AssureTox Demo Handbook

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LABORATORY INFORMATION MANAGEMENT SYSTEM DEMONSTRATION
FOR PHYSICIANS OFFICE LABS AND REFERENCE LABS

HL7 DOWNLOAD FOR INTEGRATION SETUP, TRAINING, AND FAX, EMAIL AND CLIENT WEB PORTAL
WITH ELECTRONIC MEDICAL RECORDS CUSTOMER SUPPORT OPTIONS FOR QUICK RESULTS REPORTING

TIME EFFICIENCY TRACKING RECORD MODIFICATION TRACKING, JOB SPECIFIC WORKLISTS AND
TO IDENTIFY BOTTLENECKS AND INTERNAL LABORATORY CHAIN OF ACCESS BASED ON ASSIGNED USER

ENSURE FAST TURNAROUND CUSTODY AND AUDIT TRAILS SECURITY ROLES

CUSTOMIZABLE AND CLIENT BILL AND DONOR PAY SPECIALTY RESULT REPORT OPTIONS
PREBUILT REPORT GENERATION INVOICE CAPABILITIES LIKE TRENDING AND SUMMARY

MANAGEMENT & SETUP …………………………………………………………………………………………………… Pages 1- 12
ASSURETOX ……………………………………………………….………………………………………………………… Page 1
ACCOUNT SETUP ……………………………………………………………………………..……………………… Pages 2- 3
COLLECTION SITE SETUP ………………………..……………………………………………..……………………… Page 3
DONOR SETUP ………………………..……………………………………………..………………….………………… Page 4
INSURANCE COMPANY SETUP ……………….……………………………………………..……………………… Page 5
CLAIMS ……………..……………..……………………………………………..………………….……………….……… Page 5
ELEMENTS ……..…………..……………………………………………..………………….……………….……… Pages 6 - 7
GROUPS/METHODS ………………………..……………………………………..………………….………………… Page 8
PANELS ………………………..……………………………………..………………….…………………………………… Page 9
QUALITY CONTROL ………………………..……………………………………..………………….………………… Page 10
TESTS ………………………..……………………………………..………………….……………………………….…… Page 11
USERS ………………………..……………………………………..………………….……………………………….…… Page 12

WORKFLOW, WORKLISTS & REPORTING ………………………………………………………………………… Pages 13 - 20
ACCESSIONING …………………………………………….………………………………………………..…… Pages 13 - 15
SCREENING ……………………………………………………………………………..………………………….……… Page 16
CONFIRMATIONS ……………………………………….…………………………..………………………….……… Page 17
REPORTING & RECORD MODIFICATIONS …………………….…………………….……..….……… Page 18 - 20

CLIENT PORTAL …………………….………………………………………………………………………………………… Pages 21 - 23
RESULTS …………………………………………….………………………………………………..…………..… Pages 21 - 22
COLLECTIONS ………………………………………………………………………..…………………..…….… Pages 22 - 23
REPORTS ……………………………………….…………………………..………………………….……………..…… Page 23

SAMPLE REPORTS …………………….……………………………………..……………………………………………… Pages 24 - 27

Management & Setup___________________________________________________________________

ASSURETOX.

AssureTox Laboratory Information Management System (LIMS) is a toxicology specific software
solution.
AssureTox can easily be customized with Laboratory specific logos and colors, upon request.
Once AssureTox is started; the user will be prompted to login. A username and password will be
required.

 Password requirements include at least 8 characters, upper and lower case characters, one
number and one special character.

 Passwords are required to be updated every six months and cannot be the same as the
previous password for that user.

Based on the security roles assigned to the user, will determine what is accessible to them on the
dashboard.
The dashboard consists of two menus, the main menu and a sub menu.

 The main menu includes tabs Management, Accessioning, Screening, Confirmation and
Reporting.

 The sub menu is only visible when the Management tab is active.
 The sub menu includes tabs Accounts, Sites, Donors, Insurance, Claims, Elements, Groups,

Panels, QC, Tests, and Users.
1|Page

ACCOUNT SETUP.

Account setup is quick and easy. Selecting the new button on the account page allows users to
enter a new account.
The account has menu items General, Notes, Panels, Providers, MROs, Collectors,
Administrators, Donors, Reporting, Insurance, Sites, and Bills (invoice history).
On the General tab, an account name, market, address, analysis type, billing type and other
general account specific information can be entered. A parent account can also be assigned to
allow the child inheritance of a parent’s address, panel information, providers, collectors and
reporting preferences.
The account tabs Providers, Administrators, MROs, Collectors, Sites, Donors and Panels allow
association to be made between the account and these record types.
The reporting tab allows account report preferences to be specified including:

 A custom logo for reports
 Receiving reports via auto-fax
 Including the RX Verification column on result reports
 Utilizing point of care results

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 Including patient trending on result reports
 Receiving result summary reports
If applicable, account insurance information can be entered. The insurance information
includes the insurance company, group number, identification number, insurance type and
other insurance specific information.

COLLECTION SITE SETUP.

Collection Site information can easily be entered from the Sites sub menu option.
Collection Site information includes an address, contact information and notes.

3|Page

DONOR/PATIENT SETUP.

Donor information can easily be entered from the Donors sub menu option.
Donor information includes general contact information, DOB, SSN, an auto generated lab
record number, monthly payment if applicable, notes, and insurance records.

4|Page

INSURANCE COMPANY SETUP.

Insurance Company information can easily be entered from the Insurance sub menu option.
Insurance Company information includes an address, contact information and notes.

CLAIMS.

Claims can easily be tracked from the Claims sub menu option. Claims are associated to test
information.

 A claim is automatically created when a new test is created.
 The claim allows users to track costs, balances, and payment history.
 The claim also allows users to generate invoices and download HL7 data for

Electronic Medical Record (EMR) or Billing submittal.
5|Page

ELEMENTS.

Elements include:
 Medications
 Diagnosis/Reason Codes
 Analytes

The medication list allows a new medication to be entered and appropriate analytes to be
associated. This information is used when determining the RX verification column on the
report.
AssureTox also allows users to specify a note that should be returned if a verification is
unexpected, expected or analyte values have mismatched results.

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 An example would be if a sample belonging to a patient with a reported Suboxone
prescription had Buprenorphine detected yet Norbuprenorphine was not, the result
mismatch note would be returned on the result report.

Other clinical considerations can be entered here.

Diagnosis/Reason codes can be created. The Diagnosis code information includes:
 Code
 Description
 Whether it is for forensic or medical use

Analytes can easily be entered and updated. Analyte information includes:
 Analyte name
 Abbreviation
 Drug Class
 Analysis Type: Confirm, Screen, or Rapid
 Test Code
 CPT Code
 Detection Window
 An unexpected note to be returned if the analyte results positive with no applicable
medications reported

7|Page

GROUPS/METHODS.

Group\Methods can be created from the Groups sub menu option. A group name, group type,
acquisition method, batch size, calibrator value, and confirmation panel for auto confirms can
be entered here.
Cutoff comparison, upper levels, cutoff levels and analytes are associated with groups. A result
order can also be included for results to be placed in a specific order on reports.
Quality Control (QC) Groups can be associated with a Group/Method if it is necessary for a
specific QC to be analyzed before the Group/Method.

8|Page

PANELS.

New Panels can easily be created or edited from the Panels sub menu option. A panel name,
code, type, price, and EMS price can be entered.
Groups/Methods are associated with panels and can have a report order designated so the
groups will appear in the specified order on reports.

9|Page

QUALITY CONTROL (QC).

Quality Control records can be created from the QC sub menu option.
The created date and time, controls to be tested, status, result and other QC specific
information can be specified.

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TESTS.

Tests can be viewed from the Tests sub menu option. Test information includes the account,
collection site, donor, collector, requisition/specimen id number, laboratory accession number,
date created, collected date, and other test specific information.
Screening and confirmation panels are associated with the test.
Notes, Report Comments, Documents, Medications, and Point of Care (POC) results can also be
associated with the test record.
Reports can easily be generated from the test record. The reports can be:

 Viewed
 Faxed – auto fax
 Emailed - encrypted attachment
An Internal Laboratory Chain of Custody can also be viewed for the test record. This will show
any batch custody data applicable to the test record.

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USERS.

Users can easily be entered from the Users sub menu option.
User information includes username, password, job title, an address, contact information,
preferred result method, and other user specific information.
Security roles can also be associated to users to limit or grant access to different software pages
and worklists.

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Workflow, Worklists & Reporting_________________________________________________

ACCESSIONING.

The Accessioning Worklist allows users to accession incoming specimens, immediately putting
them into batches.
The Accessioning Worklist is split into three parts; Screening, Confirmations, and Disposal.
The Disposal Worklist allows users to see all specimens in need of disposal.
Samples can easily be sorted by selecting options ‘TEMP STORAGE’ or ‘FREEZER’ from the drop
down menu.

 Samples in temporary storage are displayed after one week
 Samples in the freezer are displayed after one year
Users can quickly print a copy of their worklist by selecting the print worklist button for easy
specimen retrieval.

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To create a batch of new samples, users will select the Create Worklist button.

The user can select if the batch is regulated or non-regulated, document any reason for
rejection if applicable, document the collection date and time, and select all requested panels
for the test record.

AssureTox is capable of detecting scanned barcodes for quick data input or users can type
directly into fields.

When a specimen is added to a batch, the test record is date and time stamped, the
accessioner is documented, and a laboratory accession number is generated and associated
with the test record.

Accession barcodes will be printed for each specimen accessioned. Once the batch is
completed, a batch barcode will be printed.

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AssureTox allows users to easily generate barcodes to be placed at stations around the
laboratory. Users can scan the batch barcode and any station barcode to maintain a complete
chain of custody for the batch.

 An example would be if a station barcode was printed and placed on a trash receptacle.
When a batch is disposed of, the user can scan the trash receptacle barcode followed by
the batch barcode to document the batch custody.

Users can scan requisition/specimen id barcodes or laboratory accession barcodes to open a
test record.

The user can complete all necessary data entry for the specimen and upload a copy of any
applicable documentation. (i.e. a chain of custody, requisition form, or insurance card copy).

By selecting the Worklist Batch button, users can create a batch of existing specimens from
their screening or confirmation worklists.

The Screening Worklist under the Accessioning tab allows users to see all specimens in need of
an aliquot for screening purposes. These samples can be compiled into a batch and sent on for
analysis.

The Confirmation Worklist under the Accessioning tab allows users to see all specimens in need
of an aliquot for confirmation purposes. These samples can be compiled into a batch and sent
on for analysis.

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SCREENING.

The Screening Worklist allows users to view test information that is unanalyzed, pending,
analyzed and reviewed.
By scanning the batch barcode, batch data can easily be sent into a specified analyzer.
The batch data is then placed on the pending worklist until analysis is complete. Once the
analysis is complete, the batch data will move from the pending worklist to analyzed.
Users can update, review, and certify result data.
If an account is setup for auto-confirms, and a screening result is certified as positive, the
confirmation panel specified for the positive group on the Group/Method setup will
automatically be added to the test record. The test record will be placed on the Accessioning
Confirmation Worklist to alert accessioners that an aliquot is needed for confirmation.
Samples can easily be sent for a repeat, a retest, or sent to confirm.

 When a retest is requested, the test record will be placed on the Accessioning Screening
Worklist to notify accessioners that a new aliquot is needed.

 When a sample is sent to confirm, the test record will be placed on the Accessioning
Confirmation Worklist to alert accessioners that an aliquot is needed for confirmation.

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CONFIRMATIONS.

The Confirmation Worklist allows users to view test information that is unanalyzed, pending,
analyzed and reviewed.
By scanning the batch barcode, batch data will be displayed and quality control data can be
associated with the batch.
Once the applicable QC data is submitted, an analyzer can be specified.
Users can associate vial positions for each aliquot contained in the batch. Once vial positions
are submitted, the vial positions must be verified. Once vial positions are verified, the batch
data is sent into the analyzer.
The batch data is then placed on the pending worklist until analysis is complete. Once the
analysis is complete, the batch data will move from the pending worklist to analyzed.
Users can update, review, and certify result data.
Users can also easily access each test record, associated documents, quality control data, batch
custody information and chromatographs from the Confirmation Worklist.

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REPORTING & RECORD MODIFICATIONS.

When the Reporting tab is active, users can easily review lab workflow data for the day or any
date specified.
The lab workflow data displays the time each batch has spent in a laboratory area (i.e.
accessioning, screening, and confirmations). This helps identify bottlenecks.
Users can also generate prebuilt reports like trending, summary, volume, payment comparison,
batch custody, fax history, invoices, and more.

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Users can use the Report Builder feature to pull requested data with specified criteria from the
database in a report form.
The Report Builder tool can also be used to pull audit data and track database changes.

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To ensure quality, a record modification report can also be generated. When certain records
are updated a user notation is required. The changes made to the record are also documented.
The modifications can be viewed under the Notes tab of the record. A complete list of all
modifications made to a record can be pulled in a report form from the Reporting tab. The user
who made the change, along with the date and time the change was made is also documented.

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Client Portal___________________________________________________________________________________

CLIENT PORTAL: RESULTS.

The AssureTox Client Portal is a web-based extension of the AssureTox software.
Once a user is authenticated by logging in with their username and password, they will be
directed to the dashboard.
The dashboard consists of three pages: Results, Collections, and Reports.

The Results page displays all patient result data in order of most recent.
Selecting a record will open the Result Report.
Users can easily download HL7 data by selecting the ’Download HL7 V 2.4’ link on the record
row.
Users can view the Result Summary report by selecting the ‘Summary Report’ link on the record
row.
Result data can be sorted by selecting column headers.

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Result data can also be filtered to narrow down the results displayed.
 For example, if a user would like to view a specific patients result records, they can
specify their criteria in the filter on the donor column header.

Result records can be archived to keep track of the results that have already been reviewed.

CLIENT PORTAL: COLLECTIONS.

The Collections page displays all samples that have been entered and are in transit to the
laboratory.
New collections can be entered by selecting the New button.
The collection order page allows users to enter test data including the account, collection site,
ordering physician, requisition/specimen id number, diagnosis codes, donor information,
panels, point-of-care results, notes, and medications.
Users can upload copies of relevant documents like insurance card information.

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Once a new collection has been entered and saved, a requisition form can be generated and
printed.

CLIENT PORTAL: REPORTS.

The reports page allows user to print patient trending reports and result summary reports.

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SAMPLE REPORTS: SUMMARY REPORT

P.I.S. Laboratory Kryder E. VanBuskirk, MD
861620 NLaokrethwaMyaDinrivSet. Laboratory Director
JRaumsseelsltSopwrinn,gKsY, K4Y264229642
825750.-587616.-43176632

CLIA #: 18D2055102

Result Summary

Accession #: SPECIMEN Name: PATIENT Name: FACILITY
Req/Spec ID: PLA10100 Gender: Doe, Chino Address: Lincoln Collections
Collected: LA102M DOB: Male 1223 White Road, Suite 5
Received: 9/25/2015 8:13:00 AM LR #: 4/5/2015 Provider: Jamestown, KY 42642
Completed: 9/28/2015 10:03:00 AM LR0001140 Sarah Harper, MD
9/28/2015 10:09:00 AM

EXPECTED RESULTS - REPORTED MEDICATION DETECTED

REPORTED PRESCRIPTION ANTICIPATED POSITIVES AMOUNT DETECTED TYPICAL DETECTION WINDOW
Morphine 1 to 4 days after last dose
Morphine 75 ng/mL

UNEXPECTED RESULTS - REPORTED MEDICATION NOT DETECTED

REPORTED PRESCRIPTION ANTICIPATED POSITIVES AMOUNT DETECTED TYPICAL DETECTION WINDOW
Opana 1 to 4 days after last dose
Oxymorphone NEGATIVE

UNEXPECTED POSITIVE RESULTS - NO MEDICATION FOR ANALYTE DETECTED

ANALYTE DETECTED AMOUNT DETECTED TYPICAL DETECTION WINDOW
205 ng/mL 1 to 4 days after last dose
Oxycodone 500 ng/mL 1 to 4 days after last dose
THC-COOH 101 ng/mL 1 to 4 days after last dose
Alprazolam 215 ng/mL 1 to 4 days after last dose
Oxazepam 58 ng/mL 2 to 7 days after last dose
a-Hydroxyalprazolam

TEST SPECIMEN VALIDITY RESULTS RESULT OUTCOME
NL RANGE 6 OUT OF RANGE
Creatinine > 20 OUT OF RANGE
Speci c Gravity 1.005 - 1.03 2.01 OUT OF RANGE
<1 6
Oxidants 4.5 - 8.5 6 NEGATIVE
pH

POINT OF CARE RESULTS POSITIVE NEGATIVE
NEGATIVE NEGATIVE
TEST NEGATIVE NEGATIVE
POSITIVE POSITIVE
Tricyclic Antidepressants (TCA) NEGATIVE NEGATIVE
Barbiturates (BAR) POSITIVE POSITIVE
NEGATIVE NEGATIVE
Benzodiazepines (BZO) NEGATIVE NEGATIVE
Buprenorphine (BUP) NEGATIVE NEGATIVE
POSITIVE POSITIVE
THC (THC) POSITIVE POSITIVE
Ecstasy (MDMA) NEGATIVE NEGATIVE
Propoxyphene (PPX) NEGATIVE NEGATIVE
Amphetamine (AMP) POSITIVE POSITIVE
Cocaine (COC) POSITIVE POSITIVE
Methamphetamine (MAMP)
Phencyclidine (PCP)
Methadone (MTD)

Opiates (OPI)
Oxycodone (OXY)

SAMPLE REPORTS: RESULTS REPORT

P.I.S. Laboratory Kryder E. VanBuskirk, MD
686102LNakoertwhaMy DariniveSt. Laboratory Director
RJuasmseellsStoprwinng,sK, YKY4246226942
287505-.856761-.34716623

CLIA #: 18D2055102

Results Report

PATIENT SPECIMEN FACILITY
Doe, Chino Lincoln Collections
Name: Male Accession #: PLA10100 Name: 1223 White Road
Gender: 4/5/2015 Req/Spec ID: LA102M Address: Jamestown, KY 42642
DOB: LR0001140 Collected: 9/25/2015 8:13:00 AM Sarah Harper, MD
LR #: Received: 9/28/2015 10:03:00 AM Provider:

Completed: 9/28/2015 10:09:00 AM

MEDICATIONS: Morphine, Opana,

ANALYTE: RESULT: CUTOFF: RX VERIFICATION:
Comprehensive 11 Panel Drug Screen, 101
FINAL REPORT Date Completed: 9/29/2015 10:34:17 AM

Opiates NEGATIVE 300 ng/mL
Oxycodone POSITIVE 300 ng/mL
Methadone NEGATIVE 300 ng/mL

Tramadol NEGATIVE 200 ng/mL

Buprenorphine NEGATIVE 5 ng/mL
Benzodiazepines POSITIVE 200 ng/mL
Barbiturates NEGATIVE 200 ng/mL

Amphetamines NEGATIVE 500 ng/mL

Cocaine Metabolite NEGATIVE 150 ng/mL

Phencyclidine (PCP) NEGATIVE 25 ng/mL
Cannabinoids (THC) POSITIVE 50 ng/mL

Specimen Validity Panel, 103 FINAL REPORT Date Completed: 10/19/2015 11:13:49 AM

Specimen Validity

Oxidants POSITIVE 0 ng/mL
pH POSITIVE 5 ng/mL
Speci c Gravity POSITIVE 1.005 ng/mL

Creatinine NEGATIVE 113 ng/mL

Premier Comprehensive Con rmation Panel, 201 FINAL REPORT Date Completed: 9/29/2015 10:34:48 AM

Opiate/Opioid

Hydrocodone Group Codeine NEGATIVE 50 ng/mL EXPECTED
Oxycodone Group Morphine 75 ng/mL 50 ng/mL EXPECTED
Buprenorphine Group Tramadol NEGATIVE 50 ng/mL EXPECTED
Fentanyl Group
Methadone Group Hydrocodone NEGATIVE 50 ng/mL EXPECTED
Barbiturate Hydromorphone NEGATIVE 50 ng/mL EXPECTED

Oxycodone 205 ng/mL 50 ng/mL UNEXPECTED
Oxymorphone NEGATIVE 50 ng/mL UNEXPECTED

Buprenorphine NEGATIVE 5 ng/mL EXPECTED
Norbuprenorphine NEGATIVE 5 ng/mL EXPECTED

Fentanyl NEGATIVE 2 ng/mL EXPECTED
Norfentanyl NEGATIVE 10 ng/mL EXPECTED

Methadone NEGATIVE 100 ng/mL EXPECTED
EDDP NEGATIVE 100 ng/mL EXPECTED

Phenobarbital NEGATIVE 200 ng/mL EXPECTED
Butalbital NEGATIVE 200 ng/mL EXPECTED

Benzodiazepine NEGATIVE 50 ng/mL EXPECTED
215 ng/mL 50 ng/mL UNEXPECTED
Alprazolam Group Lorazepam
Oxazepam 101 ng/mL 50 ng/mL UNEXPECTED

Alprazolam

Printed: 11/9/2015 4:28:10 PM 1 of 2 Patient: Doe, Chino Collected: 9/25/2015 8:13:00 AM SAMPLE Version 1.0RREP-2015

SAMPLE REPORTS: RESULTS REPORT (CONT.)

P.I.S. Laboratory Kryder E. VanBuskirk, MD
Laboratory Director
686102 LNaokertwhayMDariinveSt.
RJausmseellsStoprwinng,s,KKYY4422662492
287505-.856761-.34716623

CLIA #: 18D2055102

Results Report

PATIENT SPECIMEN FACILITY
Doe, Chino Lincoln Collections
Name: Male Accession #: PLA10100 Name: 1223 White Road
Gender: 4/5/2015 Req/Spec ID: LA102M Address: Jamestown, KY 42642
DOB: LR0001140 Collected: 9/25/2015 8:13:00 AM Sarah Harper, MD
LR #: Received: 9/28/2015 10:03:00 AM Provider:

Completed: 9/28/2015 10:09:00 AM

MEDICATIONS: Morphine, Opana,

ANALYTE: RESULT: CUTOFF: RX VERIFICATION:

Premier Comprehensive Con rmation Panel, 201 FINAL REPORT Date Completed: 9/29/2015 10:34:48 AM

Benzodiazepine

Alprazolam Group

a-Hydroxyalprazolam 58 ng/mL 50 ng/mL UNEXPECTED

Clonazepam Group NEGATIVE 50 ng/mL EXPECTED
NEGATIVE 50 ng/mL EXPECTED
Clonazepam
NEGATIVE 10 ng/mL EXPECTED
7-Aminoclonazepam
NEGATIVE 100 ng/mL EXPECTED
Sedative hypnotic NEGATIVE 100 ng/mL EXPECTED

Zolpidem NEGATIVE 10 ng/mL EXPECTED
NEGATIVE 5 ng/mL EXPECTED
Stimulant 500 ng/mL 10 ng/mL UNEXPECTED

Amphetamine NEGATIVE 50 ng/mL EXPECTED
Methamphetamine NEGATIVE 25 ng/mL EXPECTED

Other Detectable Drugs NEGATIVE 100 ng/mL EXPECTED
NEGATIVE 100 ng/mL EXPECTED
Cocaine Group 6-Acetylmorphine NEGATIVE 100 ng/mL EXPECTED
Ecstasy Group Phencyclidine
THC-COOH

Cocaine
Benzoylecgonine

MDMA
MDA
MDEA

Comments: Further clinical consideration may be warranted. A-Hydroxyalprazolam is the major urinary metabolite of Clonazepam.

PATIENT TRENDING REPORT LA10017W LA10018W LA9999M LA102M LA14M LA17M
SPECIMEN ID 9/1/2015 9/1/2015 9/22/2015 9/25/2015 10/5/2015 10/5/2015
COLLECTION DATE 305 ng/mL 75 ng/mL 111 ng/mL
ANALYTE CUTOFF 158 ng/mL 500 ng/mL
Oxymorphone 50 ng/mL 55 ng/mL 195 ng/mL 101 ng/mL 10 ng/mL
THC-COOH 10 ng/mL 250 ng/mL 58 ng/mL
Alprazolam 50 ng/mL 215 ng/mL
a-Hydroxyalprazolam 50 ng/mL
Oxazepam 50 ng/mL 205 ng/mL
Buprenorphine 5 ng/mL 75 ng/mL
Oxycodone 50 ng/mL
Morphine 50 ng/mL

Printed: 11/9/2015 4:28:11 PM 2 of 2 Patient: Doe, Chino Collected: 9/25/2015 8:13:00 AM SAMPLE Version 1.0RREP-2015

P.I.S. Laboratory SAMPLE REPORTS: TRENDING REPOKrRydTer E. VanBuskirk, MD
660 Lakeway Drive Laboratory Director

Russell Springs, KY 42642

270-866-3762

CLIA #: 18D2055102 Trending Report Kryder E. VanBuskirk, MD
P.I.S. Laboratory Laboratory Director

861620 NLaokrethwaMyaDinrivSet.

8JR2a57u50mss-.58ee76lsl16tSo.-4p3w1r7in63,g2KsL,AYKS4TY2S46P2E69C4IM2 EN Name: PATIENT Name: FACILITY
CALcIcAes#si:o1n8#D: 20551P0L2A10100 Doe, Chino Lincoln Collections

Req/Spec ID: Trending ReportGender: Address:
Collected:
DOB:
LA102M Male 1223 White Road
9/25/2015 8:13:00 AM 4/5/2015 Jamestown, KY 42642

Received: LAS9T/S2P8E/C2I0M1E5N10:03:00 AM LR #: LR000P1A1T4IE0NT Provider: SaraFhAHCaILrIpTeYr, MD

CAoccmepssleiotend#:: 9P/L2A81/02100105 10:09:00 AM Name: Doe, Chino Name: Lincoln Collections

Req/Spec ID: LA102M Gender: Male Address: 1223 White Road

PCAoTIlEleNcTteTRdE: NDING RE9P/O2R5T/2015 8:13:00 AM DOB: 4/5/2015 Jamestown, KY 42642
LAL1R0001090W1140
SRPeEcCeIMivEeNdI:D 9/28/2015 10:03:00 AM LA1100L5RM#: 8/31/2015 LA10017W LA100P1r8oWvider: LSA9a9r9a9hMHarper, MLAD102M
CCOoLmLEpClTeIOteNdD: ATE 9/28/2015 10:09:00 AM 8/28/2015 9/1/2015 9/1/2015
9/22/2015 9/25/2015

ANALYTE CUTOFF

PFAenTtIEaNnyTlTRENDING REPORT 2 ng/mL 8 ng/mL 5 ng/mL 7 ng/mL 28 ng/mL 5 ng/mL 9 ng/mL
LA11005M LA10019W LA10017W LA10018W LA9999M LA102M
TSHPECC-CIMOEONHID 10 ng/mL 53 ng/mL 8/31/2015 9/1/2015 9/1/2015 9/22/2015 9/25/2015
8/28/2015 5 ng/mL 5 ng/mL 5 ng/mL 5 ng/mL
CPOheLnLcEyCcTlIiOdiNneDATE 5 ng/mL 5 ng/mL 5 ng/mL 5 ng/mL 6 ng/mL 5 ng/mL 6 ng/mL
55 nngg//mmLL 87 nngg//mmLL 728ngn/gm/mL L 55 nngg//mmLL 195nngg/m/mLL
ANNorAbLuYpTrEenorphine C5UnTgO/mFFL 5 ng/mL
58 nngg//mmLL 5 ng/mL 5 ng/mL 5 ng/mL 5 ng/mL
BFuenptraennyolrphine 52 nngg//mmLL 53 ng/mL

THC-COOH 10 ng/mL 5 ng/mL
MPheedniccyactliiodninse: Suboxo5nneg, /mL

Norbuprenorphine 5 ng/mL 5 ng/mL 5 ng/mL 5 ng/mL 6 ng/mL 5 ng/mL 6 ng/mL

Buprenorphine 5 ng/mL 5 ng/mL 5 ng/mL 8 ng/mL 7 ng/mL 5 ng/mL 15 ng/mL

Medications: Suboxone,

Printed: 9/30/2015 4:32:18 PM 1 of 1 Patient: Doe, Chino

SAMPLE Version 1.0TREP-2015