Proficiency Testing Catalog. Approved by: CMS, COLA, TJC, U.S. State Agencies and International regulatory bodies. CAP accepted analytes offered.

Transcription

1 2016 Proficiency Testing Catalog Follow ACP on Facebook for MLE updates: Approved by: CMS, COLA, TJC, U.S. State Agencies and International regulatory bodies. CAP accepted analytes offered.

2 MLE is already known for providing prompt, courteous service to all of our customers; but now we are excited to provide the best-inclass customer service experience with personalized care from the beginning to the end of your ordering process. MLE s White Glove Concierge Service Our White Glove Concierge Service will provide: Responses to your calls within two hours (during normal business hours) Affordable test packages Assistance in choosing the appropriate test modules for your instrumentation Verification of orders within one week Analysis of your reported analyte test menu for CLIA compliance. Assistance in your entire process from ordering to submission Auto renewal of customers with their previous year s orders upon request As an extra special touch, our expert concierge team is responsible for your overall accounts and will be at your side from ordering to submission by assisting in your entire proficiency testing process. Rest assured, with our expert concierge team on the job, you can leave the worry to us. From your White Glove Concierge Team , option 5 mle@acponline.org

3 Table of Contents At a Glance Overview Overview/How MLE Works Test Index and Module Descriptions Test Index (See pages 16 and 17 for CAP Accepted Analytes listing) Hematology Blood Bank Coagulation Provider-Performed Microscopy (PPM) Urinalysis Microbiology Immunology Chemistry Waived Testing E-Notification of Waived Devices and Recalls Supplies & Services Automatic Renewal Continuing Education Online Result Reporting Off-Schedule Testing CAP Accepted Analytes , 17 Ordering and Discounts MLE DISCOUNT OFFERS Inside Back Cover Price Match Service , 20, 21 How to Order/Ordering Instructions FAQ Order Changes/Cancellations Price List Proficiency Testing Order Form Save Money! Price Matching for Unmatched Service Found a lower price? We ll match it! Complete the MLE Price Match Request Form (pages 20-21), 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. Customer Service Hours and Contact Information Monday through Friday from 9:00 a.m. to 5:00 p.m. ET Telephone: , option 5 mle@acponline.org Fax: Web: Enrollment/Renewal of Proficiency Testing Enroll early to ensure the availability of specimens for the 2016 program year. Once we process your order, you will be mailed an order verification for your review and signature. Online Order Form: Visit Click on the Enrollment Information link. Complete the appropriate electronic order form to automatically calculate pricing, and you will receive an order summary page. MLE PT Order Form: Detach the order form on page 24, complete it and fax it. (If submitting a purchase order, please fax.) Fax: Mail: Mailing Form with Payment AC003 American College of Physicians 190 N. Independence Mall West Philadelphia, PA Method of 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 Proficiency Testing Provides laboratories with an option for immediate, ondemand proficiency testing, a complement to the regular scheduled proficiency testing. For more details on this service, see page 15. Educational Resources Mailing Form w/o Payment ACP/MLE Suite Massachusetts Ave. NW Washington, DC For a listing of Educational Resources, including the G2 NIR publication, please see our web site at: Medical Laboratory Evaluation

4 Test Index CMS regulated analytes for CLIA purposes are in bold type. ABO Group Acetaminophen Acetone Affirm VPIII (DNA) Albumin , 12 Alcohol, Serum Alkaline Phosphatase , 12 Allergy Testing Alpha-fetoprotein (AFP) ALT (SGPT) , 12 Ammonia Amylase , 12, 14 Anti-dsDNA Anti-HAV (IgM) Anti-HAV (Total/IgG) Anti-HBc (IgM) Anti-HBc (Total/IgG) Anti-HBs Anti-HCV Anti-HIV Waived methods Anti-RNP Anti-RNP/Sm Anti-SSA Anti-SSA/SSB Anti-SSB Anti-Sm Anti-Streptolysin O (ASO) Antibody Identification Antimicrobial Susceptibility Testing Antinuclear Antibody (ANA) Apolipoprotein A Apolipoprotein B AST (SGOT) , 12 Beta (b)-2 Microglobulin Bilirubin, Total , 12 Bilirubin, Direct , 13 Bilirubin, Neonatal Blood Cell Identification Blood Culture Blood Gases Blood Smear BNP C-Peptide CA CA CA CA 27/ Calcium , 12, 14 Calcium, Ionized , 13 Candida, Affirm VPIII(DNA) Carbamazepine CEA C. difficile Chlamydia (EIA/DNA) Chloride , 12, 13, 14 Cholesterol, Total , 12 CK-MB CO , 12 Colony Count Compatibility Testing Complement C Complement C Cortisol C-Reactive Protein (CRP) , 10 C-Reactive Protein, high sensitivity (HS-CRP) Creatine Kinase (CK) , 12 Creatinine, Serum , 12 Creatinine, Urine , 14 Crossmatch Cryptosporidium, Antigen Detection Crystal Screening CSF Culture D-Dimer Dermatophyte Screen DHEA-S Differential, Automated Digoxin Drug Screen, Urine Eosinophils, Nasal (PPM) , 7, 15 Estradiol Fecal Leukocytes (PPM) , 7, 15 Fecal Occult Blood , 15 Fecal Suspension, parasitology Fern Testing (PPM) , 7, 15 Ferritin Fibrinogen Fluid Cell Count Folate Fructosamine FSH Gardnerella, Affirm VPIII (DNA) GC (EIA/DNA) Genital Culture , 9 Gentamicin GGT , 12 Giardia lamblia, Antigen Detection Glucose, serum , 12 Waived methods , 11, 14, 15 Whole blood methods , 7, 14, 15 Glucose, urine Glycohemoglobin Gram Stain , 9 Gram Stain Morphology , 9 HBeAg HBsAg hcg, serum hcg, urine , 15 HDL Cholesterol , 12 Hematocrit , 11 Waived methods , 7, 11, 15 Hemoglobin , 11 Waived methods , 7, 11, 15 Hemoglobin A1C (Glycohemoglobin) Homocysteine H. pylori, Antibody Detection Medical Laboratory Evaluation 2016

5 i-stat Chemistry Waived cartridge IgA, Total IgE, Total IgG, Total IgM, Total Infectious Mononucleosis , 10 Waived methods Influenza A, Antigen Detection Waived methods Influenza B, Antigen Detection Waived methods Influenza A/B Combo, Antigen Detection Waived methods INR Insulin Iron KOH Vaginal Prep (PPM) , 7, 15 KOH Skin Prep (Slides) , 9 Lactic Acid , 13 LDH LDL Cholesterol , 12 Lead, Blood Waived methods Legionella, Antigen Detection LH Lipase Lithium Lyme Disease Serology Magnesium , 14 Microalbumin, quantitative Microalbumin, urine dipstick MRSA Screening Mycoplasma, IgG Myoglobin Nasal Eosinophils (PPM) , 7, 15 NT-proBNP Occult Blood, Fecal , 15 Osmolality Parasitology Parathyroid hormone (PTH) Partial Thromboplastin Time (APTT) or (PTT) pco ph Phenobarbital Phenytoin Phosphorus , 12, 14 Pinworms (PPM) , 7, 15 Platelet Count po Potassium , 12, 13, 14 Progesterone Prolactin Protein, Total , 12, 14 Prothrombin Time (PT) Whole blood methods (non-waived) Waived methods Provider-Performed Microscopy (PPM) , 7, 15 PSA, Total PSA, Free PVA Slide, parasitology Red Blood Cell Count , 6 Respiratory Culture Reticulocyte Count Rheumatoid Factor (RA) , 10 Rh Factor (D Type) Rotavirus, Antigen Detection RSV, Antigen Detection Waived methods Rubella, IgG Salicylate Scabies (PPM) , 7, 15 Sedimentation Rate , 6 SHBG Sodium , 12, 13, 14 Sperm (PPM) , 7, 15 Stool Culture Strep A, Antigen Detection Waived methods , 8, 15 Strep pneumoniae, Antigen Detection Syphilis Serology T3, Free T3, Total T3, Uptake T4, Free T4, Total tco Testosterone Testosterone, Bioavailable Testosterone, Free Theophylline Throat Culture Thyroglobulin Thyroglobulin antibody Thyroid Microsomal antibody TIBC Transferrin Trichomonas, Affirm VPIII (DNA) Triglyceride , 12 Troponin I Troponin T TSH UIBC Unexpected Antibody Detection Urea Nitrogen (BUN) , 12, 14 Uric Acid , 12, 14 Urine Chemistry Urine Culture Urine Dipstick , 15 Urine Drug Screen Urine hcg , 15 Urine Sediment Identification , 15 Valproic Acid Vancomycin Vitamin B Vitamin D, 25-Hydroxy Waived and PPM packages , 15 Wet Mount Preparations (PPM) , 7, 15 White Blood Cell Count , 6 Wound Culture Medical Laboratory Evaluation

6 Overview An essential tool for quality improvement, Proficiency Testing (PT) was originally developed as an educational tool to help laboratories investigate internal procedural problems and take corrective action to minimize the effect on patient results. Today, PT is the standard of competency most heavily weighed by regulatory inspectors. MLE s Proficiency Testing (PT) program is designed for easy access, simple performance, and clear reporting. PT is the practice of testing specimens of unknown values sent from an outside source. After submitting your test results, you receive data that compare your laboratory s performance with that of other labs that did the same procedures on the same specimens. All tests in the MLE Program are included in the same shipment. Ordering information and instructions start on page 18. Our Guarantee If a specimen is missing, leaking, broken, not labeled, hemolyzed, or crushed, and you contact us within three (3) working days of receipt of your kit, we will provide a replacement for the specimen(s) FREE of charge (limited to material availability) or your lab will receive a grading exception for that test. How MLE Works MLE Order Order Program Kit Test Data Evaluation Catalog Form Verification Binder Shipments Completion Processing Distribution 1 MLE sends you a catalog to review ordering options. 2 You complete an online or hard copy order form (page 24) and return it to MLE for processing. 3 MLE processes your order and sends you an Order Verification for your review and approval. This is your proof of enrollment. 4 Approximately four weeks prior to the upcoming shipment, MLE sends you a program binder to prepare for your first testing event. 5 MLE sends you scheduled shipments of test kits that include specimens to analyze in the same way that you regularly test patient specimens. 6 Upon completion of the testing, you submit your results online or mail to MLE for evaluation. 7 MLE performs statistical compilation of all participants results. 8 MLE mails or s you an evaluation report, graded according to regulatory requirements, that compares your performance with that of other laboratories that used similar methods and instruments. 4 Medical Laboratory Evaluation 2016

7 Hematology Note: Module descriptions within each category are NOT listed in numerical order. They are grouped by the type of test. Please pay close attention to instrument compatibility notes when selecting hematology modules. Questions? Contact MLE Customer Service. See Hematology Instrument List online at enroll_us.htm 210 Hematology Module $240 Includes 211 and 230. Blood Cell Identification Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count 211 Basic Hematology $228 Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count Platelet Count 212 Hemoglobin/Hematocrit $ Hemoglobin/Hematocrit Waived $147 For waived methods only. 215 Hemoglobin/Glucose $156 For HemoCue only. 223 Hematology with 5-part Differential $330 Compatible with most Abbott CELL-DYN 5-part differential instruments only. Automated Differential Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count 224 Sysmex with 3-part Differential $273 Compatible with Sysmex 3-part automated differential instruments only. Automated Differential Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count 225 Hematology with 3-part Differential $282 Compatible with most 3-part differential instruments. Sysmex users see 224. Automated Differential Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count 226 Hematology with 5-part Differential $330 Compatible with most Beckman Coulter 5-part differential instruments EXCEPT for the AcT 5diff (see 228). Automated Differential Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count 228 Hematology with 5-part Differential $330 Compatible with Beckman Coulter AcT 5diff and ABX Pentra 5-part differential instruments. Automated Differential Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count 229 Sysmex with 5-part Differential $330 Compatible with most Sysmex 5-part differential instruments only. Automated Differential Platelet Count Hematocrit Red Blood Cell Count Hemoglobin White Blood Cell Count 230 Blood Cell Identification (Add-On) $36 Same as 231. Only available with 223 through Blood Cell Identification $108 Stand-alone module. Five challenges consisting of color photographs. 240 Reticulocyte Count $210 Compatible with automated and manual reticulocyte counting methods. Not for use with brilliant cresyl blue staining methods. 247 Sedimentation Rate $168 Not for use with Sedimat 15 / 15 Plus *Sedimentation Rate is not required by CAP. Medical Laboratory Evaluation 2016 CAP accepted analytes 5

8 248 Sedimat 15 ESR $168 Compatible with the Polymedco Sedimat 15 / 15 Plus instruments only. *Sedimentation Rate is not required by CAP. 250 Fluid Cell Count/Crystals $183 Fluid for Hemocytometer cell count and color photographs for identification of crystals. Crystal Screening WBC Count RBC Count Blood Bank 450 Rh Factor (D Type) $237 For Slide Methods ONLY. 324 Roche CoaguChek XS INR $174 INR 328 i-stat Prothrombin Time $333 Compatible with the i-stat instruments only. INR Prothrombin Time 330 CoaguChek XS Plus Prothrombin Time $285 For CoaguChek XS Plus only. INR Prothrombin Time 331 CoaguChek XS Plus Prothrombin Time Waived $174 For CoaguChek XS Plus only. INR Prothrombin Time 451 ABO & Rh Factor (D Type) $276 Not for use with slide methods. 452 Blood Bank $378 Not for use with slide methods. ABO Group Rh Factor (D Type) Unexpected Antibody Detection 453 Blood Bank $396 Not for use with slide methods. ABO Group Rh Factor (D Type) Antibody Identification Unexpected Antibody Compatibility Testing Detection (Crossmatch) Coagulation Provider-Performed Microscopy 534 Provider-Performed Microscopy (PPM) $114 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. *Scabies examination is not required by CAP. 320 Coagulation Module $189 Requires 1-mL pipette (see item 121 on page 15). 535 Provider-Performed Microscopy (PPM) Add-On..$33 Same as 534. Only available with 530, 531, 532, 541. Fibrinogen Partial Thromboplastin Time INR Prothrombin Time 538 KOH Slides $153 Two fixed glass slides for determining the presence or absence of fungal elements in skin scrapings. 321 Prothrombin Time $180 Requires 1-mL pipette (see item 121 on page 15). INR Prothrombin Time 6 CAP accepted analytes Medical Laboratory Evaluation 2016

9 Urinalysis 530 Urinalysis Module $105 Includes modules 531 and 532. One challenge each unless otherwise noted in parentheses. Bilirubin ph Blood/Hemoglobin Protein Nitrite Specific Gravity Glucose Microalbumin Ketones (dipstick only) Urobilinogen Leukocyte Esterase Urine Sediment Identification (2) 531 Urinalysis Dipstick $84 hcg not included. One challenge each. Bilirubin ph Blood/Hemoglobin Protein Nitrite Specific Gravity Glucose Microalbumin Ketones (dipstick only) Urobilinogen Leukocyte Esterase 532 Urine Sediment Identification $108 Two challenges consisting of photographs. 533 Urine Sediment Identification (Add-On) $27 Same as 532. Only available with 531, 534, Urine Microalbumin/Creatinine (Add-On) $87 Same as 539. Only available with 530, 531, 541, 868, Fecal Occult Blood $105 Stand-alone module. *Fecal occult blood testing is not required by CAP. 540 Urine hcg (Add-On) $27 Same as 541. Only available with 530, Urine hcg $81 Stand-alone module. One challenge. 901 Waived and PPM Package $249 Number of challenges noted in parentheses. Fecal Occult Blood* (2) Urine hcg (1) Hemoglobin (2) Urine Sediment (2) Hematocrit (2) Strep A Antigen PPM (6)** Detection (2) Urinalysis (1) Whole Blood Glucose (2) *Fecal occult blood testing is not required by CAP. **Scabies examination is not required by CAP. 902 Basic Waived and PPM Package $210 Number of challenges noted in parentheses. Fecal Occult Blood* (2) Urinalysis (1) PPM (6)** Urine hcg (1) Strep A Antigen Urine Sediment (2) Detection (2) Whole Blood Glucose (2) *Fecal occult blood testing is not required by CAP. **Scabies examination is not required by CAP. 539 Urine Microalbumin/Creatinine $108 Stand-alone module. Compatible with quantitative and semi-quantitative (dipstick) methods. One challenge each. 537 Fecal Occult Blood (Add-On) $81 Same as 542. Only available with 530, 531, 532, 534, 541. *Fecal occult blood testing is not required by CAP. Medical Laboratory Evaluation 2016 CAP accepted analytes 7

10 Microbiology The specimens included may contain dangerous pathogens and must be treated with extreme care. These specimens must be handled and disposed of only by personnel trained to work with pathogenic microorganisms. 630 Bacteriology $306 Consists of each of the following: Urine Culture (1) Gram Stain (2) Throat Culture (1) Antimicrobial Genital Culture (1) Susceptibility Testing (1) Gram Stain Morphology (2) Plus, an additional three challenges from the following sources: blood, CSF, wound, respiratory, and/or stool for a total of 6 cultures each shipment. 640 Bacteriology $294 Urine Culture (2) Strep A Antigen Throat Culture (2) Detection (1) Gram Stain (2) Antimicrobial Genital Culture (1) Susceptibility Testing (1) Gram Stain Morphology (2) 643 Urine Culture $282 Urine Culture (5) Gram Stain (1) Antimicrobial Gram Stain Susceptibility Testing (1) Morphology (1) 644 Urine Culture/Strep A Antigen Detection......$273 Urine Culture (2) Strep A Antigen Gram Stain (1) Detection (3) Antimicrobial Gram Stain Susceptibility Testing (1) Morphology (1) 645 Urine/Throat Culture $288 Urine Culture (3) Throat Culture (2) Gram Stain (1) Antimicrobial Gram Stain Morphology (1) Susceptibility Testing (1) 647 Urine Presumptive ID/Colony Count $333 Best suited for paddle-dipping methods. Presumptive Colony Count (2) Identification (5) Antimicrobial Gram Stain (1) Susceptibility Testing (1) Gram Stain Morphology (1) 648 Colony Count* $207 *Colony Count does not contribute to the overall minimum of five bacteriology challenges! No presumptive identification may be submitted for this module. For presumptive identification, order module Urine Presumptive ID/Strep A Antigen Detection $315 Best suited for urine paddle-dipping methods. Presumptive Colony Count (2) Identification (2) Antimicrobial Gram Stain (1) Susceptibility Testing (1) (directly from Strep A Antigen sample provided) Detection (5) Gram Stain Morphology (1) 652 Urine Presumptive ID/Throat Culture $333 Best suited for urine paddle-dipping methods. Presumptive Colony Count (2) Identification (2) Antimicrobial Gram Stain (1) Susceptibility Testing (1) (directly from Throat Culture (3) sample provided) Gram Stain Morphology (1) 650 Gram Stain $177 Five fixed glass slides. Gram Stain Gram Stain Morphology 641 Throat Culture $282 Not suitable for Strep A kits. 642 Throat Culture/Strep A Antigen Detection.....$273 Throat Culture (2) Strep A Antigen Detection (3) 660 Strep A Antigen Detection $174 Not suitable for culture. 662 Strep A Antigen Detection Waived $108 For waived Strep A Antigen Detection kits only. 646 Genital Culture $282 Genital Culture (5) Gram Stain (1) Gram Stain Morphology (1) 8 CAP accepted analytes Medical Laboratory Evaluation 2016

11 654 Genital Culture (Add-On) $123 Same as 646. Only available with 641 through 645, 647, 649, 650, 652, 660, 670. Genital Culture (2) Gram Stain Gram Stain (1) Morphology (1) 668 Affirm VP III (DNA) $399 Candida sp. Trichomonas vaginalis Gardnerella vaginalis 670 Chlamydia (EIA, DNA) $ Chlamydia/GC (EIA, DNA) $354 Chlamydia trachomatis Neisseria gonorrhoeae 673 Chlamydia (EIA, DNA) Add-On $144 Same as 670. Only available with 630 through 647, 649, 650, 652, 660. Note 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 most stringent of the two. All urine culture specimens are suitable for presumptive identification (ie, growth/no growth, Gram stain interpretation) and/or definitive identification (ie, genus and/or species). The number of challenges is noted in parentheses. 678 Dermatophyte Screen $189 Appropriate for determining the presence or absence of dermatophytes. 538 KOH Slides $153 Two fixed glass slides for determining the presence or absence of fungal elements in skin scrapings. 680 Respiratory Antigen Detection Waived $186 Influenza A Influenza A/B Combo Influenza B RSV 681 Respiratory Antigen Detection $285 Influenza A Influenza A/B Combo Influenza B RSV 682 C. difficile/rotavirus Antigen Detection $249 C. difficile Toxin/ Rotavirus Common Antigen 683 Giardia lamblia/cryptosporidium Antigen Detection $300 Cryptosporidium Giardia lamblia 686 Legionella Antigen Detection $225 For use with the Binax NOW Legionella Urinary Antigen Detection kits only. 687 Streptococcus pneumoniae Antigen Detection..$225 For use with the Binax NOW Streptococcus pneumoniae Urinary Antigen Detection kit only. 690 Parasitology $276 Provides five challenges from among the following: PVA Slide (for permanent stain), Fecal Suspension (direct wet mount examination for ova and parasites), Blood Smear for Parasites. 695 MRSA Screening $267 Screening for the prescence or absence of methicillinresistant Staphylococcus aureus only. Immunology 750 Immunology Module $264 Infectious Mononucleosis Anti-Streptolysin O Rheumatoid Factor (ASO) 751 Rheumatology Module $186 Includes 763 and 764. C-Reactive Protein (2) Rheumatoid Factor (5) Not for high-sensitivity methods Medical Laboratory Evaluation 2016 CAP accepted analytes 9

12 755 Infectious Mononucleosis Waived $111 For waived Infectious Mononucleosis kits only. 762 Infectious Mononucleosis $ Infectious Mononucleosis/Rheumatoid Factor...$246 Includes 762 and Rheumatoid Factor $ C-Reactive Protein (CRP) $108 Not for high-sensitivity methods. 776 C-Reactive Protein (CRP) Add-On $57 Not for high-sensitivity methods. Only available with High-Sensitivity C-Reactive Protein (HS-CRP)...$ High-Sensitivity C-Reactive Protein (HS-CRP) Add-On $60 Only available with 750, Antinuclear Antibody (ANA) $171 For Latex methods ONLY. 778 Antinuclear Antibody (ANA) Add-On $108 Same as 766. For Latex methods ONLY. Only available with Antinuclear Antibody (ANA) $183 For non-latex methods ONLY. 779 Antinuclear Antibody (ANA)-Add-On $120 Same as 767. For non-latex methods ONLY. Only available with ANA Expanded $240 For non-latex methods ONLY. ANA Anti-SSA Anti-dsDNA Anti-SSB Anti-RNP Anti-SSA/SSB Anti-RNP/Sm Anti-Sm 783 ANA Expanded (Add-On) $180 Same as 782. Only available with 750, 751. For non-latex methods ONLY. 784 Complement/Immunoglobulins $213 Complement C3 IgG, Total Complement C4 IgM, Total IgA, Total 771 Rubella $177 For lgg methods only. 772 Syphilis Serology $198 MHA-TP RPR TPA VDRL 789 diagnostics direct Syphilis Health Check $210 TPA - For the Syphilis Health Check ONLY. RPR - For use with any RPR methods. 770 Specific Allergen Testing $336 Number of challenges noted in parentheses. Includes 2 sets of samples for large volume requirements. Does not include Total IgE. Allergen Specific IgE (14) 740 Additional Specific Allergen Material $78 Includes 1 additional set of samples for large volume requirements. Only available with 773. Allergen Specific IgE (14) 773 Diagnostic Allergy $336 Number of challenges noted in parentheses. Allergen Specific IgE (14) Total IgE (5) 774 Lyme Disease Serology $216 Anti-Borrelia burgdorferi *Lyme Disease Serology is not required by CAP CAP accepted analytes Medical Laboratory Evaluation 2016

13 775 Viral Markers $450 Anti-HAV (IgM) Anti-HAV (Total/IgG) Anti-HBc (IgM) Anti-HBc (Total/IgG) Anti-HBs Anti-HCV Anti-HIV HBeAg HBsAg 780 H. pylori Antibody Detection $ Mycoplasma $135 IgG only. 790 Anti-HIV Waived $159 For waived HIV kits only. 791 Anti-HIV $312 Chemistry Chemistry Ordering Tips If you perform chemistry panels designed to match CPT panels, see modules 813 through 816, which are configured to match CPT profiles. If you use the i-stat instrument, select modules 817, 818, or 832 which are specifically for i-stat instruments. Please pay close attention to instrument compatibility notes when selecting any of the chemistry modules. If you need further assistance, call MLE Customer Service at , option 5, or us at 811 Lipid Panel/Glucose - Waived $168 For Waived testing ONLY. Cholesterol, Total LDL Cholesterol - Calculated* Glucose Triglyceride HDL Cholesterol *LDL Cholesterol - Calculated is not required by CAP. 833 Piccolo Waived Chemistry (Add-On) $75 Same as 812. Only available with 824. NEW! 812 Piccolo Waived Chemistry $210 For the Abaxis Piccolo Instrument (waived cartridges ONLY). Albumin CO2 Phosphorus Alkaline Phosphatase Creatine Kinase Potassium ALT (SGPT) (CK) Sodium Amylase Creatinine Total Bilirubin AST (SGOT) GGT Total Protein Calcium Glucose Triglyceride Chloride HDL Cholesterol Urea Nitrogen Cholesterol LDL Cholesterol Uric Acid - Calculated* *LDL Cholesterol - Calculated is not required by CAP. 817 i-stat Chemistry $336 For i-stat analyzer only. Includes 818 and i-stat Chemistry $237 For i-stat analyzer only. Chloride Ionized Calcium Creatinine Potassium Glucose Sodium Hematocrit tco2 * Hemoglobin Urea Nitrogen *tco2 is not required by CAP. 832 i-stat Chemistry Waived $168 For i-stat analyzer (Waived cartridges only). Chloride Ionized Calcium Creatinine Potassium Glucose Sodium Hematocrit tco2 * Hemoglobin Urea Nitrogen *tco2 is not required by CAP. 810 Chemistry Module $342 Includes CMP, BMP, hepatic, thyroid and lipid profiles. Includes 821, 822, 823, 825, 827, Comprehensive Metabolic Panel $276 Includes 814, 816, Basic Metabolic Panel $216 Calcium Glucose Chloride Potassium CO2 Sodium Creatinine Urea Nitrogen Medical Laboratory Evaluation 2016 CAP accepted analytes 11

14 815 Hepatic Profile $210 Albumin Alkaline Phosphatase ALT (SGPT) AST (SGOT) Direct Bilirubin Total Bilirubin Total Protein 816 Hepatic Profile (Add-On) $45 Same as 815. Only available with 814, , 824, 826, 828, 830, Chemistry $192 Cholesterol, Total Urea Nitrogen Glucose Potassium 820 Chemistry $228 Total Bilirubin Glucose Chloride Potassium Cholesterol, Total Sodium CO2 Urea Nitrogen Creatinine Uric Acid 821 Chemistry $258 Total Bilirubin LDL Cholesterol - Chloride Direct Cholesterol, Total Potassium CO2 Sodium Creatinine Triglyceride Glucose Urea Nitrogen HDL Cholesterol Uric Acid LDL Cholesterol - Calculated* *LDL Cholesterol - Calculated is not required by CAP. 834 Additional Chemistries $216 Stand alone module. Albumin Total Protein Calcium TIBC - Calculated* Iron TIBC - Direct Lactic Acid UIBC - Direct Magnesium Uric Acid Phosphorus *TIBC - Calculated is not required by CAP. 822 Additional Chemistries (Add-On) $45 Same as 834. Only available with 814, 815, , 824, 826, 828, Enzyme Chemistry - Ship Alone $216 ALT (SGPT) Alkaline Phosphatase Amylase AST (SGOT) NEW! Creatine Kinase (CK) GGT LDH Lipase 823 Enzyme Chemistry (Add-On) $45 Same as 828. Only available with , , 824, 826, 830, Thyroid Profile $237 Alpha-fetoprotein (AFP) T3 Uptake Cortisol Thyroxine (T4) Free T3 Triiodothyronine (T3) Free Thyroxine (T4) TSH 825 Thyroid Profile (Add-On) $54 Same as 824. Only available with , , 826, 828, 830, Lipid Profile $228 Cholesterol, Total LDL Cholesterol - HDL Cholesterol Direct LDL Cholesterol - Triglyceride Calculated* *LDL Cholesterol - Calculated is not required by CAP. 827 Lipid Profile (Add-On) $45 Same as 826. Only available with , 819, 824, 828, 830, Apolipoproteins $129 Apolipoprotein A1 Apolipoprotein B 830 Therapeutic Drug Monitoring $225 Acetaminophen Lithium Theophylline Carbamazepine Phenobarbital Valproic Acid Digoxin Phenytoin Vancomycin Gentamicin Salicylate 831 Therapeutic Drug Monitoring (Add-On) $60 Same as 830. Only available with 810, , , 824, 826, 828, Serum Alcohol/Acetone $ CAP accepted analytes Medical Laboratory Evaluation 2016

15 836 Ammonia $ Blood Lead $ Blood Lead Waived $ Neonatal Bilirubin $219 Direct Bilirubin Total Bilirubin 842 Direct Bilirubin (Add-On) $39 Same as 843. Only available with 814, , 824, 826, Direct Bilirubin $ Cardiac Markers $297 Quantitative only. BNP NT-proBNP CK-MB Troponin I D-Dimer Troponin T Myoglobin 846 BNP/D-Dimer $213 B-type Natriuretic Peptide BNP* NT-proBNP D-Dimer *CAP accepted for waived methods only. 847 Blood Gases $288 Compatible with the i-stat analyzer as well as other blood gas instruments. Chloride ph Ionized Calcium po2 Lactic Acid Potassium pco2 Sodium 850 Glycohemoglobin $180 NOT compatible with Afinion analyzer. CAP accepted for waived methods only. 851 Afinion Glycohemoglobin $ Fructosamine $153 NOT compatible with the LXN Test System. 854 SHBG/Testosterone $318 Lyophilized samples. NEW! Sex Hormone Binding Testosterone, Free Globulin Testosterone, Bioavailable Testosterone 859 PSA (Add-On) $57 Same as 861. Only available with Endocrinology/Hematology/Oncology $216 CEA LH DHEA-S Progesterone Estradiol Prolactin Ferritin Testosterone Folate Transferrin FSH Vitamin B12 Homocysteine 861 PSA $ Tumor Markers $381 Beta (b)-2 Microglobulin CA 27/29 CA 125 CEA CA 15-3 Free PSA CA 19-9 PSA Thyroglobulin 863 Endocrinology $186 Lyophilized samples. C-Peptide Parathyroid hormone Insulin (PTH) Vitamin D, 25-Hydroxy 864 Thyroid Antibodies $228 Thyroglobulin Antibody Thyroid Microsomal Antibody (Anti-TPO) 865 Serum hcg $ Serum hcg (Add-On) $87 Same as 865. Only available with 810, 813, 814, 815, 819, 820, 821, 824, 826, 828, 834. Medical Laboratory Evaluation 2016 CAP accepted analytes 13

16 872 Urine Chemistry $219 Amylase Calcium Chloride Creatinine Glucose Magnesium Osmolality Phosphorus Potassium Sodium Total Protein Urea Nitrogen Uric Acid 868 Urine Drug Screen $198 For the qualitative detection of drugs in urine. 10ml each. Each challenge will include one or more of the following: Acetaminophen MDMA Amphetamines Methadone Amphetamines/ Methamphetamines Methamphetamines Methanol Barbiturates Methaqualone Benzodiazepines 6-Monoacetylmorphine Buprenorphine Opiates (Morphine Cannabinoids (THC) Trihydrate) Cocaine Metabolites Oxycodone Cotinine Phencyclidine EDDP Propoxyphene Ethanol (Alcohol) Tramadol Fentanyl Tricyclic Antidepressants LSD 870 Whole Blood Glucose $ Whole Blood Glucose Waived $ Additional Chemistry Testing Material $108 Includes all analytes in Chemistry Module 810 and Therapeutic Drug Monitoring Module 830. It is the same material used in those modules and will be shipped to your laboratory at the same time as your regular Chemistry samples. You can use it as: Extra PT material in case you have a problem and need extra testing material. A way to double-check unacceptable PT results after corrective action. An educational tool to train personnel. A means to meet the CMS quality assurance requirements for a second chemistry instrument. Waived Testing Waived Testing The Importance of Performing Proficiency Testing Certificate of Waiver (CW) laboratories must only perform waived laboratory tests. When the Centers for Medicare & Medicaid Services (CMS) began random inspections of some CW laboratories in 2002, many laboratories chose to participate in proficiency testing as a quality assurance check. MLE responded by preparing special two-sample proficiency modules, designed for the needs of the waived testing laboratory. Our custom selection of waived modules appears on the following pages. E-notification Service A value-added service to enhance the quality and safety of patient care. The notification service 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 to mle@acponline.org and request to be added to the recipient list. In the request, be sure to include your MLE ID number CAP accepted analytes Medical Laboratory Evaluation 2016

17 901 Waived and PPM Package $249 Number of challenges noted in parentheses. Fecal Occult Blood* (2) Urine hcg (1) Hemoglobin (2) Urine Sediment (2) Hematocrit (2) Strep A Antigen PPM (6)** Detection (2) Urinalysis (1) Whole Blood Glucose (2) *Fecal occult blood testing is not required by CAP. **Scabies examination is not required by CAP. 902 Basic Waived and PPM Package $210 Number of challenges noted in parentheses. Fecal Occult Blood* (2) Urinalysis (1) PPM (6)** Urine hcg (1) Strep A Antigen Urine Sediment (2) Detection (2) Whole Blood Glucose (2) *Fecal occult blood testing is not required by CAP. **Scabies examination is not required by CAP. Supplies & Services Supplies 121 Pipette 1mL $25 For use with 320 and 321. Reusable Class A volumetric pipette required for reconstitution of lyophilized proficiency testing specimens. 126 Pipette Pump $45 For use with product 121 above. 107 Hard Copy of Participant Summary for the Year..$ Additional Program Binder $15 Services Cost Effective Package for Waived Testing Automatic Program Renewal 116 Automatic Program Renewal FREE Free yourself from re-enrollment/re-ordering hassles. We ll do it for you! To enroll, add module 116 to your order. Online Result Reporting FREE To register or receive more information, send an e- mail to ptwebsupport@acponline.org. E-Notify Notification of newly waived tests and FDA Recalls delivered to your account free To sign up for E-Notify, send an to mle@acponline.org. Continuing Education MLE CEexpress FREE MLE offers continuing education through COLA s LabUniversity. MLE CEexpress courses are provided free of charge to MLE participants. Discounts available on COLA courses. Call MLE at , option 5 or us at mle@acponline.org to learn more. Publication 142 G2 s National Intelligence Report Subscription $176 Bi-weekly newsletter covering government policy for diagnostic testing and related medical services. Off-Schedule Proficiency Testing Discounted Price Starts at $200 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 PT program. Who Needs Off-Schedule Testing? Laboratories with unsuccessful performance (score of less than 80%) 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 (score of 80% or better) 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. For information on cost and availability, contact MLE Customer Service at , option 5, or us at mle@acponline.org. Medical Laboratory Evaluation 2016 CAP accepted analytes 15

18 College of American Pathologists (CAP) Accepted Analytes for the MLE PT Program As of JANUARY 1, To download, visit: HEMATOLOGY Module 210 Hematology Module Module 211 Basic Hematology Module 212 Hemoglobin/Hematocrit Module 213 Hemoglobin/Hematocrit (waived) Module 215 Hemoglobin/Glucose (waived Hemocue only) Module 223 Hematology with 5-part Differential (CL samples) Module 224 Sysmex with 3-part Differential Module 225 Hematology with 3-part Differential Module 226 Hematology with 5-part Differential (DIF samples) Module 228 Hematology with 5-part Differential (BCX samples) Module 229 Hematology with 5-part Differential (MX samples) Module 230 Blood Cell Identification (Add-On) Module 231 Blood Cell Identification Module 240 Reticulocyte Count Note: Sedimentation rate is not required by CAP COAGULATION Module 324 Roche CoaguChek XS INR Module 328 I-STAT Prothrombin Time PT/INR Module 330 CoaguCheck XS Plus PT/INR Module 331 CoaguCheck XS Plus-Waived PT/INR BLOOD BANK (IMMUNOHEMATOLOGY) Module 451 ABO & Rh Factor (D Type) Module 452 Blood Bank 1 Module 453 Blood Bank 2 EXCEPT Antibody Identification URINALYSIS Module 530 Urinalysis Module Module 539 Urine Microalbumin/Creatinine Module 531 Urinalysis Dipstick Module 540 Urine hcg (Add-On) Module 532 Urine Sediment Identification Module 541 Urine hcg Module 533 Urine Sediment Identification (Add-On) Module 901 Waived and PPM Package * Module 536 Urine Microalbumin/Creatinine (Add-On) Module 902 Basic Waived and PPM Package * Module 538 KOH slides (fungal elements) * Note: Fecal Occult Blood & Scabies Identification are not required by CAP PROVIDER-PERFORMED MICROSCOPY (PPM) Module 534 Provider-Performed Microscopy (PPM) - Except Scabies Identification Module 535 Provider-Performed Microscopy (PPM) (Add-On) - Except Scabies Identification Note: Scabies Identification is not required by CAP MICROBIOLOGY Module 630 Bacteriology 1 Module 640 Bacteriology 2 Module 643 Urine Culture Module 644 Urine Culture/Strep A Antigen Detection Module 645 Urine/Throat Culture Module 647 Urine Presumptive ID/Colony count Module 648 Colony Count Module 649 Urine Presumptive ID/Strep A Antigen Detection Module 650 Gram Stain Module 652 Urine Presumptive ID/Throat Culture Module 641 Throat Culture Module 642 Throat Culture/ Strep A Antigen Detection Module 660 Strep A Antigen Detection Module 662 Strep A Antigen Detection (waived) Module 646 Genital Culture Module 654 Genital Culture (Add On) Module 668 Affirm VP III (DNA) Module 681 Rapid Antigen Detection 1 Module 670 Chlamydia (EIA, DNA) Module 682 Rapid Antigen Detection 2 Module 673 Chlamydia (EIA, DNA) (Add On) Module 686 Legionella antigen Detection Module 675 Chlamydia/GC (EIA, DNA) Module 687 Streptococcus pneumonia Antigen detection Module 678 Dermatophyte Screen Module 695 MRSA Screening Module 680 Rapid Antigen Detection 1 (Waived) IMMUNOLOGY Module 750 Immunology Module - EXCEPT ASO Module 751 Rheumatology Module Module 755 Infectious Mononucleosis (waived) Module 761 Infectious Mononucleosis/Rheumatoid Factor Module 762 Infectious Mononucleosis Module 763 Rheumatoid Factor Module 764 C-Reactive Protein (CRP) Module 779 Antinuclear Antibody (ANA) (Add On) (ELISA) Module 771 Rubella Module 772 Syphilis Serology RPR ONLY Module 780 H. pylori Antibody Detection Module 776 C-Reactive Protein (CRP) (Add On) Module 765 High-Sensitivity C-Reactive Protein (HS-CRP) Module 766 Antinuclear Antibody (ANA) (Latex method) Module 767 Antinuclear Antibody (ANA) (ELISA) Module 777 High-Sensitivity C-Reactive Protein (HS-CRP) (Add On) Module 778 Antinuclear Antibody (ANA) (Add On) (Latex method) Module 782 ANA Expanded - ANA ONLY Module 783 ANA Expanded (Add On) - ANA ONLY Module 775 Viral Markers: Anti-HBs, Anti-HCV, Anti-HIV & HbsAg ONLY Module 790 Anti-HIV-Waived Module 791 Anti-HIV Note: Lyme Disease Serology is not required by CAP 16 Medical Laboratory Evaluation 2016

19 College of American Pathologists (CAP) Accepted Analytes for the MLE PT Program As of JANUARY 1, To download, visit: CHEMISTRY Module 810 Chemistry Module All analytes EXCEPT AFP & T Uptake * Module 811 Lipid Panel/Glucose - Waived * Module 812 Piccolo Waived Chemistry * Module 833 Piccolo Waived Chemistry (Add-On) * Module 819 Chemistry 1 Module 813 Comprehensive Metabolic Panel * Module 820 Chemistry 2 Module 814 Basic Metabolic Panel Module 821 Chemistry 3 * Module 815 Hepatic Profile Module 822 Chemistry (Add On) * Module 816 Hepatic Profile (Add On) Module 834 Additional Chemistries * Module 823 Enzyme Chemistry (Add On) Module 828 Enzyme Chemistry - Ship Alone Module 824 Thyroid Profile Module 825 Thyroid Profile (Add on) Module 826 Lipid Profile * Module 827 Lipid Profile (Add on) * * Note: For TIBC & LDL: CAP does not monitor calculated values; only direct measurement is accepted. Module 817 i-stat Chemistry 1 ** Chloride Hemoglobin From blood gas sample: Creatinine Ionized Calcium ph Glucose Potassium po2 Hematocrit Sodium pco2 Urea Nitrogen Module 818 i-stat Chemistry 2 ** Module 832 i-stat Chemistry-Waived ** ** Note: For tco2: CAP does not monitor calculated values; this analyte is not required. Module 830 Therapeutic Drug Monitoring - Digoxin & Phenytoin ONLY Module 831 Therapeutic Drug Monitoring (Add-On) - Digoxin & Phenytoin ONLY Module 841 Neonatal Bilirubin Module 842 Direct Bilirubin (Add On) Module 843 Direct Bilirubin Module 845 Cardiac Markers - EXCEPT NT-proBNP & Troponin T Module 846 BNP/D-Dimer - EXCEPT NT-proBNP. BNP accepted for waived methods only Module 847 Blood Gases - ph, po2, pco2 Module 850 Glycohemoglobin for waived methods only Module 851 Afinion Glycohemoglobin Module 860 Endocrinology/Hematology/Oncology - EXCEPT Transferrin Module 861 PSA Module 859 PSA (Add On) Module 862 Tumor Markers CA 125 CA 27/29 Free PSA CA 15-3 CEA PSA Module 863 Endocrinology 2 Parathyroid hormone (PTH) ONLY Module 865 Serum hcg Module 866 Serum hcg (Add On) Module 868 Urine Drug Screen Acetaminophen Cocaine Metabolites Oxycodone Amphetamines Ethanol Opiates (Morphine Trihydrate) Barbiturates MDMA Phencyclidine Benzodiazepines Methadone Propoxyphene Buprenorphine Methamphetamines Tricyclic Antidepressants Cannabinoids Module 870 Whole Blood Glucose Module 871 Whole Blood Glucose (waived) Medical Laboratory Evaluation

20 Frequently Asked Questions 1. Automatic Renewal Option: I do not want to worry about whether we are enrolled from year to year. Do you have an automatic renewal option? We sure do! By checking the Automatic Renewal box on the PT order form or your renewal form, you will never again have to worry about proficiency testing enrollment or placing your order for a new program year. We will automatically re-order the modules in which you participated the previous year, generate an order verification for your review, and send an order change form should you wish to add or delete modules from your renewed order. Simple. Easy. And best of all, one important management detail that you never have to worry about again! See the Cancelling an Automatic Renewal Order section for more information. 2. When to Order: When does my order have to be submitted to ensure availability of the modules I ordered? We encourage you to enroll in MLE as soon as you can to guarantee product availability. Enrolling by December 11, 2015, will ensure that you receive shipments for the entire year. Remember, payment is not due until 30 days AFTER enrollment. You may enroll any time during the year at a prorated cost depending on the availability of specimens. For every missed event that you are not enrolled, 1/3 of the module price is deducted. The annual administration fee remains. Note: The online ordering form automatically displays prorated prices. 3. Order Changes: Can I change my order at any time? Sure! We make every effort to accommodate new orders or order changes throughout the year, subject to product availability. See New Orders or Additions and Cancelling a Module for more information. 4. Irregular Order Frequency: Can I order modules outside my regular order? If so, do I have to be an MLE participant to order modules from you? Proficiency Testing is available upon request at any time during the program year (subject to product availability). Those enrolled with other PT providers are welcome to call upon MLE for help with reinstatement and compliance emergencies. See page 15 for details on off-schedule testing. 5. Individual International Orders: I live outside the United States and Canada and I am not with a distributor of MLE in my country. Please tell me about the shipping process. Individual laboratories outside the U.S. and Canada are subject to a minimum $50 fee per shipment to cover shipping costs. Some destinations may be subject to additional S/H. Contact MLE Customer Service for specific shipping pricing information. Additionally, MLE cannot replace kits that are delayed or refused entry into your country. We will not issue credit or refunds on such shipments. When enrolling in any of the MLE modules that involve hazardous material, laboratories outside the U.S., including Canadian laboratories, must send to MLE any copies of the necessary valid permits for attachment to each shipment. The shipments will not be sent without required documentation. Freight charges are not included in the commercial pricing. You will be invoiced for freight charges AFTER each shipment. These charges are due BEFORE your evaluation is mailed. 6. Individual Non-Continental U.S. Orders: Individual Non-Continental U.S. laboratories are subject to a minimum $15 fee per shipment to cover additional shipping costs (Alaska and Hawaii excluded). 7. Needing Assistance: What if I need help with my order, testing, or regulations? Who can I turn to for immediate service? Our friendly and knowledgeable MLE Customer Service Representatives are available to assist with order selection, billing, address/name changes, order changes, and regulatory information. Additionally, experienced laboratory professionals will guide you through technical issues, interpretation of your results, and steps necessary for corrective action. Changes/Cancellations New Orders or Additions All new orders must be submitted in writing to MLE. All changes to an existing order must be submitted in writing to MLE before they can be entered into the order processing system. You must send your order changes in writing at least four weeks prior to the next shipping date to avoid additional shipping fees. MLE ships three times per year. You may enroll throughout the year. Note: The MLE catalog lists prices for the full year. After the first event, module pricing is prorated. If you add a module less than four weeks prior to the next shipping date, you MAY be subject to a rush order fee. Call MLE Customer Service at , option 5, for more information. Cancelling a Module If we receive your written request for cancellation of a module(s) at least four weeks prior to the next shipping date, you will not be held accountable for payment of the module for the remaining shipments. Unless otherwise requested, we will credit your account for that amount and the credit will be applied to additions to your order or toward enrollment for the next year. If you cancel a module less than four weeks prior to the next shipping date, you are financially responsible for the cost of the module for the next shipment. You will NOT be financially responsible for subsequent shipments. For example, you cancel (in writing) a module on January 2, The first shipment (M1) is scheduled to be shipped on February 1, You are responsible for the cost of the module for M1 but not for M2 or M3. Cancelling an Analyte Please submit a Test Menu Deletion form if your laboratory reported tests during the previous event that have since been discontinued, but you are not cancelling the module. Download the form at scroll to Forms for Current Enrollees, or copy the form in your MLE Program Guide, p. 34. Cancelling the Entire Order ALL Cancellations must be requested in writing. Failure to return the Order Verfication Form and/or not paying your invoice are not indications of cancellation. We will refund any charges for unshipped specimens if we receive notification in writing four weeks prior to the next shipping date. The annual administration fee is non-refundable. Once shipped, orders for pipettes/pumps are non-refundable and non-returnable. Cancelling an Automatic Renewal Order If you are enrolled in Module 116 (automatic renewal) and wish to cancel your entire order, you are required to contact MLE in writing NO LATER THAN December 11, 2015, to avoid any charges for the upcoming year. Failure to return the Order Verfication Form and/or not paying your invoice are not indications of cancellation Medical Laboratory Evaluation 2016

21 Price Matching for Unmatched Service! Found a better price? We ll match it! MLE protects your need for budgetary constraint while providing the best possible PT service in the industry. Complete the MLE Price Match Request Form (pages 20-21), listing only the tests you actually perform. This form enables MLE to match your actual needs to our most economic offerings and save you the most money. If our prices aren t the best, we will match our competitor s pricing for the same test menu coverage. We strive to give you more of what you need without the excess! Medical Laboratory Evaluation