3.14484133Assay of urine potassium7ea$ - 0
B.3.14584134Assay of prealbumin49ea$ - 0
B.3.14684144Assay of progesterone22ea$ - 0
B.3.14784146Assay of prolactin220ea$ - 0
B.3.148Psa battery, PSA(84153), Free PSA(84154) %110ea$ - 0
B.3.14984153Assay of psa, total880ea$ - 0
B.3.15084154Assay of psa, free110ea$ - 0
B.3.15184155Assay of protein12ea$ - 0
B.3.152Serum electrophoresis: (84165, 84155)110ea$ - 0
B.3.153Urine electrophoesis (84165, 84155)56ea$ - 0
B.3.15484202Assay RBC protoporphyrin12ea$ - 0
B.3.15582671Assay of estrogen29ea$ - 0
B.3.15684244Assay of renin12ea$ - 0
B.3.15784300Assay of urine sodium12ea$ - 0
B.3.15884402Assay of testosterone39ea$ - 0
B.3.15984403Assay of total testosterone29ea$ - 0
B.3.16084430Assay of thiocyanate5ea$ - 0
B.3.16186800Assay of thyroglobulin17ea$ - 0
B.3.16284436Assay of total thyroxine166ea$ - 0
B.3.16384439Assay of free thyroxine550ea$ - 0
B.3.16484443Assay thyroid stim hormone2530ea$ - 0
B.3.16584445Assay of tsi17ea$ - 0
B.3.16684450Transferase (AST) (SGOT)29ea$ - 0
B.3.16784460Alanine amino (ALT) (SGPT)29ea$ - 0
B.3.16884466Assay of transferrin29ea$ - 0
B.3.16984478Assay of triglycerides29ea$ - 0
B.3.17084481Free assay (FT-3)44ea$ - 0
B.3.17184484Assay of troponin, quant4ea$ - 0
B.3.17284520Assay of urea nitrogen4ea$ - 0
B.3.17384550Assay of blood/uric acid83ea$ - 0
B.3.17484585Assay of urine vma12ea$ - 0
B.3.17584681Assay of c-peptide29ea$ - 0
B.3.17684702Chorionic gonadotropin test; quant7ea$ - 0
B.3.17785025Automated hemogram12ea$ - 0
B.3.17885027Automated hemogram12ea$ - 0
B.3.17985210Blood clot factor II test5ea$ - 0
B.3.18085220Blood clot factor V test5ea$ - 0
B.3.18185230Blood clot factor VII test5ea$ - 0
B.3.18285240Blood clot factor VIII test5ea$ - 0
B.3.18385250Blood clot factor IX test5ea$ - 0
B.3.18485260Blood clot factor X test5ea$ - 0
B.3.18585270Blood clot factor XI test5ea$ - 0
B.3.18685280Blood clot factor XII test5ea$ - 0
B.3.18785290Blood clot factor XIII test5ea$ - 0
B.3.18885301Antithrombin III test12ea$ - 0
B.3.189Protein C + S activity; 85303,8530617ea$ - 0
B.3.19085303Blood clot inhibitor test; protein C activity12ea$ - 0
B.3.19185305Blood clot inhibitor assay; protein S total12ea$ - 0
B.3.19285306Blood clot inhibitor test; protein S free12ea$ - 0
B.3.19385384Fibrinogen test7ea$ - 0
B.3.19485379D-Dimer12ea$ - 0
B.3.19585460Hemoglobin, fetal ; Kleihauer5ea$ - 0
B.3.19685651Rbc sed rate, nonautomated5ea$ - 0
B.3.19785670Thrombin time, plasma5ea$ - 0
B.3.19885730Thromboplastin time, partial7ea$ - 0
B.3.19986000Agglutinins, febrile17ea$ - 0
B.3.20086001Allergen specific igg110ea$ - 0
B.3.20186003Allergen specific IgE, Multi-Allergen110ea$ - 0
B.3.20286005Allergen specific IgE110ea$ - 0
B.3.20386022Platelet antibodies17ea$ - 0
B.3.20486038Antinuclear antibodies990ea$ - 0
B.3.20586060Antistreptolysin o, titer5ea$ - 0
B.3.20686140C-reactive protein330ea$ - 0
B.3.20786157Cold agglutinin, screen7ea$ - 0
B.3.20886160Complement, antigen C334ea$ - 0
B.3.20986160Complement, antigen C428ea$ - 0
B.3.21086162Complement, total (CH50)22ea$ - 0
B.3.21186225DNA antibody5ea$ - 0
B.3.21286235Sjorgen's Syndrome (SS-A) Antibody5ea$ - 0
B.3.21386235Sjorgen's Syndrome (SS-A, SS-B) Antibody5ea$ - 0
B.3.21486235Sjorgen's Syndrome (SS-B) Antibody5ea$ - 0

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