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Oakland Sheriff's Dept Fee Schedule 02.09 CLIENT SERVICE FEE SCHEDULE NAME: OAKLAND SHERIFF'S DEPT ACCT SETUP: 2/1/87 REP ID: GRP BILL #: 22857610 GRP CD: N DISC %: FS ID: 01 FS DESCR: 2003 CLIENT FEES PRICE TYPE: SERVICE CODE SERVICE NAME UPF PRICE TEST PRICE UPF DISC IND 0000018 PLT SODIUM CITRATE $12.86 $4.37 Y 0000022 APC RESISTANCE $101.62 $34.55 Y 0000201 ACETAMINOPHEN $110.24 $37.48 Y 0000202 ACETALDEHYDE (B) $73.00 $73.00 N 0000203 ARSENIC,TISSUE $302.00 $302.00 N 0000204 DHT $182.70 $62.12 Y 0000205 ACETONE (B) $102.20 $34.75 Y 0000206 ACETYLCHOLINE $165.00 $56.10 Y 0000208 ACID PHOS, PROS, IMM $35.60 $12.10 Y 0000210 ACID PHOS, TOTAL $37.22 $12.65 Y 0000211 ACTH $110.00 $37.40 Y 0000212 AMYLASE (U) $45.45 $15.45 Y 0000213 IMMUNOFIX, UR $67.39 $22.91 Y 0000214 ETHOSUXIMIDE $112.07 $38.10 Y 0000216 ANTITHROMBIN III ACT $170.46 $57.96 Y 0000219 ALA, QUANT $107.10 $36.41 Y 0000223 ALBUMIN $22.88 $22.88 N 0000224 ALBUMIN, CSF $36.25 $12.33 Y 0000225 CYCLIC AMP, UR $205.80 $69.97 Y 0000227 ALDOLASE $32.08 $10.91 Y 0000228 A-2-MACROGLOB. $78.75 $26.78 Y 0000229 ALDOSTERONE (U) $251.58 $85.54 Y 0000230 ALDOSTERONE $207.10 $70.41 Y 0000231 ALK PHOS ISOENZYMES $61.34 $20.86 Y 0000232 AFP, FLUID W/RFX $107.40 $36.52 Y 0000233 LEUKOCYTE ALK PHOS $34.60 $11.76 Y 0000234 ALKALINE PHOSPHATASE $22.88 $22.88 N 0000235 A-1-ANTITRYPSN $40.22 $13.67 Y 0000236 AMIKACIN $99.91 $33.97 Y 0000237 AFP,TUMOR (CHIRON) $53.86 $18.31 Y 0000238 AMINO ACID SCR $87.15 $29.63 Y 0000240 RAST PANEL #103 $62.00 $62.00 N 0000241 AMPHETAMINE GC/MS $111.70 $37.98 Y 0000242 CYCLIC AMP $205.80 $69.97 Y 0000243 AMYLASE $16.42 $5.58 Y 0000248 HACKBERRY IGE $35.40 $35.40 N 0000249 ANA W/RFX $55.00 $18.70 Y 0000250 *AMIKACIN,PEAK&TROUGH $199.83 $67.94 Y 0000251 ANDROSTENEDIONE $180.65 $61.42 Y 0000252 ANTI-DIUR. HOR $223.65 $76.04 Y 0000255 ANTI-DSDNA AB, EIA $55.00 $55.00 N 0000256 ANTI-DNASE B TITER $92.61 $31.49 Y 0000257 GBM ANTIBODY $168.00 $57.12 Y 0000259 MITOCHONDRIAL W/REFL $67.12 $22.82 Y 0000261 MYOCARDIAL W/TITER $137.15 $46.63 Y 0000262 PARIETAL CELL W/TITR $73.55 $25.01 Y 0000263 SMOOTH MUSC RFX/TIT $44.05 $14.98 Y 0000264 ANTIMONY (U) $76.00 $76.00 N 0000265 ASO TITER $26.31 $8.95 Y 0000266 SKELETAL MUSC W/TITR $96.10 $32.67 Y 0000267 THYROGLOBULIN AB $37.59 $12.78 Y 0000269 ARSENIC (B) $131.00 $44.54 Y 0000270 ARSENIC (U) $131.00 $44.54 Y 0000272 NORTRIPTYLINE $53.15 $18.07 Y 0000273 IMCAP, SCALLOPS (F338) $7.43 $2.53 Y 0000275 IGG4 PANEL 400-906 $49.85 $49.85 N 0000278 BERYLLIUM (B) $79.00 $79.00 N 0000280 IGG4 FOOD PANEL #1 $180.10 $180.10 N 0000282 STREP AG TEST, GP A $23.11 $7.86 Y 0000285 BILIRUBIN, DIRECT $22.88 $22.88 N 0000287 BILIRUBIN, TOTAL $22.88 $22.88 N 0000289 BILIRUBIN, AM. FL. $53.15 $53.15 N 0000294 UREA NITROGEN (BUN) $22.88 $22.88 N 0000296 BUN/CREAT RATIO $23.53 $23.53 N 0000297 C1-EST(FUNCT) $67.75 $23.04 Y 0000298 C1-ESTERASE IN $93.94 $31.94 Y 0000299 CADMIUM (B) $131.00 $44.54 Y 0000300 COMP, C3, PRO $79.30 $26.96 Y 0000302 CALCIUM BY AA $39.40 $13.40 Y 0000303 CALCIUM $22.88 $22.88 N 0000304 IMM COMP C1Q $122.75 $122.75 N 0000305 CAFFEINE $74.05 $25.18 Y 0000306 CALCIUM,IONIZED $50.00 $17.00 Y 0000309 CARBOXYHEMOGLOBIN $58.99 $20.06 Y 0000310 CARBON DIOXIDE $22.88 $22.88 N 0000311 CAROTENE $56.54 $19.22 Y 0000312 CARISOPRODOL $122.90 $41.79 Y 0000314 CATECHOL, F&T, PL $188.76 $64.18 Y 0000318 CATECHOLAMINES, FRAC $160.68 $54.63 Y 0000319 VLDL $23.60 $8.02 Y 0000324 CEA, FL $112.50 $38.25 Y 0000326 CERULOPLASMIN $62.82 $21.36 Y 0000327 CT,DIFF PLEURAL FL $36.20 $12.31 Y 0000329 CARBAMAZEPINE, TOTAL $50.03 $17.01 Y 0000330 CHLORIDE $22.88 $22.88 N 0000331 COAG FACTOR II ACT $176.97 $60.17 Y 0000334 CHOLESTEROL, TOTAL $13.60 $4.62 Y 0000335 CHOLINESTERASE (P) $24.15 $8.21 Y 0000338 CHOLINESTERASE RBC & P $89.44 $30.41 Y 0000339 CIMETIDINE $88.00 $88.00 N 0000340 CLONAZEPAM $118.36 $40.24 Y 0000344 COAG FACTOR V ACT $176.97 $60.17 Y 0000345 COBALT $91.00 $91.00 N 0000346 COAG FACTOR VII ACT $184.05 $62.58 Y 0000347 FACTOR VIII ACTIVITY $22.88 $22.88 N 0000349 COLD HEMAGGLUTININS $22.50 $7.65 Y 0000351 COMPLEMENT C3C $28.25 $9.61 Y 0000352 COAG FACTOR IX ACT $176.97 $60.17 Y 0000353 COMPLEMENT C4C $46.13 $15.68 Y 0000354 COMPLEMENT C-5 $110.50 $37.57 Y 0000359 COAG FACT X ACT $184.05 $62.58 Y 0000360 COAG FACT XI ACT $184.05 $62.58 Y 0000361 COOMBS, DIRECT $15.49 $5.27 Y 0000362 COAG FACTOR XII ACT $184.05 $62.58 Y 0000363 COPPER $78.00 $26.52 Y 0000365 COPPER (U) $93.09 $93.09 N 0000367 CORTISOL, TOTAL $54.46 $18.52 Y 0000368 CHLORIDE, 24 HOUR UR $40.05 $13.62 Y 0000372 C-PEPTIDE $111.89 $38.04 Y 0000373 CHLORPROPAMIDE $73.00 $73.00 N 0000374 CK, TOTAL $34.00 $5.27 Y 0000375 CREATININE $22.88 $22.88 N 0000376 CRYOFIBRINOGEN, QU $42.06 $14.30 Y 0000377 CK ISOENZYMES $65.00 $22.10 Y 0000381 CREATININE (U) $16.75 $5.70 Y 0000383 CRYOGLOBULIN QL $33.70 $33.70 N 0000388 CULTURE, CSF $48.15 $48.15 N 0000389 CULTURE, BLOOD $40.40 $13.74 Y 0000391 BIOTIN $61.00 $61.00 N 0000393 NIACIN $61.00 $61.00 N 0000394 CULTURE, THROAT $34.93 $11.88 Y 0000395 CULTURE, UR ROUTINE $27.21 $9.25 Y 0000396 HCG, TOTAL (U) QL $17.29 $5.88 Y 0000397 CRYSTALS (U) $4.68 $4.68 N 0000398 CELL CT AND DIFF,CSF $36.20 $12.31 Y 0000400 CYANIDE BLOOD $114.25 $114.25 N 0000401 CYSTINE QN RANDOM UR $73.90 $25.13 Y 0000402 DHEA-SULFATE $150.00 $51.00 Y 0000403 CMV IGG AB, EIA $59.21 $20.13 Y 0000404 HEPARIN ANTI-XA $160.65 $54.62 Y 0000406 COPPER (H) $269.00 $269.00 N 0000410 DHEA, UNCONJU. $182.01 $61.88 Y 0000412 DESIPRAMINE $117.05 $39.80 Y 0000414 HITA(HEPARIN IND AB) $141.52 $48.12 Y 0000415 DIFF CT, MANUAL $10.55 $3.59 Y 0000416 DISOPYRAMIDE $92.80 $31.55 Y 0000417 DIGITOXIN $45.15 $45.15 N 0000418 DIGOXIN $44.24 $15.04 Y 0000421 DYPHYLLINE $82.00 $82.00 N 0000423 AMITRIPTYLINE $104.24 $35.44 Y 0000425 EOSINOPHIL COUNT (B) $29.30 $29.30 N 0000426 EOSINOPHIL CT, NASAL $24.55 $24.55 N 0000427 ERYTHROPOIETIN $141.02 $47.95 Y 0000429 ESTRADIOL, ORAL HRT $165.85 $56.39 Y 0000431 ESTRADIOL (U) $158.55 $53.91 Y 0000433 COMPLEMENT C-2 $104.26 $35.45 Y 0000434 ESTRIOL, UNCONJ $92.80 $31.55 Y 0000439 ESTROGEN, TOTAL $122.60 $41.68 Y 0000441 ESTROGEN, TOTAL (U) $132.30 $44.98 Y 0000442 STONE RISK DIAG PR $420.00 $420.00 N 0000443 ALCOHOL, ETHYL(B) $37.14 $12.63 Y 0000444 *GENTAMICIN,PK&TROUGH $85.29 $85.29 N 0000449 NON-EST FAT AC $69.00 $23.46 Y 0000451 MECONIUM DRUG PNL 1 $114.00 $114.00 N 0000452 NITROFURANTOIN $228.00 $228.00 N 0000453 MECODIUM DRUG PNL $114.00 $114.00 N 0000454 DRUG PANEL 5, MECON $106.70 $106.70 N 0000455 FECAL FAT QN $143.76 $48.88 Y 0000456 FUROSEMIDE $104.00 $104.00 N 0000457 FERRITIN $45.54 $15.48 Y 0000458 FIBRIN SPLIT PROD QN $50.03 $17.01 Y 0000461 FIBRINOGEN QN $25.45 $8.65 Y 0000462 EUGLOBULIN LYS $83.00 $28.22 Y 0000463 MECONIUM DRUG PNL $114.00 $114.00 N 0000464 COMPLEMENT C-6 $101.85 $34.63 Y 0000465 PLATELET CT, MANUA $23.60 $8.02 Y 0000466 FOLATE,SERUM $47.44 $16.13 Y 0000467 FOLATE, RBC $52.72 $17.92 Y 0000468 GLUCOSE, CSF $30.50 $30.50 N 0000469 A-1-AC GLYCO $78.75 $26.78 Y 0000470 FSH $57.29 $19.48 Y 0000478 GASTRIN $43.73 $14.87 Y 0000479 METHARBITAL $99.00 $99.00 N 0000480 CULTURE, NEISSERIA $24.73 $8.41 Y 0000481 GENTAMICIN $42.65 $14.50 Y 0000482 GAMMA GLUT TRANSPEP $15.74 $5.35 Y 0000483 GLUCOSE, SERUM $22.88 $22.88 N 0000484 GLUCOSE, PLASMA $20.00 $6.80 Y 0000494 GOLD (U) $76.00 $76.00 N 0000496 HEMOGLOBIN A1C, IEC $31.72 $10.78 Y 0000497 GRAM STAIN $12.25 $4.17 Y 0000498 HEP B SURF AG W/CONF $55.00 $9.63 Y 0000499 HEP B SURFACE AB QL $34.93 $11.88 Y 0000500 G-6-PD (B) $51.86 $17.63 Y 0000501 HEP B CORE AB, TOTAL $46.13 $15.68 Y 0000502 HAPTOGLOBIN $40.15 $13.65 Y 0000504 HPL $143.00 $143.00 N 0000505 HCG (TUMOR MARKER) $92.29 $31.38 Y 0000508 HEP A AB, TOTAL $62.18 $21.14 Y 0000509 HEMATOCRIT $19.05 $6.48 Y 0000510 HEMOGLOBIN (B) $19.05 $6.48 Y 0000511 HEMOGLOBIN A2(QUANT) $41.95 $41.95 N 0000512 HEP A IGM AB $90.00 $16.54 Y 0000513 FETAL HEMOGLOBIN $63.95 $21.74 Y 0000514 HEMOGLOBIN, (P) $70.93 $24.12 Y 0000518 HEMOSIDERIN STAIN $48.40 $16.46 Y 0000519 GLUCAGON $125.00 $42.50 Y 0000521 HGH $103.46 $35.18 Y 0000523 HIAA, 5-, URINE $79.32 $26.97 Y 0000525 HISTAMINE, BLD $186.84 $63.53 Y 0000526 HISTOPLASMA AB BY ID $70.05 $23.82 Y 0000528 HLA-B27 ANTIGEN $135.00 $41.09 Y 0000530 HVA,24 HR URINE $152.70 $51.92 Y 0000534 HYDROXYPROG., 17-A- $70.88 $24.10 Y 0000535 HYDROXYPRO.
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