Wellness Green Package

Last Modified: 5/17/2023 5:27:18 AM


Medical Necessity Documentation:  
Client Notes:  
Patient Preparation: 10 to 12 hours Fasting
Specimen Requirements: 4.0 mL Serum in a SST Gold Top Tube

and

3.0 mL Whole Blood in a Lavender Top Tube - EDTA
Collection Instructions: Avoid Hemolysis
Transport & Storage: Temperature/Stability: 7 days Refrigerated

48 hours on cells
Reference Range:

Refer to Interpretive Results
Critical Ranges:  
Test Comments:  
Methodology: Multiple
Clinical Significance:  
Documentation:  
Custom Panel: No

PRODUCTION SCHEDULE

Days Performed: Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Sites Performed: Parkview Dekalb Hospital, Parkview Huntington Hospital, Parkview LaGrange Hospital, Parkview Noble Hospital, Parkview Randallia Hospital, Parkview Regional Medical Center, Parkview Wabash Hospital, Parkview Warsaw , Parkview Whitley Hospital
PHL Test Code: W3
Alternate Test Names: Green Package
Included Tests: Glycohemoglobin Estimated Average Glucose (eAG); Glycohemoglobin (HbA1C)

Lipid Profile Cholesterol; Cholesterol HDL; Cholesterol LDL (Calculated); Chol/HDL Ratio (Calculated); Triglycerides
CPT Coding: 80061; 83036

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