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2021Proficiency Testing Catalog acponline.org/mle
Approved by: CMS, COLA, TJC, U.S. State Agencies and International regulatory bodies.
Proficiency Testing at its Best.
Expert Customer ServiceEnjoy the best-in-class customer service experience with personalized care to support you from module selection to re-sult evaluation.
What you can expect:• Response to your call within two hours (during standard business hours)• Help in choosing test modules• Verification of orders within one week
Enrollment/Renewal of Proficiency TestingEnroll early to ensure the availability of specimens for the 2021 program year. Once we process your order, you will be mailed an order verification for your review and signature.
How to OrderOnline• Visit acponline.org/mle and click on the “Enrollment Information” link. Complete the appropriate electronic order form to automatically calculate pricing and receive your order summary.
MLE PT Order Form• Detach the order form on page 35, complete it and fax it. (If submitting a purchase order, please include it with your order form.)
Making a Payment Enrollments received by renewal form or order form will be invoiced within one week of activation. Auto Renewals will be invoiced in early October. Invoices are due within 30 days. Payment options include credit card (Mastercard or Visa), purchase order, or check. Overdue accounts are subject to holds and/or cancellations.
Off-Schedule/Reinstatement TestingProvides laboratories with an option for immediate, on-demand proficiency testing, a complement to the regular scheduled proficiency testing. For more details on this service, see page 2.
AT A GLANCE
Contact Information p: 1-800-338-2746, ext. 4510 (M-F, 9 a.m.- 5 p.m. ET) e: mle@acponline.org f: 1-202-835-0440 w: acponline.org/mle
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
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Table of Contents
How to Order
2 Ordering
Module Descriptions & Test Index
3 Hematology 6 Coagulation7 Blood Bank8 Provider-Performed Microscopy 9 Urinalysis & Occult Blood
11 Waived Testing Packages12 Microbiology18 Immunology21 Chemistry31 Test Index
Other Products & Services
30 Supplies & E-notification Services30 Continuing Education & Publication
Ordering and Discounts
34 Price List35 Proficiency Testing Order Form
Found a lower price? We’ll match it! Complete the MLE Price Match Request Form online, listing only the tests you actually perform. If our prices aren’t the lowest, we’ll match our competitor’s quote for the same total test menu coverage.
Save Money! Price Matching for Unmatched Service.
See Inside Back Cover for MLE Discount OFFERS.
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
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Ordering InformationMLE accepts enrollments throughout the year. Order early to ensure product specimen availability. If you are enrolling for the entire 2021 program, you should order by December 4, 2020 to ensure product specimen availability. You may enroll anytime during the program year depending on specimen availability at a prorated price.
Please call or email the ACP MLE PT team for a quote or help selecting the appropriate modules for your laboratory.
• Phone: 800-338-2746, ext. 4510
• Email: mle@acponline.org
How To Order• Online at acponline.org/mle
• Fax the completed order form included here (w/ PO if applicable) to: 1-202-835-0440
Next Steps
Order Verification: MLE will process your order and send you an Order Verification within one week for your review. Contact MLE for any corrections.
Invoice: Your invoice will follow within two weeks. Invoices may be paid by check, VISA or Mastercard. Billing terms are net 30 days. Tax ID: 23-1520302DUNS NO: 071625974
Non-Continental U.S. Orders: An additional $30 fee will be added per shipment ($90 annually), Alaska and Hawaii excluded.
Single Module Orders: An additional $20 shipping fee will be added per shipment ($60 annually).
NOTE: Overdue accounts are subject to holds and/or cancellations.
Automatic RenewalActivate Automatic Renewal to ensure uninterrupted yearly enrollment. Prior to the next program year, you will receive an Order Verification for review in late summer and your annual invoice in October. You may make any changes at this time.
Order Changes and CancellationsAll order changes/cancellations/additions must be made in writing. To avoid additional costs, MLE must be notified at least 4 weeks prior to the affected shipment date.
Module additions: Modules may be added throughout the year, depending on availability, at least 4 weeks prior to the next shipment at no additional cost. After that time, an addi-tional shipping fee will apply.
Module cancellations: Modules may be cancelled through-out the year. Cancellation requests received at least 4 weeks prior to the next shipment will be prorated. After that time, we will only be able to cancel any remaining shipments and you will be financially responsible for the uncancelled ship-ment.
Analyte cancellation: To cancel an analyte(s), submit a Test Menu Deletion Form available on the MLE web site.
Entire order cancellation: Order cancellations may be made at any time. Written cancellations must be received at least 4 weeks prior to the next shipment to receive a refund for that and subsequent shipments, if applicable. The annual admin-istration fee is non-refundable.
Automatic Renewal order cancellation: Written notification must be received no later than December 4, 2020 to avoid any charges for the upcoming year.
Off-Schedule Proficiency Testing Off-schedule proficiency testing (PT) provides laboratories with immediate, on-demand, customized proficiency testing for reinstatement or remedial purposes; a complement to the regularly scheduled PTprogram.
Who Needs Off-Schedule Testing?
• Laboratories with unsuccessful performance for two out of three regular testing events may be required to perform off-schedule PT to lift a “cease-testing” order from their regulatory or accrediting agency. In these cases, two acceptable proficiency performances may be required for the lab to resume testing patients.
• Some laboratories use off-schedule PT to verify that corrective actions were effective. This service is available to every laboratory, regardless of MLE enrollment status.
Contact MLE Customer Service for information on cost and availability at 1-800-338-2746, ext. 4510, or e-mail us at mle@acponline.org.
Failure to return the Order Verification form and/or not paying your invoice are NOT indications of cancellation. Notification must be submitted in writing.
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
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Hematology
210 Hematology Module................................................................................$279
Five challenges each. Blood Cell Identification Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count
212 Hemoglobin/Hematocrit/WBC...............................................................$237
Five challenges each.
213 Hemoglobin/Hematocrit—Waived.........................................................$177 For waived methods only.
Two challenges each.
215 Hemoglobin/Glucose...............................................................................$195 For HemoCue only.
Two challenges each.
223 Hematology with 5-part Differential.....................................................$372 Compatible with most Abbott CELL-DYN 5-part differential instruments only. Five challenges each. Automated Differential Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count
224 Sysmex with 3-part Differential.............................................................$330 Compatible with Sysmex 3-part automated differential instruments only.
Five challenges each. Automated Differential Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count
Pay close attention to instrument compatibility notes when selecting hematology modules. Questions? Contact MLE Customer Service. See the “Hematology Instrument List” online at www.acponline.org/mle in the Enrollment Information & Forms section.
Continued on next page
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225 Hematology with 3-part Differential.....................................................$321 Compatible with most 3-part differential instruments EXCEPT Sysmex (see 224).
Five challenges each. Automated Differential Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count
226 Hematology with 5-part Differential.....................................................$372 Compatible with most Beckman–Coulter 5-part differential instruments EXCEPT for the AcT 5diff (see 228).
Five challenges each. Automated Differential Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count
228 Hematology with 5-part Differential.....................................................$372 Compatible with Beckman Coulter AcT 5diff and ABX Pentra 5-part differential instruments.
Five challenges each. Automated Differential Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count
229 Sysmex Hematology with 5 or 6-part Differential...............................$372 Compatible with most Sysmex 5 or 6 part differential instruments only.
Five challenges each. Automated Differential Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count Immature Granulocytes
Continued on next page
Hematology (continued)
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Hematology (continued)
231 Blood Cell Identification..........................................................................$138 Stand-alone module.
Five challenges consisting of color photographs.
230 Blood Cell Identification (Add-On)..........................................................$48 Same as 231. Only available with 223 through 229.
240 Reticulocyte Count...................................................................................$243 Compatible with automated and manual reticulocyte counting methods. Not for use with brilliant cresyl blue staining methods.
Two challenges.
247 Sedimentation Rate.................................................................................$195 Not for use with Sedimat 15 / 15 Plus. Not compatible with Alcor ISED.
Two challenges.
248 Sedimat 15 ESR........................................................................................$195 Compatible with the Polymedco Sedimat 15 / 15 Plus instruments only.
Two challenges.
250 Fluid Cell Count/Crystals.........................................................................$231 Fluid for Hemocytometer cell count and color photographs for identification of crystals.
Two challenges each. Crystal Screening RBC Count WBC Count
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Coagulation
320 Coagulation Module ................................................................................$228 Requires 1 mL pipette (see item 121 on page 30).
Five challenges each. Fibrinogen INR Partial Thromboplastin Time Prothrombin Time
324 Roche CoaguChek XS INR—Waived......................................................$213 Not for use with CoaguChek XS Plus/Pro. (see 331)
Two challenges. INR
328 i-STAT Prothrombin Time.......................................................................$369 Compatible with the i-STAT instruments only.
Five challenges each. INR Prothrombin Time
330 CoaguChek XS Plus/Pro PT/INR............................................................$321 For CoaguChek XS Plus/Pro only.
Five challenges each. INR Prothrombin Time
331 CoaguChek XS Plus/Pro PT/INR—Waived............................................$213 For CoaguChek XS Plus/Pro only.
Two challenges each. INR Prothrombin Time
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
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Blood Bank
451 ABO & Rh Factor (D Type)......................................................................$309 Not for use with slide methods.
Five challenges each.
452 Blood Bank................................................................................................$414 Not for use with slide methods. Five challenges each. ABO Group Rh Factor (D Type) Unexpected Antibody Detection
453 Blood Bank 2............................................................................................$444 Not for use with slide methods. Five challenges each. ABO Group Antibody Identification Compatibility Testing (Crossmatch) Rh Factor (D Type) Unexpected Antibody Detection
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
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Provider-Performed Microscopy
534 Provider-Performed Microscopy (PPM)...............................................$141 Color photographs depicting microscopic fields for the examination of:
Fecal Leukocytes (M2,M3) Fern Testing (M1,M3) Nasal Eosinophils (M1,M2,M3) Pinworms (M1,M2) Scabies (M1,M2) Sperm (M2,M3) Vaginal KOH Preparations (M1,M3) Vaginal Wet Mount Preparations (M1,M2,M3)
Six challenges total per shipment as indicated in parentheses above.
535 Provider-Performed Microscopy (PPM) (Add-On)................................$45 Same as 534. Only available with 530, 531, 532.
538 KOH Slides.................................................................................................$183 Two fixed glass slides for determining the presence or absence of fungal elements in skin scrapings. Two challenges.
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
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Urinalysis & Occult Blood
530 Urinalysis Module.....................................................................................$138
One challenge each unless otherwise noted in parentheses. Bilirubin Nitrite Blood/Hemoglobin pH Glucose Protein Ketones Specific Gravity Leukocyte Esterase Urobilinogen Microalbumin (dipstick) Urine Sediment Identification (2)
531 Urinalysis Module.....................................................................................$114 hCG not included. One challenge each.
Bilirubin Nitrite Blood/Hemoglobin pH Glucose Protein Ketones Specific Gravity Leukocyte Esterase Urobilinogen Microalbumin (dipstick)
541 Urine hCG..................................................................................................$105 Stand-alone module.
One challenge each.
540 Urine hCG (Add On)...................................................................................$30 Same as 541. Only available with 530, 531.
Continued on next page
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Urinalysis & Occult Blood (continued)
532 Urine Sediment Identification.................................................................$129
Two challenges consisting of photographs.
533 Urine Sediment Identification (Add-On).................................................$36
Same as 532. Only available with 531, 534.
539 Urine Microalbumin/Creatinine..............................................................$138 Stand-alone module. Compatible with quantitative and semi-quantitative (dipstick) methods.
One challenge each.
536 Urine Microalbumin/Creatinine (Add-On)..............................................$96 Same as 539. Only available with 530, 531.
542 Fecal Occult Blood...................................................................................$132 Stand-alone module.
Two challenges each.
537 Fecal Occult Blood (Add-On)....................................................................$93 Same as 542. Only available with 530, 531.
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
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Waived Testing—The Importance of Performing Proficiency Testing
Tests classified as “waived” are exempt from most federal regulations, including PT requirements. Many labs choose to participate in PT however, to ensure the quality of their patient testing. Performing PT provides an excellent indicator of the accu-racy and reliability of your waived test results. In addition, some states, third-party payers and other regulators require proficiency testing to be performed, even for CLIA-waived procedures. MLE offers economical waived order options designed for the needs of the waived testing laboratory.
901 Waived and PPM Package......................................................................$333
Number of challenges noted in parentheses.
Fecal Occult Blood (2) Urinalysis (1) Hemoglobin (2) Urine Sediment (2) Hematocrit (2) Strep A Antigen (2) PPM (6) Whole Blood Glucose (2) Strep A Antigen Detection (2)
902 Basic Waived and PPM Package ...........................................................$291 Number of challenges noted in parentheses.
Fecal Occult Blood (2) PPM (6) Strep A Antigen Detection (2)
Waived Testing Packages
Urinalysis (1)Urine hCG (1)Urine Sediment (2)Whole Blood Glucose (2)
Urinalysis (1)Urine hCG (1)Urine Sediment (2)Whole Blood Glucose (2)
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
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Microbiology
Bacteriology
630 Bacteriology 1..........................................................................................$351 Six cultures per shipment consisting of the following: Antimicrobial Susceptibility Testing (1) Genital Culture (1) Gram Stain (2) Gram Stain Morphology (2) Miscellaneous Culture (3) * Throat Culture (1) Urine Culture (1) *Possible sources include: Blood, CSF, Ear, Eye, Sputum, Stool, Wound.
640 Bacteriology 2...........................................................................................$333 Antimicrobial Susceptibility Testing (1) Genital Culture (1) Gram Stain (2) Gram Stain Morphology (2) Strep A Antigen Detection (1) Throat Culture (2) Urine Culture (2)
Continued on next page
• Federal law requires a minimum of five CMS regulated (non-waived methods) bacteriology challenges per shipment. Individual state laws may differ. When enrolling, ensure your order meets the requirement that is the more stringent of the two. The number of challenges is noted in parentheses.
• All urine culture specimens are suitable for presumptive identification and/or definitive identification.
Note: The specimens included may contain dangerous pathogens and must be treat-ed with extreme care. These specimens must be handled and disposed of only by personnel trained to work with pathogenic microorganism.
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643 Urine Culture...............................................................................................$324 Antimicrobial Susceptibility Testing (1) Gram Stain (1) Gram Stain Morphology (1) Urine Culture (5)
647 Urine Presumptive ID/Colony Count .......................................................$363 Best suited for paddle-dipping methods.
Antimicrobial Susceptibility Testing (1) Colony Count (2) Gram Stain (1) Gram Stain Morphology (1) Urine Presumptive Identification (5)
648 Colony Count..............................................................................................$228 Colony Count does not contribute to the minimum of five bacteriology challenges. No presumptive identification may be submitted for this module.
Two challenges.
653 Genital/Urine Culture.................................................................................$327 Antimicrobial Susceptibility Testing (1) Genital Culture (3) Gram Stain (2) Gram Stain Morphology (2) Urine Culture (2)
646 Genital Culture...........................................................................................$324 Gram Stain (1) Gram Stain Morphology (1) Genital Culture (5)
Continued on next page
Mircrobiology (continued)
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Mircrobiology (continued)
645 Urine/Throat Culture...............................................................................$327 Antimicrobial Susceptibility Testing (1) Gram Stain (1) Gram Stain Morphology (1) Throat Culture (2) Urine Culture (3)
652 Urine Presumptive ID/Throat Culture ..................................................$363 Best suited for urine paddle-dipping methods.
Antimicrobial Susceptibility Testing (1) Colony Count (2) Gram Stain (1) Gram Stain Morphology (1) Urine Presumptive Identification (2) Throat Culture (3)
641 Throat Culture.........................................................................................$324 Not suitable for Strep A kits.
Five challenges.
660 Strep A Antigen Detection....................................................................$201 Not suitable for culture.
Five challenges.
662 Strep A Antigen Detection—Waived....................................................$132 For waived Strep A Antigen Detection kits only.
Two challenges.
650 Gram Stain...............................................................................................$204 Five fixed glass slides.
Five challenges each. Gram Stain Gram Stain Morphology
Continued on next page
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Mircrobiology (continued)
651 Miscellaneous Cultures (Add-On)........................................................$189 Only available with 640 through 647, 652, 653. Miscellaneous Culture (3) Possible sources include: Blood, CSF, Ear, Eye, Sputum, Stool, Wound.
695 MRSA Culture.........................................................................................$297 Screening for the presence or absence of methicillin-resistant Staphylococcus aureus only.
Five challenges.
686 Legionella Antigen Detection..............................................................$261 For use with Binax NOW Legionella Urinary Antigen Detection kits only.
Five challenges.
687 Streptococcus pneumoniae Antigen Detection................................$267 For use with Binax NOW Streptococcus pneumoniae Urinary Antigen Detection kit only.
Five challenges.
682 C. difficile/Rotavirus Antigen Detection.............................................$291
Five challenges each. C. difficile Rotavirus
675 Chlamydia/GC (EIA, DNA)...................................................................$378
Five challenges each. Chlamydia trachomatis Neisseria gonorrhoeae
673 Chlamydia/GC (EIA, DNA)—Add-On ...................................................$189 Same as 675. Only available with 630 through 647, 652, 653.
Two challenges.Continued on next page
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668 Affirm VP III (DNA)..................................................................................$399
Five challenges each. Candida sp. Trichomonas vaginalis Gardnerella vaginalis
692 Bacterial Vaginosis—Waived..................................................................$192 For Sekisui OSOM BVBlue Test
Two challenges. Bacterial Vaginosis Screen
693 Trichomonas vaginalis—Waived............................................................$192 For Sekisui OSOM Trichomonas Rapid Test Two challenges. Trichomonas vaginalis
Mycology
678 Dermatophyte Culture...........................................................................$282
Five challenges.
538 KOH Slides..............................................................................................$183 Two fixed glass slides for determining the presence or absence of fungal elements in skin scrapings.
Two challenges.
Mircrobiology (continued)
Continued on next page
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Parasitology
683 Cryptosporidium/Giardia lamblia Antigen Detection.......................$342
Five challenges each. Cryptosporidium Giardia lamblia
690 PVA Slides (Add On).................................................................$180 Only available with 691. Zinc polyvinyl alcohol fixed glass slides for the identification of fecal parasites.
Two challenges.
691 Parasitology................................................................................$345 Number of challenges noted in parentheses.
Fecal Suspension (4) Blood Smear (1)
Virology
681 Respiratory Antigen Detection.............................................................$321
Five challenges each. Influenza A RSV Influenza B
680 Respiratory Antigen Detection—Waived..............................................$213 For waived kits only.
Two challenges each. Influenza A RSV Influenza B
Mircrobiology (continued)
NEW!
NEW!
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
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Immunology
750 Immunology Module..............................................................................$333
Five challenges each. Anti-Streptolysin O (ASO) Infectious Mononucleosis Rheumatoid Factor
761 Infectious Mononucleosis/Rheumatoid Factor...................................$315
Five challenges each.
762 Infectious Mononucleosis......................................................................$213
Five challenges.
755 Infectious Mononucleosis—Waived ......................................................$135 For waived Infectious Mononucleosis kits only.
Two challenges.
751 Rheumatology Module..........................................................................$252 Number of challenges noted in parentheses.
C-Reactive Protein (2) (Not for high-sensitivity methods) Rheumatoid Factor (5)
763 Rheumatoid Factor..................................................................................$207 For IgG methods only.
Five challenges.
764 C-Reactive Protein (CRP).......................................................................$129 Not for high-sensitivity methods (see 765).
Two challenges.
Continued on next page
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776 C-Reactive Protein (CRP)—Add-On..........................................................$63 Not for high-sensitivity methods. (see 777) Same as 764. Only available with 750.
765 High-Sensitivity C-Reactive Protein (HS-CRP).....................................$138
Two challenges.
777 High-Sensitivity C-Reactive Protein (HS-CRP)—Add-On......................$69 Same as 765. Only available with 750 and 751.
782 ANA Panel................................................................................................$291
Five challenges each. ANA Anti-SSA Anti-dsDNA Anti-SSA/SSB Anti-RNP Anti-SSB Anti-RNP/Sm Anti-Sm
783 ANA Panel (Add-On)...............................................................................$222 Same as 782. Only available with 750 and 751.
784 Complement/Immunoglobulins ............................................................$249
Five challenges each. Complement C3 IgG, Total Complement C4 IgM, Total IgA, Total
771 Rubella.......................................................................................................$207 For lgG methods only.
Five challenges.
780 H. pylori Antibody Detection.................................................................$180
Two challenges.
Immunology (continued)
Continued on next page
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Immunology (continued)
781 Mycoplasma Antibody...........................................................................$171
Two challenges.
772 Syphilis Serology.....................................................................................$228
Five challenges each. MHA-TP RPR TPA VDRL
775 Viral Markers............................................................................................$495
Five challenges each. Anti-HAV (IgM) Anti-HCV Anti-HAV (Total/IgG) Anti-HIV Anti-HBc (IgM) HBeAg Anti-HBc (Total/IgG) HBsAg Anti-HBs
791 Anti-HIV....................................................................................................$309
Five challenges.
790 Anti-HIV—Waived.....................................................................................$183 For waived HIV kits only.
Two challenges.
770 Specific Allergen Testing........................................................................$369 Number of challenges noted in parentheses. Includes 2 sets of samples for large volume requirements. Does not include Total IgE. Allergen Specific IgE (14)
773 Diagnostic Allergy...................................................................................$369 Number of challenges noted in parentheses. Allergen Specific IgE (14) Total IgE (5)
for large volume requirements. Does not include Total IgE. Allergen Specific IgE (14)
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Chemistry
810 Chemistry Module....................................................................................$384
Five challenges each. Albumin Glucose Alkaline Phosphatase Iron Alpha-fetoprotein Lactate (Lactic Acid) ALT (SGPT) LDH Amylase Lipase AST (SGOT) Magnesium Bilirubin, Direct Phosphorus Bilirubin, Total Potassium Calcium Protein, Total Chloride Sodium Cholesterol, HDL T3 Uptake Cholesterol, LDL - Calc Thyroxine (T4) Cholesterol, LDL – Direct TIBC - Calc Cholesterol, Total TIBC - Direct CO2 Triglyceride Cortisol Triiodothyronine (T3) Creatine Kinase (CK) TSH Creatinine UIBC - Direct Free T3 Urea Nitrogen Free Thyroxine (T4) Uric Acid GGT
Pay close attention to instrument compatibility notes when selecting any of the chemistry modules.
If you need any assistance, call MLE Customer Service at 1-800-338-2746, ext. 4510, or e-mail us at mle@acponline.org.
Continued on next page
GlucoseIronLactate (Lactic Acid)LDHLipaseMagnesiumPhosphorusPotassiumProtein, TotalSodiumT3 UptakeThyroxine (T4)TIBC - CalcTIBC - DirectTriglycerideTriiodothyronine (T3)TSHUIBC- DirectUrea NitrogenUric Acid
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813 Comprehensive Metabolic Panel.........................................................$309
Five challenges each. Albumin Lactate (Lactic Acid) Alkaline Phosphatase Magnesium ALT (SGPT) Phosphorus AST (SGOT) Potassium Bilirubin, Direct Protein, Total Bilirubin, Total Sodium Calcium TIBC - Calc Chloride TIBC - Direct CO2 UIBC - Direct Creatinine Urea Nitrogen Glucose Uric Acid Iron
812 Waived Chemistry Panel.......................................................................$234
Two challenges each. Albumin Creatine Kinase (CK) Alkaline Phosphatase Creatinine ALT (SGPT) GGT Amylase Glucose AST (SGOT) Phosphorus Bilirubin, Total Potassium Calcium Protein, Total Chloride Sodium Cholesterol, HDL Triglyceride Cholesterol, LDL-Cal Urea Nitrogen Cholesterol, Total Uric Acid CO2
833 Waived Chemistry Panel (Add-On) ........................................................$81 Same as 812. Only available with 824.
Chemistry (continued)
Continued on next page
Magnesium
Creatinine
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824 Thyroid Profile..........................................................................................$258
Five challenges each. Alpha-fetoprotein Thyroxine (T4) Cortisol Thyroxine (T4), Free T3, Free Triiodothyronine (T3) T3 Uptake TSH
841 Neonatal Bilirubin....................................................................................$243
Five challenges each. Bilirubin, Direct Bilirubin, Total
826 Lipid Profile...............................................................................................$246
Five challenges each. Cholesterol, HDL Cholesterol, LDL - Calc Cholesterol, LDL - Direct Cholesterol, Total Triglyceride
811 Lipid Panel/Glucose—Waived.................................................................$192 For waived testing ONLY.
Two challenges each. Cholesterol, LDL - Calculated Cholesterol, HDL Cholesterol, Total Glucose Triglyceride
Chemistry (continued)
Continued on next page
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817 i-STAT Chemistry 1..................................................................................$390
Five challenges each. Calcium, Ionized pCO2 Chloride pH Creatinine pO2 Glucose Potassium Hematocrit Sodium Hemoglobin tCO2 Lactate Urea Nitrogen
818 i-STAT Chemistry 2..................................................................................$270
Five challenges each. Calcium, Ionized Hemoglobin Chloride Potassium Creatinine Sodium Glucose tCO2 Hematocrit Urea Nitrogen
832 i-STAT Chemistry—Waived.....................................................................$195
Two challenges each. Calcium, Ionized Hemoglobin Chloride Potassium Creatinine Sodium Glucose tCO2 Hematocrit Urea Nitrogen
847 Blood Gases.............................................................................................$324 Compatible with the i-STAT analyzer as well as other blood gas instruments.
Five challenges each. Chloride pH Calcium, Ionized pO2 Lactate Potassium pCO2 Sodium
Chemistry (continued)
Continued on next page
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831 Therapeutic Drugs (Add-On)...................................................................$66 Only available with 810.
Five challenges each. Acetaminophen Phenytoin Carbamazepine Salicylate Digoxin Theophylline Gentamicin Valproic Acid Lithium Vancomycin Phenobarbital
835 Serum Alcohol/Acetone..........................................................................$252
Five challenges each.
836 Ammonia...................................................................................................$180
Two challenges.
838 Blood Lead—Waived................................................................................$222
Two challenges.
845 Cardiac Markers.......................................................................................$333
Five challenges each. Quantitative only. BNP NT-proBNP CK-MB Troponin I D-Dimer Troponin T Myoglobin
846 BNP/D-Dimer............................................................................................$237
Two challenges each. BNP NT-proBNP D-Dimer
Continued on next page
Chemistry (continued)
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
26 Medical Laboratory Evaluation 2021 acponline.org/mle
860 Endocrinology/Hematology/Oncology................................................$249
Two challenges each. CEA LH DHEA-S Prealbumin Estradiol Progesterone Ferritin Prolactin Folate Testosterone FSH Transferrin Homocysteine Vitamin B12
863 Endocrinology 2.......................................................................................$219 Lyophilized samples.
Two challenges each. C-Peptide Insulin Parathyroid Hormone, Intact (PTH) Vitamin D, 25-Hydroxy
854 SHBG/Testosterone..................................................................................$342 Lyophilized samples.
Two challenges each. Sex Hormone Binding Globulin Testosterone Testosterone, Bioavailable Testosterone, Free
861 PSA.............................................................................................................$156
Two challenges.
859 PSA (Add-On)..............................................................................................$69 Same as 861. Only available with 860.
865 Serum hCG................................................................................................$198
Five challenges each.Continued on next page
Chemistry (continued)
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
27 acponline.org/mle Medical Laboratory Evaluation 2021
Chemistry (continued)
866 Serum hCG (Add-On)................................................................................$99 Same as 865. Only available with 810, 813, 817, 818, 824, 826.
862 Tumor Markers........................................................................................$399
Two challenges each. Beta (ß)-2 Microglobulin CEA CA 125 PSA CA 15-3 PSA, Free CA 19-9 Thyroglobulin CA 27/29
864 Thyroid Antibodies.................................................................................$261
Two challenges each. Thyroglobulin Antibody Thyroid Peroxidase Antibody (TPO)
850 Glycohemoglobin...................................................................................$210 Not compatible with Afinion analyzer.
Two challenges.
851 Afinion Glycohemoglobin......................................................................$225
Two challenges.
870 Whole Blood Glucose............................................................................$282
Five challenges.
871 Whole Blood Glucose—Waived.............................................................$180
Two challenges.
Continued on next page
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
28 Medical Laboratory Evaluation 2021 acponline.org/mle
872 Urine Chemistry.........................................................................................$249
Two challenges each. Amylase Phosphorus Calcium Potassium Chloride Protein, Total Creatinine Sodium Glucose Urea Nitrogen Magnesium Uric Acid Osmolality
868 Urine Drug Screen....................................................................................$240
Two challenges -10 mL each. For the qualitative detection of drugs in urine. Each challenge will include one or more of the following:
Acetaminophen MDMA Amphetamines Meperidine Amphetamines/ Methadone Methamphetamines Methamphetamines Barbiturates Methanol Benzodiazepines Methaqualone Buprenorphine 6-Monoacetylmorphine Cannabinoids (THC) Opiates (Morphine Trihydrate) Carisoprodol Oxycodone Cocaine Metabolites Phencyclidine Cotinine Propoxyphene EDDP Tramadol Ethanol (Alcohol) Tricyclic Antidepressants Fentanyl Zolpidem Hydrocodone
Continued on next page
Chemistry (continued)
LSDMDMAMeperidineMethadoneMethamphetaminesMethanolMethaqualone6-MonoacetylmorphineOpiates (Morphine Trihydrates)OxycodonePhencyclidinePropoxypheneTramadolTricyclic AntidepressantsZolpidem
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
29 acponline.org/mle Medical Laboratory Evaluation 2021
Chemistry (continued)
873 Ethyl Glucuronide (EtG) (Add-On) ..........................................................$78 Only available with 868.
Two challenges.
874 Adulterated Urine (Add-On).....................................................................$93 Only available with 868. Compatible with quantitative and semi-quantitative (dipstick) methods.
Two challenges each. Creatinine Nitrite Oxidants Specific Gravity
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
30 Medical Laboratory Evaluation 2021 acponline.org/mle
Supplies
108 MLE Program Binder.........................................................................................................................$15
121 Pipette - 1mL .....................................................................................................................................$25 Reusable Class A volumetric pipette.
126 Pipette Pump......................................................................................................................................$45 For use with product 121 above.
E-notification Service
A value-added service to enhance the quality and safety of patient care. The e-mail notification ser-vice will provide Class I and Class II recall information and field corrections pertaining to waived test devices. Class I recalls are those that have a “probable risk of harm or death” to a patient if the items remain in use. Class II recalls have a “significant risk of harm” to a patient if they remain in use.
In addition to the recall e-notification service, MLE provides:
• Notification of changes or additions to the CMS list of waived laboratory tests.• A wide array of cost-saving Waived Testing Modules for continued quality assurance at a lower cost.• A reminder prompt for notifications involving Microbiology tests, to ensure regulatory compliance for any remaining non-waived analytes.
To receive “E-Notify on Waived Tests” and the “Recalls and Field Corrections: Devices—Class I and Class II” report, send an e-mail to mle@acponline.org and request to be added to the recipient list. In the e-mail request, be sure to include your MLE ID number.
Continuing Education
MLE CEexpress...........................................................................................................................................FREE
MLE offers continuing education through COLA’s LabUniversity®. MLE CEexpress courses are pro-vided free of charge to MLE participants. Discounts available on COLA courses. Call MLE at 1-800-338-2746, ext. 4510 or e-mail us at mle@acponline.org to learn more.
Publications
142 National Intelligence Report Subscription..................................................................................$240
Monthly newsletter covering government policy for diagnostic testing and related medical services.
Other Products & Services
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
31 acponline.org/mle Medical Laboratory Evaluation 2021
CMS regulated analytes for CLIA purposes are in bold
ABO Group ...................................................................................7Acetaminophen, serum ........................................................... 25Acetaminophen, urine ............................................................. 28Acetone ...................................................................................... 25Adulterated Urine ..................................................................... 29Affirm VPIII (DNA) ..................................................................... 16Albumin ...............................................................................21, 22Alcohol, serum .......................................................................... 25Alcohol, urine ............................................................................ 28Alkaline Phosphatase ........................................................21, 22Allergy Testing .......................................................................... 20Alpha-fetoprotein (AFP) ....................................................21, 23ALT (SGPT) ..........................................................................21, 22Ammonia ................................................................................... 25Amphetamines .......................................................................... 28Amphetamines/Methamphetamines ..................................... 28Amylase, serum ..................................................................21, 22Amylase, urine ........................................................................... 28Anti-dsDNA................................................................................ 19Anti-HAV .................................................................................... 20Anti-HBc ..................................................................................... 20Anti-HBs ..................................................................................... 20Anti-HCV .................................................................................... 20Anti-HIV ...................................................................................... 20Anti-RNP ..................................................................................... 19Anti-RNP/Sm .............................................................................. 19Anti-SSA ..................................................................................... 19Anti-SSA/SSB ............................................................................. 19Anti-SSB ..................................................................................... 19Anti-Sm ....................................................................................... 19Anti-Streptolysin O (ASO) ....................................................... 18Antibody Identification ..............................................................7Antimicrobial Susceptibility Testing ....................... 12, 13, 14Antinuclear Antibody (ANA) ................................................... 19AST (SGOT) .........................................................................21, 22Automated Differential ........................................................ 3, 4Bacterial Vaginosis ................................................................... 16Barbiturates ............................................................................... 28Benzodiazepines ....................................................................... 28Beta (ß)-2 Microglobulin .......................................................... 27Bilirubin, Total .............................................................. 21, 22, 23Bilirubin, Direct ............................................................ 21, 22, 23Bilirubin, Neonatal ................................................................... 23Bilirubin, urine ...................................................................... 9, 11Blood Cell Identification ....................................................... 3, 5Blood Culture ......................................................................12, 15Blood Gases .............................................................................. 24Blood/Hemoglobin, urine .................................................. 9, 11
Blood Smear, parasitology ..................................................... 17BNP ........................................................................................... 25Buprenorphine .......................................................................... 28C-Peptide ................................................................................... 26C-Reactive Protein (CRP) ...................................................18, 19C-Reactive Protein, high sensitivity (HS-CRP) ....................... 19CA 125 ....................................................................................... 27CA 15-3 ...................................................................................... 27CA 19-9 ...................................................................................... 27CA 27/29 .................................................................................... 27Calcium, serum ...................................................................21, 22Calcium, urine ........................................................................... 28Calcium, Ionized ....................................................................... 24Candida, Affirm VPIII(DNA) ..................................................... 16Cannabinoids (THC) ................................................................. 28Carbamazepine ........................................................................ 25Carisoprodol ............................................................................. 28CEA .....................................................................................26, 27C. difficile, Antigen Detection ................................................ 15Chlamydia (EIA/DNA) .............................................................. 15Chloride, serum ........................................................... 21, 22, 24Chloride, urine .......................................................................... 28Cholesterol, HDL ........................................................ 21, 22, 23Cholesterol, LDL ......................................................... 21, 22, 23Cholesterol, Total ....................................................... 21, 22, 23CK-MB ........................................................................................ 25CO2 .....................................................................................21, 22Cocaine Metabolites ................................................................ 28Colony Count ......................................................................13, 14Compatibility Testing .................................................................7Complement C3 ....................................................................... 19Complement C4 ....................................................................... 19Cortisol .................................................................................21, 23Cotinine ...................................................................................... 28Creatine Kinase (CK) .........................................................21, 22Creatinine, serum ........................................................ 21, 22, 24 Creatinine, urine .......................................................... 10, 28, 29Crossmatch ...................................................................................7Cryptosporidium, Antigen Detection .................................... 17Crystal Screening .........................................................................5CSF Culture .........................................................................12, 15D-Dimer ...................................................................................... 25Dermatophyte Culture ............................................................ 16DHEA-S....................................................................................... 26Digoxin ...................................................................................... 25Drug Screen, Urine ................................................................... 28Ear Culture...........................................................................12, 15EDDP .......................................................................................... 28
Test Index
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
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CMS regulated analytes for CLIA purposes are in bold
Eosinophils, Nasal (PPM) ..................................................... 8, 11Estradiol ..................................................................................... 26Ethanol, urine ............................................................................ 28Ethyl Glucuronide (EtG) ........................................................... 29Eye Culture ..........................................................................12, 15Fecal Leukocytes (PPM) ....................................................... 8, 11Fecal Occult Blood .............................................................10, 11Fecal Suspension, parasitology ............................................. 17Fentanyl ...................................................................................... 28Fern Testing (PPM) ............................................................... 8, 11Ferritin ........................................................................................ 26Fibrinogen ....................................................................................6Fluid Cell Count ...........................................................................5Folate ......................................................................................... 26FSH ........................................................................................... 26Gardnerella, Affirm VPIII (DNA) ............................................. 16GC (EIA/DNA) ........................................................................... 15Genital Culture ...................................................................12, 13Gentamicin ................................................................................ 25GGT .....................................................................................21, 22Giardia lamblia, Antigen Detection ....................................... 17Glucose, serum ........................................................... 21, 22, 24Glucose, urine .................................................................9, 11, 28Glucose, whole blood................................................. 11, 23, 27Glycohemoglobin ..................................................................... 27Gram Stain .................................................................... 12, 13, 14Gram Stain Morphology ............................................. 12, 13, 14Granulocytes, Immature .............................................................4HBeAg ........................................................................................ 20HBsAg ........................................................................................ 20hCG, serum ..........................................................................26, 27hCG, urine ............................................................................ 9, 11Hematocrit .................................................................. 3, 4, 11, 24Hemoglobin ........................................................... 3, 4, 9, 11, 24Hemoglobin A1C (Glycohemoglobin) ................................... 27Homocysteine ........................................................................... 26H. pylori, Antibody Detection ................................................. 19Hydrocodone ............................................................................ 28i-STAT Chemistry ...................................................................... 24IgA, Total ................................................................................... 19IgE, Total .................................................................................... 20IgG, Total ................................................................................... 19IgM, Total .................................................................................. 19Infectious Mononucleosis ....................................................... 18Influenza A, Antigen Detection .............................................. 17Influenza B, Antigen Detection .............................................. 17INR ..............................................................................................6Insulin ......................................................................................... 26Iron .....................................................................................21, 22Ketones, urine ...................................................................... 9, 11KOH Vaginal Prep (PPM) ..................................................... 8, 11
KOH Skin Prep (Slides) ......................................................... 8, 16Lactate (Lactic Acid) ................................................... 21, 22, 24LDH ........................................................................................... 21Lead, Blood ............................................................................... 25Legionella, Antigen Detection ............................................... 15Leukocyte Esterase, urine .................................................... 9, 11LH ........................................................................................... 26Lipase ......................................................................................... 21Lithium ....................................................................................... 25LSD ........................................................................................... 28Magnesium, serum .............................................................21, 22Magnesium, urine ..................................................................... 28MDMA ........................................................................................ 28Meperidine ................................................................................ 28Methadone ................................................................................ 28Methamphetamines ................................................................. 28Methanol .................................................................................... 28Methaqualone ........................................................................... 28MHA-TP ...................................................................................... 20Microalbumin ..................................................................9, 10, 11Miscellaneous Culture .......................................................12, 156-Monoacetylmorphine ........................................................... 28MRSA Culture............................................................................ 15Mycoplasma, IgG ...................................................................... 20Myoglobin.................................................................................. 25Nasal Eosinophils (PPM) ...................................................... 8, 11Nitrite, urine .....................................................................9, 11, 29NT-proBNP ................................................................................ 25Occult Blood, Fecal ............................................................10, 11Opiates (Morphine Trihydrate) ............................................... 28Osmolality, urine ....................................................................... 28Oxidants, urine .......................................................................... 29Oxycodone ................................................................................ 28Parasitology .............................................................................. 17Parathyroid hormone (PTH) ..................................................... 26Partial Thromboplastin Time (APTT) or (PTT) .........................6pCO2 .......................................................................................... 24pH ........................................................................................... 24pH, urine ................................................................................ 9, 11Phencyclidine ............................................................................ 28Phenobarbital ........................................................................... 25Phenytoin ................................................................................... 25Phosphorus, serum .............................................................21, 22 Phosphorus, urine ..................................................................... 28Pinworms (PPM) .................................................................... 8, 11Platelet Count ......................................................................... 3, 4pO2 ........................................................................................... 24Potassium, serum ........................................................ 21, 22, 24Potassium, urine ........................................................................ 28Prealbumin ................................................................................ 26Progesterone ............................................................................. 26
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
33 acponline.org/mle Medical Laboratory Evaluation 2021
CMS regulated analytes for CLIA purposes are in bold
Prolactin ..................................................................................... 26Propoxyphene ........................................................................... 28Protein, Total, serum ..........................................................21, 22Protein, Total, urine ........................................................9, 11, 28Prothrombin Time (PT) ...............................................................6Provider-Performed Microscopy (PPM) ............................. 8, 11PSA, Total .............................................................................26, 27PSA, Free ................................................................................... 27PVA Slide, parasitology ........................................................... 17Red Blood Cell Count ............................................................ 3, 4Reticulocyte Count ......................................................................5Rheumatoid Factor (RA) ......................................................... 18Rh Factor (D Type) ......................................................................7Rotavirus, Antigen Detection ................................................. 15RPR ........................................................................................... 20RSV, Antigen Detection ........................................................... 17Rubella, IgG............................................................................... 19Salicylate .................................................................................... 25Scabies (PPM) ........................................................................ 8, 11Sedimentation Rate .....................................................................5SHBG .......................................................................................... 26Sodium, serum ............................................................. 21, 22, 24Sodium, urine ............................................................................ 28Specific Gravity, urine ....................................................9, 11, 29Sperm (PPM) .......................................................................... 8, 11Sputum Culture...................................................................12, 15Stool Culture .......................................................................12, 15Strep A Antigen Detection ........................................ 11, 12, 14Strep pneumoniae, Antigen Detection ................................. 15Syphilis Serology ...................................................................... 20T3, Free ................................................................................21, 23T3, Total ...............................................................................21, 23T3 Uptake ............................................................................21, 23T4, Free ................................................................................21, 23T4, Total ...............................................................................21, 23tCO2 ........................................................................................... 24Testosterone .............................................................................. 26Testosterone, Bioavailable ...................................................... 26Testosterone, Free .................................................................... 26Theophylline ............................................................................. 25
Throat Culture .....................................................................12, 14Thyroglobulin ............................................................................ 27Thyroglobulin antibody ........................................................... 27Thyroid Peroxidase antibody (TPO) ...................................... 27TIBC .....................................................................................21, 22Tramadol .................................................................................... 28Transferrin .................................................................................. 26Treponema pallidum (TPA) ..................................................... 20Trichomonas vaginalis, Affirm VPIII (DNA) ............................ 16Trichomonas vaginalis (OSOM-Waived) ............................... 16Tricyclic Antidepressants ......................................................... 28Triglyceride .................................................................. 21, 22, 23Troponin I .................................................................................. 25Troponin T ................................................................................. 25TSH .....................................................................................21, 23UIBC .....................................................................................21, 22Unexpected Antibody Detection ..............................................7Urea Nitrogen (BUN), serum .......................................21,22, 24Urea Nitrogen (BUN), urine ..................................................... 28Uric Acid, serum .................................................................21, 22Uric Acid, urine ......................................................................... 28Urine Chemistry ........................................................................ 28Urine Culture ................................................................ 12, 13, 14Urine Dipstick ..................................................................9, 10, 11Urine Drug Screen .................................................................... 28Urine hCG .............................................................................. 9, 11Urine Sediment Identification .......................................9, 10 ,11Urobilinogen, urine .............................................................. 9, 11Valproic Acid ............................................................................. 25Vancomycin ............................................................................... 25VDRL ........................................................................................... 20Vitamin B12 ............................................................................... 26Vitamin D, 25-Hydroxy ............................................................. 26Waived and PPM packages ..................................................... 11Wet Mount Preparations (PPM) .......................................... 8, 11White Blood Cell Count ........................................................ 3, 4Wound Culture ...................................................................12, 15Zolpidem .................................................................................... 28
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
34 Medical Laboratory Evaluation 2021 acponline.org/mle
MLE Proficiency Testing Price List
Code/Description *Full Year
HEMATOLOGY210/Hematology . . . . . . . . . . . . . . . . . . . . . . . $279212/Hemoglobin/Hematocrit/WBC . . . . . . . $237213/Hemoglobin/Hematocrit W . . . . . . . . . . $177215/Hemoglobin/Glucose—HemoCue . . . . . $195223/Abbott 5-Part Diff . . . . . . . . . . . . . . . . . . . $372224/Sysmex 3-Part Diff . . . . . . . . . . . . . . . . . . $330225/Hematology 3-Part Diff . . . . . . . . . . . . . . $321226/Hematology 5-Part Diff . . . . . . . . . . . . . . $372228/Hematology 5-Part diff- ACT 5 & Pentra 60C+ . . . . . . . . . . . . . . . . . . $372229/Hematology 5 or 6-Part diff-Sysmex . . . . . . . . . . . . . . . . . . . . . . . . . . $372230/Blood Cell Id A . . . . . . . . . . . . . . . . . . . . . . .$48231/Blood Cell Id . . . . . . . . . . . . . . . . . . . . . . . $138240/Reticulocyte Count . . . . . . . . . . . . . . . . . $243247/Sed Rate . . . . . . . . . . . . . . . . . . . . . . . . . . $195248/Sed Rate-Sedimat15 . . . . . . . . . . . . . . . . $195250/Body Fluid/Cell Ct/Crystals . . . . . . . . . . $231
COAGULATION320/Coagulation . . . . . . . . . . . . . . . . . . . . . . . $228324/Roche CoaguChek XS INR W . . . . . . . . $213328/i-STAT Prothrombin Time . . . . . . . . . . . . $369330/CoaguChek XS PLUS/Pro PT/INR . . . . . $321331/CoaguChek XS PLUS/Pro PT/INR W . . . $213
BLOOD BANK451/ABO & Rh Factor (D Type) . . . . . . . . . . . $309452/Blood Bank 1 . . . . . . . . . . . . . . . . . . . . . . $414453/Blood Bank 2 . . . . . . . . . . . . . . . . . . . . . . $444
URINALYSIS & PPM530/Urinalysis . . . . . . . . . . . . . . . . . . . . . . . . . . $138531/Urinalysis Dipstick . . . . . . . . . . . . . . . . . . $114532/Urine Sed Id . . . . . . . . . . . . . . . . . . . . . . . $129533/Urine Sed Id A . . . . . . . . . . . . . . . . . . . . . . .$36534/PPM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $141535/PPM A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$45536/Microalbumin/Creatinine—Quant A . . . . .$96537/Fecal Occult Blood A . . . . . . . . . . . . . . . . .$93538/KOH Slides . . . . . . . . . . . . . . . . . . . . . . . . $183539/Microalbumin/Creatinine—Quant . . . . . $138540/Urine hCG A . . . . . . . . . . . . . . . . . . . . . . . . .$30541/Urine hCG . . . . . . . . . . . . . . . . . . . . . . . . . $105542/Fecal Occult Blood . . . . . . . . . . . . . . . . . $132
MICROBIOLOGY630/Bacteriology 1 . . . . . . . . . . . . . . . . . . . . . $351640/Bacteriology 2 . . . . . . . . . . . . . . . . . . . . . $333641/Throat Culture . . . . . . . . . . . . . . . . . . . . . $324643/Urine Culture . . . . . . . . . . . . . . . . . . . . . . $324
645/Urine/Throat Culture . . . . . . . . . . . . . . . . $327
646/Genital Culture . . . . . . . . . . . . . . . . . . . . . $324
647/Urine Culture/Presump.ID/CC . . . . . . . . $363
Code/Description *Full Year
648/Colony Count . . . . . . . . . . . . . . . . . . . . . . $228
650/Gram Stain . . . . . . . . . . . . . . . . . . . . . . . . $204
651/Miscellaneous Culture A . . . . . . . . . . . . . $189
652/Throat Culture/Urine Presump ID . . . . . . . . . . . . . . . . . . . . . . . . . . $363
653/Genital/Urine Culture . . . . . . . . . . . . . . . $327
660/Strep A Antigen Detection . . . . . . . . . . . $201
662/Strep A AntigenW . . . . . . . . . . . . . . . . . . $132
668/Affirm VP Antigen Testing . . . . . . . . . . . $399
673/Chlamydia/GC A . . . . . . . . . . . . . . . . . . . $189
675/Chlamydia/GC (EIA, DNA ) . . . . . . . . . . $378
678/Dermatophyte Culture . . . . . . . . . . . . . . $282
680/Resp. Antigen DetectionW . . . . . . . . . . . $213
681/Resp. Antigen Detection . . . . . . . . . . . . $321
682/C. diff/Rotavirus Ag Detection. . . . . . . . $291
683/Cryptosporidium/
Giardia lamblia Ag Detection . . . . . . . . . . $342
686/Legionella Antigen Detection . . . . . . . . $261
687/Strep pneumoniae Antigen Detection.. $267
690/PVA Slides A . . . . . . . . . . . . . . . . . . . . . . . $180
691/Parasitology . . . . . . . . . . . . . . . . . . . . . . . $345
692/Bacterial Vaginosis W . . . . . . . . . . . . . . . $192
693/Trichomonas vaginalisW . . . . . . . . . . . . . $192
695/MRSA Culture . . . . . . . . . . . . . . . . . . . . . . $297
IMMUNOLOGY
750/Immunology Module . . . . . . . . . . . . . . . $333
751/Rheumatology Module . . . . . . . . . . . . . . $252
755/Infectious Mono W . . . . . . . . . . . . . . . . . . $135
761/Infect Mono/Rheumatoid Factor . . . . . . $315
762/Infectious Mono . . . . . . . . . . . . . . . . . . . . $213
763/Rheumatoid Factor . . . . . . . . . . . . . . . . . $207
764/CRP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $129
765/HS-CRP. . . . . . . . . . . . . . . . . . . . . . . . . . . . $138
770/Specific Allergen Testing . . . . . . . . . . . . $369
771/Rubella . . . . . . . . . . . . . . . . . . . . . . . . . . . . $207
772/Syphilis Serology . . . . . . . . . . . . . . . . . . . $228
773/Diagnostic Allergy . . . . . . . . . . . . . . . . . . $369
775/Viral Markers . . . . . . . . . . . . . . . . . . . . . . $495
776/CRP A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$63
777/HS-CRP A . . . . . . . . . . . . . . . . . . . . . . . . . . . .$69
780/H. pylori Antibody Detection . . . . . . . . . $180
781/Mycoplasma Antibody . . . . . . . . . . . . . . $171
782/ANA Panel . . . . . . . . . . . . . . . . . . . . . . . . . $291
783/ANA Panel A . . . . . . . . . . . . . . . . . . . . . . . $222
784/Complement/Immunoglobulins . . . . . . $249790/Anti-HIV W . . . . . . . . . . . . . . . . . . . . . . . . . $183791/Anti-HIV . . . . . . . . . . . . . . . . . . . . . . . . . . . $309
Code/Description *Full Year
CHEMISTRY810/Chemistry . . . . . . . . . . . . . . . . . . . . . . . . . $384811/Lipid Panel/GlucoseW . . . . . . . . . . . . . . $192812/Waived Chemistry Panel W . . . . . . . . . . $234813/Comp. Metabolic Panel . . . . . . . . . . . . . $309817/i-STAT Chemistry 1 . . . . . . . . . . . . . . . . . $390818/i-STAT Chemistry 2 . . . . . . . . . . . . . . . . . $270824/Thyroid Profile . . . . . . . . . . . . . . . . . . . . . $258826/Lipid Profile . . . . . . . . . . . . . . . . . . . . . . . . $246831/Therapeutic Drugs A . . . . . . . . . . . . . . . . . .$66832/i-STAT Chemistry W . . . . . . . . . . . . . . . . . $195833/Waived Chemistry Panel A W . . . . . . . . . .$81835/Serum Alcohol/Acetone . . . . . . . . . . . . . $252836/Ammonia . . . . . . . . . . . . . . . . . . . . . . . . . . $180838/Blood Lead W . . . . . . . . . . . . . . . . . . . . . . $222841/Neonatal Bilirubin . . . . . . . . . . . . . . . . . . $243845/Cardiac Markers . . . . . . . . . . . . . . . . . . . . $333846/BNP/D-Dimer . . . . . . . . . . . . . . . . . . . . . . $237847/Blood Gases . . . . . . . . . . . . . . . . . . . . . . $324850/Glycohemoglobin . . . . . . . . . . . . . . . . . . $210851/Afinion Glycohemoglobin . . . . . . . . . . . $225854/SHBG/Testosterone . . . . . . . . . . . . . . . . . $342859/PSA A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$69860/Endocrinology/Hematology/Oncol . . . $249861/PSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $156862/Tumor Markers . . . . . . . . . . . . . . . . . . . . . $399863/Endocrinology 2 . . . . . . . . . . . . . . . . . . . . $219864/Thyroid Antibodies . . . . . . . . . . . . . . . . . $261865/Serum hCG . . . . . . . . . . . . . . . . . . . . . . . . $198866/Serum hCG A . . . . . . . . . . . . . . . . . . . . . . . .$99868/Urine Drug Screening—Qual . . . . . . . . . $240870/Whole Blood Glucose . . . . . . . . . . . . . . . $282871/Whole Blood Glucose W . . . . . . . . . . . . $180872/Urine Chemistry . . . . . . . . . . . . . . . . . . . . $249873/Ethyl Glucuronide A . . . . . . . . . . . . . . . . . .$78874/Adulterated Urine A . . . . . . . . . . . . . . . . . .$93
WAIVED TESTING PACKAGES901/Waived and PPM Package W . . . . . . . . $333902/Basic Waived and PPM Package W . . . $291
SUPPLIES & SERVICES108/MLE Program Binder . . . . . . . . . . . . . . . . . .$15121/1mL Pipette . . . . . . . . . . . . . . . . . . . . . . . . . .$25126/Pipette Pump . . . . . . . . . . . . . . . . . . . . . . . .$45142/G2 NIR Subscription . . . . . . . . . . . . . . . . $240
W=Waived • A=Add-On • *Enroll after the 1st event and prices are prorated by 1/3 per event.
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
35 acponline.org/mle Medical Laboratory Evaluation 2021
1 □ New Enrollee
□ Renewing Participant: MLE ID # ______________________
2 Bill to: (please print clearly or type)
Contact _____________________________________________
Facility Name ________________________________________
Address ____________________________________________
____________________________________________________
City_______________________ State______ ZIP__________
Country (other than U.S.) _____________________________
Phone_______________________ Fax ____________________
E-mail ______________________________________________
3 Lab Director _________________________________________
4 CLIA ID# ____________________________________________
5 Ship To: (no PO boxes for kit delivery)
□ Same as “bill to” address.
Contact _____________________________________________
Facility Name ________________________________________
Address ____________________________________________
____________________________________________________
City_______________________ State______ ZIP__________
Country (other than U.S.) _____________________________
Phone_______________________ Fax ____________________
E-mail ______________________________________________
□ Ship kit to different address (attach information)
6 Send a copy of my PT results to:
□ CMS (Provide CLIA ID# in section 4)
□ State Agency ID# ___________________________________
□ COLA ID# __________________________________________
□ TJC/HCO ID# _______________________________________
□ Technical Consultant (attach name, address and email)
7 □ Activate Auto Renewal at no charge.
Module # Description Price
100 Annual Admin Fee $90
Note: An additional shipping fee may apply. Contact MLE Customer Service for details.
8 Amount Due
Total Cost of Items Above = $____________
Discount Code ____________
(Please choose only one applicable code from page 37)
+ Shipping Fee (if applicable) $____________
Total Amount Due = $____________
9 Payment Options
(Tax ID # 23-1520302) (DUNS #: 071625974)
□ Purchase Order # ___________________________________
□ Send Invoice
(Net 30 days. Payment by check or credit card —Visa
or Mastercard accepted).
Overdue accounts are subject to holds and/or cancellations.
10 How did you hear about us? _________________________
11 Laboratory Type: ___________________________________
CTLG
Take note: Cancel a module IN WRITING at least 4 weeks prior to the upcoming shipment to avoid being charged.
Fax: 1-202-835-0440E-mail: mle@acponline.org
The MLE products you have ordered may contain pathogenic material. By returning this order form, you assume all risk and responsibility in connection with the receipt, handling, storage, use, and disposal of the material.
2021 MLE Proficiency Testing Order Form
2021 SHIP DATES M1: FEBRUARY 1 • M2: MAY 10 • M3: SEPTEMBER 13
36 Medical Laboratory Evaluation 2021 acponline.org/mle
Price matching is available online. Visit acponline.org/mle
MLE DISCOUNT OFFERSYour Solution to Savings Starts Here!
*Percentage discounts are applied to module pricing only.Note: Select the eligible offer that provides the greatest discount.
We are unable to apply more than one discount offer.
Review the table below to see if you qualify for any of the discount offers.
Write the Discount Code in section 8 of the PT Order Form.
ACP
DiscountCode
Multisite
Consultant
Goverment
COLA
NEW
Savings Description EligibilityRequirements
Ongoing Discounts (applied each year enrolled in MLE)
Ongoing Discounts (applied for 2021 program only)
Save $90
*Save 5%
*Save 5%
*Save 10%
Save $90
Save $90
ACP Members
Multisite
Consultant affiliation
State and Federal agencies (including FQHC and IHS)
COLA accredited For add’l benefits, visit: www.acponline.org/mle/acp-cola
New to MLE
• Current in or new to MLE and ACP
• Current in or new to MLE• Must have 5 or more enrolled labs
• Current in or new to MLE• Order must indicate independent consultant• Consultant must have 5 or more enrolled labs
• Current in or new to MLE
• COLA accredited and new to MLE
• Never enrolled in MLE• Minimum order of $500
25 Massachusetts Avenue NW, Suite 700Washington, DC 20001-7401
Proficiency Testing at its Best.
MD9333-1
What’s New for 2021NEW MODULES
MODULE RECONFIGURATIONS
691 Parasitology 17
651 Miscellaneous Cultures - Add-On 15
860 Prealbumin (now included) 26
690 PVA Slides-Add-on 17
Module No. Description Catalog Page No.
Module No. Description Catalog Page No.
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