Innovative Solutions. Technical Excellence. Send orders and payments to: Department 9526, P.O. Box 30516, Lansing, MI 48909-8016 CLIA Number HCO # 800-333-0958 LAP/CAP # 2017 Order Form Fax: 855-900-6119 State ID # api-pt.com COLA # API # (if applicable) State Zip ___ ___ D ___ ___ ___ ___ ___ ___ ___ Shipping Information Billing Information Shipping Contact Billing Contact Institution Name Institution Name Department Department Street Address (products cannot be shipped to a P.O. Box) Mailing Address Address 2 Address 2 City State Zip City Phone/Fax: Phone/Fax: Email: Email: Send copies of reports to: (a copy will also be sent to the address above) Send additional copies of reports to: (attach a list if more than two) Attention Attention Institution Name and Address Institution Name and Address City State Zip City Phone/Fax: Phone/Fax: Email: Email: State Zip If you would like your order shipped by department, please use a separate form for each department. Please use additional forms if more lines are needed. Catalog Number Description Quantity *Additional International Shipping Fees Order Total $ *Additional shipping charges may apply for AK, PR and all others sent outside of the continental U.S. *Call API for additional shipping costs if you are located in AK, PR or outside of the continental U.S. Remit to: Department 9526, P.O. Box 30516, Lansing, MI 48909-8016 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Shipping & Processing Authorized Signature: Visit www.api-pt.com to view our catalog or call us at 800-333-0958 to request a copy. Total $ Sub-Total $ Purchase Order #: Please complete the attached form if paying by credit card. Unit Price $ $95 AMERICAN PROFICIENCY INSTITUTE - 2017 PRICE LIST CHEMISTRY 137 Alcohol 138 Ammonia 166 Amniotic Fluid pH 130 Apolipoproteins 174 B-Ketone 111 Blood Gas 112 Blood Gas Plus ► 172 Blood Lead - 5 173 Blood Lead - waived 114 Blood Oximetry 206 Body Fluid Cell Count - C 207 Body Fluid Cell Count - I 168 Body Fluid Microscopy 140 Cardiac Markers - 5 920 Cardiac Markers - 2 ► 165 Additional Cardiac Markers 120 Chemistry 1 121 Chemistry 2 122 Chemistry 3 141 Chemistry - Additional Volume 125 Chemistry - Endocrinology 144 Chemistry - waived 149 CSF & Body Fluid Analysis ► 170 Cystatin C 148 Ethyl Glucuronide 142 Fetal Fibronectin 131 Fetal ROM - PAMG-1 135 Fructosamine 126 Glycohemoglobin - 5 127 Glycohemoglobin - 2 134 Glycohemoglobin - Whole Blood 179 Additional Glycohemoglobin - 5 167 Additional Glycohemoglobin - 2 128 HemoCue - 5 928 HemoCue - 2 133 Immunoassay ► 160 Immunoassay 2 145 i-Stat Chemistry - 5 945 i-Stat Chemistry - waived - 2 176 Lipid Plus - 5 976 Lipid Plus - 2 236 Microalbumin 147 Neonatal Bilirubin - 5 129 Neonatal Bilirubin - 2 169 Procalcitonin 171 SHBG and Testosterone 163 Sweat Analysis ► 132 Therapeutic Drugs ► 136 Therapeutic Drugs - Add-on to Chemistry ► 164 Thyroid Antibodies 175 Thyroid - Special 150 Tumor Markers ► 146 Urine Adulteration Test 143 Urine Chemistry 139 Urine Drug Screen 123 Whole Blood Glucose - 5 918 Whole Blood Glucose - 3 URINALYSIS, MICROSCOPY & OTHER TESTS 261 Fecal Lactoferrin 239 Gastric Occult Blood 233 Provider Performed Microscopy 260 Rapid Urease 258 Urine Eosinophils 232 Urinalysis, HCG & Occult Blood 235 Urine HCG - Qualitative 234 Urine Sediment 270 Automated Urine Microscopy - I 271 Automated Urine Microscopy - S 272 Urinalysis-I, HCG & Fecal Occult Blood 251 Waived & PPM Package ANDROLOGY 154 Antisperm Antibody ► 162 Post-Vasectomy Sperm Analysis ► 151 Sperm Count 152 Sperm Morphology 161 Sperm Motility 153 Sperm Viability HEMATOLOGY & COAGULATION 211 ACT Hemochron / Actalyke - 5 916 ACT Hemochron / Actalyke - 2 212 ACT HemoTec - 5 917 ACT HemoTec - 2 259 Advanced Virtual Blood Cell ID 224 Blood Cell ID (CMS Scored) 225 Blood Cell ID (Not CMS Scored) 214 CoaguChek XS PLUS - 5 914 CoaguChek XS PLUS - 2 217 Coagulation (PT, APTT, Fibrinogen) 245 D-dimer - Qualitative 246 D-dimer - Quantitative 229 Flow Cytometry ► 221 Hematology - 3 227 Hematology - 3S 231 Hematology - 5A 240 Hematology - 5B 230 Hematology - 5C 220 Hematology - 5C2 242 Hematology - 5D 241 Hematology - 5E $325 $175 $220 $175 $200 $425 $465 $420 $215 $325 $200 $200 $65 $300 $195 $160 $175 $245 $410 $110 $215 $175 $410 $300 $205 $355 $325 $155 $335 $210 $210 $100 $50 $245 $145 $260 $170 $310 $190 $245 $170 $175 $205 $145 $500 $405 $260 $210 $90 $295 $200 $410 $195 $290 $250 $250 $150 $160 $175 $155 $150 $70 $135 $155 $50 $200 $200 $175 $220 $260 $260 $260 $260 $300 $260 $350 $260 $350 $260 $175 $50 $50 $255 $195 $180 $150 $150 $430 $265 $265 $305 $305 $305 $265 $305 $305 HEMATOLOGY & COAGULATION (continued) 238 Hematology - 5S 247 Hemochron Jr. ACT - LR 248 Hemochron Jr. ACT + 252 Hemochron Jr. Citrate APTT ► 249 Hemochron Jr. Citrate PT 250 Hemochron Jr. PT 209 HemoCue White Blood Cell Count 215 i-Stat ACT 216 i-Stat/CoaguSense PT/INR 208 Lamellar Body Count 254 Platelet Function - IIb/IIIa Test 255 Platelet Function - Aspirin Test 256 Platelet Function - P2Y12 Test 222 QBC Hematology 223 Reticulocyte Count 228 Sed Rate - A 201 Sed Rate - B (Polymedco Sedimat 15) 202 Sed Rate - C (HemaTech ESR STAT) 203 Sed Rate - D (Alcor i-Sed) 237 Sickle Cell Screening 244 Thromboelastogram IMMUNOLOGY 421 ANA - EIA & IFA methods 429 ANA - Latex kits 424 ASO 423 Anti-CCP 425 CRP - High Sensitivity 413 CRP - Qualitative 431 CRP - Quantitative 419 Diagnostic Allergy 437 Additional Diagnostic Allergy 420 H. pylori Antibody 430 HSV-2 Antibody 432 Rapid HIV - 5 433 Rapid HIV - 2 407 Immunology Package 436 Immunoproteins / C3 & C4 411 Infectious Mono & Rheumatoid Factor 410 Infectious Mononucleosis - 5 910 Infectious Mononucleosis - 2 418 Lyme Disease 428 Mycoplasma Antibody 408 Rheumatoid Factor 415 Rubella 409 Serum HCG 416 Syphilis Serology 417 Viral Markers ► IMMUNOHEMATOLOGY 511 ABO / Rh 516 Antibody Elution 519 Antibody Titer - A 520 Antibody Titer - D 521 Antibody Titer - AD 517 Automated Blood Bank 512 Blood Bank 514 Direct Antiglobulin Testing 534 DAT Automated 518 Educational Blood Bank 532 Blood Bank w/ Electronic Crossmatch 537 Auto Blood Bank w/ Electronic Crossmatch 515 Fetal RBC ► 513 Rh Slide Test MICROBIOLOGY 335 Acid Fast Smears 359 Bacterial Vaginosis 321 Bacti Pkg. 1 (Rapid Strep A, Throat, Urine) 361 Blood Culture - Add-on 368 Blood Pathogen Panel 363 Bordetella pertussis 360 Campylobacter Antigen - Add-on 317 Candida Culture 350 C. difficile Toxin or Antigen - 5 347 C. difficile Toxin or Antigen - 2 316 Chlamydia Antigen - 5 930 Chlamydia Antigen - 2 328 Comprehensive Bacteriology 345 Cryptococcal Antigen 332 Dermatophyte Culture 369 GI Panel 342 Giardia & Crypto Antigen - 5 932 Giardia & Crypto Antigen - 2 315 GC/Group B Strep Culture - 5 929 GC/Group B Strep Culture - 2 320 Gram Stain (slides) 329 Gram Stain - Direct Smears (virtual) 330 Additional Gram Stain (slides) 312 Group A Strep Antigen - 5 912 Group A Strep Antigen - 2 913 Group A Strep Antigen - 3 365 Group B Strep (molecular) - 5 965 Group B Strep (molecular) - 2 373 HSV 1 & 2 (molecular) 339 India Ink 333 KOH Slides 340 Legionella Antigen 366 MRSA (molecular) - 2 356 MRSA Culture - 2 372 M. tuberculosis (molecular) 371 Meningitis Panel $305 $240 $240 $360 $360 $360 $265 $275 $250 $225 $240 $240 $240 $270 $235 $165 $165 $165 $225 $200 $200 $155 $160 $140 $310 $175 $90 $145 $320 $90 $150 $200 $385 $200 $435 $210 $250 $155 $90 $210 $180 $155 $155 $155 $190 $490 $295 $500 $260 $260 $360 $540 $405 $200 $240 $195 $715 $850 $290 $165 $200 $170 $280 $185 $485 $350 $135 $320 $205 $140 $315 $110 $300 $160 $260 $450 $260 $155 $240 $110 $170 $180 $110 $185 $100 $120 $240 $110 $450 $175 $175 $140 $105 $105 $350 $450 MICROBIOLOGY (continued) 344 Mycobacteriology Culture ► 331 Mycology Culture 374 Mycoplasma pneumoniae (molecular) 311 Chlamydia/GC Nucleic Acid 334 Parasitology 337 Parasitology Panel (Triage) 370 Respiratory Panel 348 Rotavirus - 5 349 Rotavirus - 3 341 S. pneumoniae Antigen 343 Shiga Toxin 364 Strep Pharyngeal (molecular) - 5 964 Strep Pharyngeal (molecular) - 2 313 Throat Culture - 5 952 Throat Culture - 2 953 Throat Culture - 3 924 Urine Culture - 2 314 Urine Culture - 5 324 Vaginitis Screen 357 VRE Culture 367 VRE (molecular) 362 Trichomonas 322 Virology Package - 5 942 Virology Package - 2 933 Virology Package - waived methods - 2 VERIFICATION PROGRAMS $350 $315 $350 $385 $270 $270 $485 $285 $165 $140 $225 $240 $110 $250 $110 $115 $175 $265 $360 $105 $105 $290 $320 $170 $160 CMS only requires PT for one instrument/method. The programs below are to test and report another instrument/method after the PT due date. No results will be reported to CMS or other regulatory agencies. The primary catalog number is shown in parenthesis next to each verification program. See page 26 of our online catalog for more details. Contact us at 800-333-0958 or [email protected] if you need assistance. J16 ACT - Hemochron (916) J17 ACT - Medtronic (917) A37 Alcohol (137) A38 Ammonia (138) E17 Auto Blood Bank (517) E12 Blood Bank (512) A11 Blood Gas (111) A12 Blood Gas Plus (112) A14 Blood Oximetry (114) A40 Cardiac Markers (140) J20 Cardiac Markers (920) A20 Chemistry 1 (120) A21 Chemistry 2 (121) A22 Chemistry 3 (122) B14 CoaguChek XS Plus (214) J14 CoaguChek XS Plus (914) B17 Coagulation (217) E14 DAT (514) B46 D-dimer quant (246) B39 Gastric Occult Blood A27 Glycohemoglobin (127) J12 Group A Strep Antigen – 2 (912) B20 Hematology - 5C2 (230) B21 Hematology - 3 (221) B27 Hematology - 3S (227) B30 Hematology - 5C (230) B31 Hematology - 5A (231) B38 Hematology - 5S (238) B40 Hematology - 5B (240) B41 Hematology - 5E (241) B42 Hematology - 5D (242) J28 HemoCue (928) B47 Hemochron Jr. ACT-LR (247) B48 Hemochron Jr. ACT+ (248) A33 Immunoassay (133) A60 Immunoassay 2 (160) B15 i-STAT ACT (215) A45 i-STAT Chemistry (145) J45 i-STAT Chemistry-waived (945) B16 i-STAT CoaguSense PT/INR (216) A29 Neonatal Bilirubin (129) B33 PPM (233) D33 Rapid HIV (433) A36 TDM - Add-on to Chem (136) B32 Urinalysis, HCG & FOB (232) A39 Urine Drug Screen (139) B35 Urine HCG-5 (235) C22 Virology Package (322) J33 Virology Package – waived (933) B51 Waived & PPM Package (251) A44 Waived Chemistry (144) X23 Extra Results WBG (123) X18 Extra Results WBG (918) X51 Extra Results WBG – Waived Package (251) A23 Whole Blood Glucose (123) J18 Whole Blood Glucose (918) SUPPLEMENTAL ITEMS 957 API 3-Ring Binder (U.S. Customers Only) 958 API 3-Ring Binder Tabs Only REG Shipping & Processing $220 $175 $260 $140 $540 $405 $60 $60 $60 $170 $115 $60 $60 $60 $205 $130 $140 $160 $120 $130 $210 $95 $265 $265 $255 $305 $305 $305 $305 $305 $305 $110 $190 $190 $210 $130 $200 $150 $95 $200 $145 $125 $140 $60 $110 $190 $125 $240 $120 $175 $135 $0 $0 $0 $210 $110 $15 $0 $95 ► Some analytes within this progarm are not CAP accepted. See our online catalog for the most recent list of CAP accepted programs. Additional shipping charges may apply to Alaska and countries outside of the U.S. American Proficiency Institute accepts Discover, MasterCard, and Visa credit card payments. Please complete the form in its entirety to ensure timely processing. All information is kept confidential. Discover MasterCard Visa Hematology Instrument List www.api-pt.com Instrument Name Body Fluid Cell Count Abbott Cell-Dyn- all models Coulter AC-T, HmX, LH, MAXM, Unicel DxH- all models Iris iQ Siemens Advia 120/2120 Sysmex XE, XN, XS, XT- all models Hematology Abbott Cell-Dyn 1400 through 1800 Abbott Cell-Dyn 3000 through 5000 Abbott Cell-Dyn Emerald Abbott Cell-Dyn Emerald 22 Abbott Cell-Dyn Ruby, Sapphire CDS Medonic CA, M-Series- all models Coulter AcT-5 Coulter Ac-T – all 3 part differential models Coulter HmX, GEN-S Coulter JT, T- all models Coulter LH500, MAXM, STKS Coulter LH-750/755/780/785 Coulter Micro Diff- all models Coulter UniCel DxH 300 Coulter UniCel DxH 600, 800 Danam Datacell- all models Diatron Abacus 5 Drew (Danam) Excell 16 Drew D3, Evolution Drew Excell 22, 2280 HemoCue- all models (for WBC only) Horiba ABX 9000, 9100, Micros, Minos- all models Horiba ABX Pentra- all models Humacount Infolab Excell 16, I-1600, I-1800- all models MD Mascot 800 Mindray BC- all models QBC Autoread, Autoread Plus QBC Reader - Manual Siemens Advia 120, 2120- all models Siemens Advia 56 Siemens Advia 60 Sysmex KX Series, pocH-100i Sysmex XE, XN, XS, XT- all models Sysmex XP-300 800-333-0958 API Catalog Number 206 206 207 206 206 221 242 221 242 242 221 231 221 220 221 220 230 221 221 230 221 242 221 221 241 209 221 231 221 221 221 221 222 222 240 242 221 227 238 227 Sedimentation Rate Alcor i-Sed BD Seditainer Chase Westergren 830 SO Dispette, Dispette 2 203 228 228 228 Globe Scientific- all methods Griener SRS, SRT HemaTech ESR STAT PLUS, STAT 180 Life Science Technologies ESRA MiniVes Polymedco Sedimat 15, 15 Plus Polymedco Sedimat/Sediplast Sedifast, Sediplast, Sediten, Seditube StaRRsed Compact Statspin ESRA-10 Streck / Analys ESR, Auto ESR Plus- all methods Ulstar Scientific Sed-Pac Ves Matic- all models Vital Diagnostic Excyte- all models Winpette 228 228 202 228 228 201 228 228 228 228 228 228 228 228 228 Coagulation Instrument List www.api-pt.com 800-333-0958 Tests and Instrument Name ACT Helena Laboratories Actalyke, Cascade POC Hemochron Jr., Jr. Signature with ACT + cuvette Hemochron Jr., Jr. Signature with ACT-LR cuvette Hemochron Response, 801 IL Gem PCL with ACT + cuvette IL Gem PCL with ACT-LR cuvette I-STAT Medtronic ACT II, HMS Plus APTT/INR/Fibrinogen/Protime BBL Fibrometer Behnk (MD) Coagulator CoaguSense Coag-Sense Diaclot Elvi Diagnostica Stago Compact, Satellite, ST4, STA-R Electra- all models Helena Cascade, Thor- all models Hemochron Jr., Signature- all models with Citrate APTT cuvette Hemochron Jr., Signature- all models with Citrate PT cuvette Hemochron Jr., Signature- all models with PT cuvette IL ACL- all models IL Gem PCL, PCL Plus with Citrate PT cuvette IL Gem PCL, PCL Plus with PT cuvette i-STAT Labor American COA Systems Lancer Coagulyzer Pacific HemostatisThromboScreen- all models Roche CoaguChek XS, XS Plus, XS Pro Roche Cobas Fibro Siemens BCS, BCSXP, BFT II Sigma Accustasis- all models Sysmex CA Series Tcoag AMAX, CoagaMate, Destiny, KC- all models Tilt Tube Wescor CoaData API Catalog Number 211/916 248 247 211/916 248 247 215 212/917 217 217 216 217 217 217 217 252 249 250 217 249 250 216 217 217 217 214/914 217 217 217 217 217 217 217
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