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200220
Add On, Genital Screen
200220
Add On, Chlamydia Antigen, 2-Vial
Method:
200224
Cryptosporidium/Giardia/E.histolytica
200231
Diagnostic Immunolgy
200233
Add On, C.difficileToxin Antigen, 2-Vial
200237
Reticulocyte for Sysmex
200242
Antibody Titer A
200243
Antibody Titer A&D
200244
Antibody Titer D
200920
Activated Clotting Time
Instrument(s):
200921
Coagulation, Plasma
200922
Prothrombin Time, Whole Blood
200928
Hematology, Centrifugal
200930
Hematology w/ Diff A
200931
Hematology w/ Diff B
Instrument(s):
200932
Hematology w/ Diff C
200933
Hematology w/ Diff D
200934
Hematology w/ Diff E
200935
Immunohematology, Basic
Instrument(s):
200936
Immunohematology, Comprehensive
Instrument(s):
200937
Antinuclear Antibody
Latex Method: ___Yes ___No
200938
Antistreptolysin O
200939
C-Reactive Protein
Results reported: ___Quantitative
___Qualitative
200940
Helicobacter Pylori Antibody
200941
Immunoproteins
IgE Performed: ___Yes ___No
200942
Mononucleosis,Infectious
200943
Lyme Disease
200944
HIV Antibodies, Oral Fluid
200945
Rheumatoid Factor
200946
Rubella
200947
Syphilis Serology
200948
HIV Markers
200949
Acid-Fast Smears
200950
Bacteriology
200951
Chlamydia/GC/Strep Grp B Antigen Screen
Method Used: _______________ Grp B Strep Performed: ___Yes ___No
200952
GC Culture
Gram Stain Performed: ___Yes ___No
200954
Gram Stain
200955
Parasitology
200956
Strep Group A Antigen Screen
200957
Throat Culture
Group A Strep Performed: ___Yes ___No
Gram Stain Performed: ___Yes ___No
200958
Throat/Urine Culture
Group A Strep Performed: ___Yes ___No
Gram Stain Performed: ___Yes ___No
200959
Urine Culture
Gram Stain Performed: ___Yes ___No
200960
Erythrocyte Sedimentation Rate (ESR)
Instrument(s):
200962
Hepatitis Markers
200967
Crytposporidium/Giardia Immunoassay
200968
Reticulocyte Count
200971
C-Reactive Protein, High Sensitivity
200972
C. Difficile Toxin Antigen Detection
200973
Viral Antigen Screen
Rotovirus Performed: ___Yes ___No
200976
D-Dimer
Results reported: ___Quantitative
___Qualitative
200979
Hematology w/ Diff G
200980
Affirm Microbial Screen
200986
Erythrocyte Sedimentation Rate (ESR), Rapid
200987
Direct Antiglobulin Test
200990
Blood Cell Identification
Reported to CMS: ___Yes ___No
200995
Prothrombin Time, CoaguChek XS Plus, Basic
200996
Prothrombin Time, CoaguChek PT XS Plus, Comp
201115
Prothrombin Time, WB, Hemochron/ITC
201215
Prothrombin Time, Whole Blood, Hemochron
209100
Peripheral Blood Smear

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