Adalimumab Quantitative with Reflex to Antibody, Serum
Centralized Core Laboratory :
Chemistry
PATIENT INFO
Patient Name:
Medical Record #:
BD: //Sex: F M
PHYSICIAN INFO
Physician Name :
Address:
Ph: ()-Fax: ()-
Additional Report to:
Ph: ()-Fax: ()-
TESTS REQUESTED
Test Name:
ICD9 Code: (required)
1. Adalimumab Quantitative with Reflex to Antibody, Serum
2.
3.
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5.
6.
SPECIMEN INFO
Collection Date & Time:
Collected By:
Hospital:
Test ID/Workstation :
ADALR/MAYO
Specimen Type:
Blood - Serum
Tube Type:
Red Top Tube (no anticoagulant)
Collection Volume:
1.25mL(minimum 1.0mL)
Cause for Rejection:
Specimens grossly lipemic and grossly hemolyzed
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Enzyme-Linked Immunosorbent Assay
Lab/Phone:
330-543-8418
TAT:
1-4 days
Additional Info:
Reference range available on patient report
CPT Code:
80145, 83520 if reflex testing added
Panel Includes:
Adalimumab Antibody, Serum Reflex Test
Synonyms:
Humira
Adalimumab Quantitative with Reflex to Antibody, Serum
Test ID/Workstation :
ADALR/MAYO
Specimen Type:
Blood - Serum
Tube Type:
Red Top Tube (no anticoagulant)
Collection Volume:
1.25mL(minimum 1.0mL)
Cause for Rejection:
Specimens grossly lipemic and grossly hemolyzed
Storage:
Refrigerated
Availability:
Sent to Reference Laboratory
Methodology:
Enzyme-Linked Immunosorbent Assay
Lab/Phone:
330-543-8418
TAT:
1-4 days
Additional Info:
Reference range available on patient report
CPT Code:
80145, 83520 if reflex testing added
Panel Includes:
Adalimumab Antibody, Serum Reflex Test
Synonyms:
Humira
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