Wellness Diamond Package without PSA

Last Modified: 1/14/2021 6:07:54 AM


Specimen Requirements: 4.0 mL Serum in a SST Gold Top Tube

and

3.0 mL Whole Blood in a Lavender Top Tube - EDTA
Reference Range:

Refer to Interpretive Results
Methodology: Mutiple
Custom Panel: No

PRODUCTION SCHEDULE

Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed: Parkview Dekalb Hospital, Parkview Huntington Hospital, Parkview Noble Hospital, Parkview Randallia Hospital, Parkview Regional Medical Center, Parkview Wabash Hospital, Parkview Warsaw , Parkview Whitley Hospital
PHL Test Code: W4
Alternate Test Names: Diamond Package Female; Wellness Diamond Package w/out PSA
Included Tests: Complete Blood Count (CBC) Hematocrit (Hct); Hemoglobin (Hgb); Mean Corpuscular Hemoglobin (MCH); Mean Corpuscular Hemoglobin Concentration (MCHC); Mean Corpuscular Volume (MCV); Platelet (PLT); Red Blood Cell Count (RBC); Red Cell Distribution Width Standard Deviation (RDWSD); Red Cell Distribution Width Coefficient Variation (RDWCV); White Blood Cell Count (WBC)

Comprehensive Medabolic Panel (CMP) Alanine Aminotransferase (ALT; SGPT); Alkaline Phosphatase; Aspartate Aminotransferase (AST; SGOT); Bilirubin, Total; Blood Urea Nitrogen (BUN); Calcium (Ca); Creatinine; Electrolytes [Carbon Dioxide (CO2); Chloride (CL); Potassium (K); Sodium (Na)]; Glucose; Protein Fractionation [A/G Ratio; Albumin;Globulin; Protein, Total]

Glycohemoglobin Estimated Average Glucose (eAG); Glycohemoglobin (HbA1C)

Lipid Profile Cholesterol; Cholesterol HDL; Cholesterol LDL (Calculated); Chol/HDL Ratio (Calculated); Triglycerides

Thyroid Stimulating Hormone (TSH)
CPT Coding: 80053; 80061 (Reflex 83721), 83036, 84443, 85027

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