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A B C D E F G H I J K L M
N O P Q R S T U V W X Y Z

Test Specimen Requirements CPT Code Method Fee
Dalmane
(Flurazepam) & Desalkylflurazepam

Quantitative - serum


Qualitative - urine




4 ml serum or plasma

(2 ml min)

15 ml urine




82742



80101



GC-TSD



GC-FID



69.50



45.50
Darvon
(Propoxyphene/Nor )


Quantitative -serum

Qualitative - urine




5 ml serum or plasma

(3 ml min)

20 ml random urine




80299

80101




GC-TSD

GC-TSD




97.50

52.50

Darvon - Confirmation 20 ml urine

Propoxyphene & Norproxyphene
80102 GC/MS 81.50
Demerol
(Meperidine)
Quantitative - serum

Qualitative - urine



5 ml serum or plasma

(3 ml min)

15 ml urine



83925



80101


GC-TSD



GC-FID


85.95



56.50
Depakene

(Valproic Acid)

Quantitative - serum total

Qualitative - urine





2 ml serum or plasma

15 ml min




80164




GC-FID

GC/MS




69.50

41.50
Department of Transportation (DOT) Drug Screen

aka SAMSHA (Formerly NIDA)

See DOT Drug Testing section

for further details

Desipramine
(Norpramin )

Quantitaive - serum




Quantitative - urine



5 ml serum or plasma
(3 ml min)

No serum separator gels

15 ml urine




80160




80101



GC-TSD




GC-FID
GC/MS




71.50



45.95
Desyrel

(Trazodone)

Quantitative - serum



Qualitative - urine



4 ml serum or plasma

(2 ml min)

15 ml urine



80299



80101



GC-TSD



GC-FID



69.50



45.50

Diazepam

(Valium)

Quantitative - serum

Qualitative - urine



3 ml serum or plasma

15 ml urine



80154



GC-TSD

GC-FID



71.50

42.50

Digitoxin 2 ml serum or plasma

(1 ml min)

80299 GC-TSD 150.50
Digoxin

(Lanoxin)

2 ml serum or plasma

(1 ml min)

80162 GC-FID 125.50
Dilantin

(Phenytoin)

Quantitative - serum Total

Total and Free



Qualitative - urine



2 ml serum or plasma

2 ml serum or plasma

No serum separator gels

15 ml urine



80185

80185



GC-TSD

GC-TSD



GC/MS



85.50

92.50



52.50

Diphenhydramine
(B
enadryl)

Quantitative - serum



Qualitative - urine




4 ml serum or plasma

(2 ml min)

15 ml urine




80299



GC-FID


GC-TSD




74.95


46.95

Disopyramide

(Norpace)

2 ml serum or plasma

(1 ml min)

80299 GC-TSD 65.50
Diurectic Screen

(Qualitative-urine)

(Chlorothiazide, Furosemide, Hydrochlorothiazide)

60 ml random urine

(20 ml min)

80101 TLC, GC-TSD 86.50
Doxepin
(Sinequan)

Quantitative- serum




Qualitative - urine




5 ml serum or plasma
(3 ml min)

No serum separator gels

15 ml urine




80166




GC-TSD




GC-MS



78.50




46.50
Drug Screen

Comprehensive-

Blood, Urine, Gastric

Qualitative & Quantitative Analysis

7 ml serum (5 ml min)

60 ml urine (25 ml min)

10 ml gastric

See Comprehensive Drug Screen section for more information

80101

80255

80102

GC,TLC

GC/MS

SPEC

204.00
Drug Screen, Serum

Quantitative Analysis

7 ml serum

(5 ml min)

See Serum Drug Screen section for more information

80299

80255

GC, SPEC TLC 129.50
Drug Screen, Urine

Qualitative Analysis

30 ml urine

(15 ml min)

See Urine Drug Screen section for more information

80255

80102

80101

GC,TLC

GC/MS

85.00
Drugs of Abuse Urine, (DAU)

Qualitative Analysis

60 ml random urine

See Drugs of Abuse section for more information

80101

80102

80255

GC, TLC,

GC/MS


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