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Test Requested By
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Set Name
|
|
Dept Name
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Order Priority
|
|
Comments
|
CC
|
|
Bill Provider / Patient / Insurance
|
AOE
|
|
Order #
|
|
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ALT / SGPT - Alanine Aminotransferase / SGPT
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
AST / SGOT - Aspartate Aminotransferase / SGOT
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
BMP - Basic Metabolic Panel
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
LIPID - Complete Lipid Panel
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
CMP - Comprehensive Metabolic Panel
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
Creatine - Creatine
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
DHEA - Dehydroepiandrosterone Sulfate
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
Estradiol - Estradiol
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
HbA1c - Hemoglobin A1c
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
Homocysteine - Homocysteine
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
Lithium - Lithium Therapeutic Massage
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
T4 Free - T4 Free - Free Thyroxine
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
Testosterone - Testosterone, Total
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
TSH - Thyroid Stimulating Hormone
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
CBCD - CBC with Diff
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
Serum Ferritin - Serum Ferritin
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
T3 Free - T3 Free Triodothyronine
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
Progeresterone - Progeresterone
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
Fasting Insulin - Fasting Insulin
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
Tegretol - Tegretol Level
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
Lamictal - Lamictal Level
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
Depakote - Depakote Level
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
RBC-M - Red Blood Cell Magnesium
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
ECG - Electrocardiogram
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
|
VIT D - 25, OH Vitamin D
|
|
|
Diag #1
|
Diag #2
|
|
Diag #3
|
Diag #4
|
