16
APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505 Age: Doctor, Test 4/5/1963 55 years 80139 Doctor: 4/17/2018 1:27 PM Gender: Male Received in Lab: 4/17/2018 1:27 PM CT Patient: CONSISTENT RESULTS - REPORTED MEDICATION DETECTED (PARENT DRUG AND/OR METABOLITE) REPORTED ANTICIPATED DETECTION WINDOW TEST POSITIVE(S) OUTCOME PRESCRIPTION ABILIFY Aripiprazole Plasma Half-Life: 75-94 hours POSITIVE ABILIFY Dehydro-Aripiprazole Plasma Half-Life: 75-94 hours POSITIVE ACETAMINOPHEN Acetaminophen Plasma Half-Life: 2-3 hours POSITIVE CODEINE Codeine Plasma Half-Life: 2-4 hours POSITIVE CODEINE NorCodeine Plasma Half-Life: 2-4 hours POSITIVE CODEINE Dihydrocodeine Plasma Half-Life: 4 hours POSITIVE CODEINE Morphine Plasma Half-Life: 1.3-7 hours NEGATIVE CYMBALTA Duloxetine Plasma Half-Life: 8-17 hours POSITIVE HYDROCODONE/APAP Hydrocodone Plasma Half-Life: 3.5-9 hours POSITIVE HYDROCODONE/APAP Norhydrocodone Plasma Half-Life: 3.5-9 hours POSITIVE HYDROCODONE/APAP Hydromorphone Plasma Half-Life: 1.5-4 hours NEGATIVE NEURONTIN Gabapentin Plasma Half-Life: 5-7 hours POSITIVE PALIPERIDONE 9-Hydroxyrisperidone Plasma Half-Life: 5-6 days POSITIVE INVEGA SUSTENNA 9-Hydroxyrisperidone Plasma Half-Life: 5-6 days POSITIVE PLAVIX (CLOPIDOGREL) Clopidogrel Plasma Half-Life: 7-8 hours POSITIVE SUDAFED (Pseudoephedrine) Pseudoephedrine Plasma Half-Life: 4-8 hours POSITIVE WARFARIN Warfarin Plasma Half-Life: 20-60 hours POSITIVE VITAMIN B7 (Biotin) Biotin Plasma Half-Life: 1 hour POSITIVE INCONSISTENT RESULTS - REPORTED MEDICATION NOT DETECTED (NEITHER PARENT DRUG NOR METABOLITE) REPORTED ANTICIPATED DETECTION WINDOW TEST POSITIVE(S) OUTCOME PRESCRIPTION Plasma Half-Life: 66 hours Vortioxetine NEGATIVE BRINTELLIX Plasma Half-Life: 6-7 hours Metformin NEGATIVE GLUMETZA (Metformin) Plasma Half-Life: <1 hour Omeprazole NEGATIVE PRILOSEC (Omeprazole) Plasma Half-Life: 6-7 Days Levothyroxine NEGATIVE SYNTHROID Plasma Half-Life: 7-10 hours Ziprasidone NEGATIVE GEODON Plasma Half-Life: 1 hour Pantoprazole NEGATIVE PANTOPRAZOLE Plasma Half-Life: 2 hours Simvastatin NEGATIVE SIMVASTATIN Drug Adherence Assessment Report Prescribed Medications: CYMBALTA, HYDROCODONE/APAP, NEURONTIN, CODEINE, ACETAMINOPHEN, ABILIFY, PRILOSEC (Omeprazole), BRINTELLIX, GLUMETZA (Metformin), SYNTHROID, PALIPERIDONE, GEODON, PLAVIX (CLOPIDOGREL), PREVACID (LANSOPRAZOLE), PANTOPRAZOLE, WARFARIN, SIMVASTATIN, SUDAFED (Pseudoephedrine), INVEGA SUSTENNA, VITAMIN B7 (Biotin) Printed: 4/25/2018 5:57 PM Page 1 of 11 Accession: 80139 Patient ID: 1-49505 Lab Results For: Sample report COMP Originally Reported On: 4/24/2018 1:03 PM STAT[S] Corrected [C] Added [A] Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK 74136 Main 918-561-6896 Fax 866-988-4887 CLIA # 37D2069751

Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

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Page 1: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

APPROVAL REQUIRED

Collection Date:Patient #:

COMP, Sample report Birth:

Acc #: 1-49505

Age: Doctor, Test4/5/196355 years

80139

Doctor: 4/17/2018 1:27 PMGender: Male Received in Lab: 4/17/2018 1:27 PM CT

Patient:

CONSISTENT RESULTS - REPORTED MEDICATION DETECTED (PARENT DRUG AND/OR METABOLITE)

REPORTED ANTICIPATED DETECTION WINDOWTESTPOSITIVE(S) OUTCOMEPRESCRIPTION

ABILIFY Aripiprazole Plasma Half-Life: 75-94 hoursPOSITIVE

ABILIFY Dehydro-Aripiprazole Plasma Half-Life: 75-94 hoursPOSITIVE

ACETAMINOPHEN Acetaminophen Plasma Half-Life: 2-3 hoursPOSITIVE

CODEINE Codeine Plasma Half-Life: 2-4 hoursPOSITIVE

CODEINE NorCodeine Plasma Half-Life: 2-4 hoursPOSITIVE

CODEINE Dihydrocodeine Plasma Half-Life: 4 hoursPOSITIVE

CODEINE Morphine Plasma Half-Life: 1.3-7 hoursNEGATIVE

CYMBALTA Duloxetine Plasma Half-Life: 8-17 hoursPOSITIVE

HYDROCODONE/APAP Hydrocodone Plasma Half-Life: 3.5-9 hoursPOSITIVE

HYDROCODONE/APAP Norhydrocodone Plasma Half-Life: 3.5-9 hoursPOSITIVE

HYDROCODONE/APAP Hydromorphone Plasma Half-Life: 1.5-4 hoursNEGATIVE

NEURONTIN Gabapentin Plasma Half-Life: 5-7 hoursPOSITIVE

PALIPERIDONE 9-Hydroxyrisperidone Plasma Half-Life: 5-6 daysPOSITIVE

INVEGA SUSTENNA 9-Hydroxyrisperidone Plasma Half-Life: 5-6 daysPOSITIVE

PLAVIX (CLOPIDOGREL) Clopidogrel Plasma Half-Life: 7-8 hoursPOSITIVE

SUDAFED (Pseudoephedrine) Pseudoephedrine Plasma Half-Life: 4-8 hoursPOSITIVE

WARFARIN Warfarin Plasma Half-Life: 20-60 hoursPOSITIVE

VITAMIN B7 (Biotin) Biotin Plasma Half-Life: 1 hourPOSITIVE

INCONSISTENT RESULTS - REPORTED MEDICATION NOT DETECTED (NEITHER PARENT DRUG NOR METABOLITE)

REPORTED ANTICIPATED DETECTION WINDOWTESTPOSITIVE(S) OUTCOMEPRESCRIPTION

Plasma Half-Life: 66 hoursVortioxetine NEGATIVEBRINTELLIXPlasma Half-Life: 6-7 hoursMetformin NEGATIVEGLUMETZA (Metformin)Plasma Half-Life: <1 hourOmeprazole NEGATIVEPRILOSEC (Omeprazole)Plasma Half-Life: 6-7 DaysLevothyroxine NEGATIVESYNTHROID

Plasma Half-Life: 7-10 hoursZiprasidone NEGATIVEGEODONPlasma Half-Life: 1 hourPantoprazole NEGATIVEPANTOPRAZOLEPlasma Half-Life: 2 hoursSimvastatin NEGATIVESIMVASTATIN

Drug Adherence Assessment ReportPrescribed Medications: CYMBALTA, HYDROCODONE/APAP, NEURONTIN, CODEINE, ACETAMINOPHEN, ABILIFY,

PRILOSEC (Omeprazole), BRINTELLIX, GLUMETZA (Metformin), SYNTHROID, PALIPERIDONE,GEODON, PLAVIX (CLOPIDOGREL), PREVACID (LANSOPRAZOLE), PANTOPRAZOLE, WARFARIN,SIMVASTATIN, SUDAFED (Pseudoephedrine), INVEGA SUSTENNA, VITAMIN B7 (Biotin)

Printed: 4/25/2018 5:57 PMPage 1 of 11

Accession: 80139 Patient ID: 1-49505Lab Results For: Sample report COMP

Originally Reported On: 4/24/2018 1:03 PM

STAT[S] Corrected [C] Added [A]

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 2: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

APPROVAL REQUIRED

Collection Date:Patient #:

COMP, Sample report Birth:

Acc #: 1-49505

Age: Doctor, Test4/5/196355 years

80139

Doctor: 4/17/2018 1:27 PMGender: Male Received in Lab: 4/17/2018 1:27 PM CT

Patient:

INCONSISTENT RESULTS - ANALYTE DETECTED BUT NO CORRESPONDING PRESCRIPTION REPORTED

DETECTED ILLICIT DETECTION WINDOWTESTOUTCOMEANALYTE

MEASUREDRESULT

CUTOFF

Caffeine 350No Plasma Half-Life: 5-6 hoursPOSITIVE<125

THC (Marijuana metabolite) 55Yes Plasma Half-Life: 4-12 hoursPOSITIVE<50

ADDITIONAL MEDICATIONS REPORTEDBUT NOT TESTED FOR IN THIS REPORT

SPECIMEN VALIDITY TESTING

TESTRANGE

TESTOUTCOME

MEASUREDRESULT

REFERENCE

Printed: 4/25/2018 5:57 PMPage 2 of 11

Accession: 80139 Patient ID: 1-49505Lab Results For: Sample report COMP

Originally Reported On: 4/24/2018 1:03 PM

STAT[S] Corrected [C] Added [A]

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 3: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

APPROVAL REQUIRED

Collection Date:Patient #:

COMP, Sample report Birth:

Acc #: 1-49505

Age: Doctor, Test4/5/196355 years

80139

Doctor: 4/17/2018 1:27 PMGender: Male Received in Lab: 4/17/2018 1:27 PM CT

Patient:

Test Name Outcome Measured Result StatusCutoff Illicit?Units

1.NARCOTIC ANALGESICS-OPIODS/OPIATES Run by: CT on 4/25/2018 5:43 PMPositive 450 Consistent ResultNong/mLAcetaminophen <50

Negative Consistent ResultNong/mLBuprenorphine <10

Negative Consistent ResultNong/mLNorbuprenorphine <10

Negative Consistent ResultNong/mLButorphanol <5

Positive 12 Consistent ResultNong/mLCodeine <10

Positive 35 Consistent ResultNong/mLNorCodeine <5

Positive 42 Consistent ResultNong/mLDihydrocodeine <5

Negative Consistent ResultNong/mLFentanyl <5

Negative Consistent ResultNong/mLNorfentanyl <5

Positive 6 Consistent ResultNong/mLHydrocodone <5

Positive 15 Consistent ResultNong/mLNorhydrocodone <5

Negative Consistent ResultNong/mLHydromorphone <10

Negative Consistent ResultNong/mLMorphine <10

Negative Consistent ResultNong/mLLevorphanol <5

Negative Consistent ResultNong/mLMeperidine <5

Negative Consistent ResultNong/mLMethadone <5

Negative Consistent ResultNong/mLEDDP <5

Negative Consistent ResultNong/mLOxycodone <5

Negative Consistent ResultNong/mLNoroxycodone <10

Negative Consistent ResultNong/mLOxymorphone <10

Negative Consistent ResultNong/mLPropoxyphene <10

Negative Consistent ResultNong/mLNorpropoxyphene <10

Negative Consistent ResultNong/mLTapentadol <10

Negative Consistent ResultNong/mLTramadol <5

Negative Consistent ResultNong/mLN-Desmethyl-Tramadol <5

Negative Consistent ResultNong/mLO-Desmethyl-Tramadol <5

2.BENZODIAZEPINES Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLBuspirone <10

Negative Consistent ResultNong/mL6-Hydroxybuspirone <10

Negative Consistent ResultNong/mLClonazepam <5

Negative Consistent ResultNong/mL7-Aminoclonazepam <5

Negative Consistent ResultNong/mLAlprazolam <10

Negative Consistent ResultNong/mLAlpha-hydroxyalprazolam

<5

Negative Consistent ResultNong/mLClobazam <5

Negative Consistent ResultNong/mLDiazepam <5

Negative Consistent ResultNong/mLNordiazepam <5

Negative Consistent ResultNong/mLTemazepam <5

Negative Consistent ResultNong/mLOxazepam <5

Negative Consistent ResultNong/mLLorazepam <125

Negative Consistent ResultNong/mLChlordiazepoxide <5

Negative Consistent ResultNong/mLNorchlordiazepoxide <10

Negative Consistent ResultNong/mLEstazolam <5

Negative Consistent ResultNong/mLFlunitrazepam <5

Negative Consistent ResultNong/mLN-Desmethyl-Flunitraz <5

Printed: 4/25/2018 5:57 PMPage 3 of 11

Accession: 80139 Patient ID: 1-49505Lab Results For: Sample report COMP

Originally Reported On: 4/24/2018 1:03 PM

STAT[S] Corrected [C] Added [A]

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 4: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

APPROVAL REQUIRED

Collection Date:Patient #:

COMP, Sample report Birth:

Acc #: 1-49505

Age: Doctor, Test4/5/196355 years

80139

Doctor: 4/17/2018 1:27 PMGender: Male Received in Lab: 4/17/2018 1:27 PM CT

Patient:

Test Name Outcome Measured Result StatusCutoff Illicit?Units

2.BENZODIAZEPINES Run by: CT on 4/25/2018 5:43 PMepam

Negative Consistent ResultNong/mLPrazepam <10

Negative Consistent ResultNong/mLTriazolam <5

Negative Consistent ResultNong/mLAlpha-Hydroxytriazolam

<5

3.ANTIPSYCHOTICS Run by: CT on 4/25/2018 5:43 PMPositive 750 Consistent ResultNong/mLAripiprazole <125

Positive 800 Consistent ResultNong/mLDehydro-Aripiprazole <125

Negative Consistent ResultNong/mLChlorpromazine <250

Negative Consistent ResultNong/mLClozapine <5

Negative Consistent ResultNong/mLClozapine_N_oxide <10

Negative Consistent ResultNong/mLFluphenazine <5

Negative Consistent ResultNong/mLHaloperidol <5

Negative Consistent ResultNong/mLOlanzapine <10

Negative Consistent ResultNong/mLRisperidone <5

Positive 22 Consistent ResultNong/mL9-Hydroxyrisperidone <5

Negative Consistent ResultNong/mLQuetiapine <5

Negative Consistent ResultNong/mLNorquetiapine <5

Negative Consistent ResultNong/mLThioridazine <10

Negative Inconsistent ResultNong/mLZiprasidone <10

Negative Consistent ResultNong/mLAsenapine <50

Negative Consistent ResultNong/mLBrexpiprazole <1

Negative Consistent ResultNong/mLIloperidone <1

Negative Consistent ResultNong/mLLurasidone <5

Negative Consistent ResultNong/mLPerphenazine <5

Negative Consistent ResultNong/mLThiothixene <10

4.ANTIDEPRESSANTS Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLCitalopram <10

Negative Consistent ResultNong/mLDoxepin <5

Negative Consistent ResultNong/mLNordoxepin <5

Positive 8 Consistent ResultNong/mLDuloxetine <5

Negative Consistent ResultNong/mLFluoxetine <5

Negative Consistent ResultNong/mLNorfluoxetine <5

Negative Consistent ResultNong/mLAmitriptyline <5

Negative Consistent ResultNong/mLBupropion <5

Negative Consistent ResultNong/mLHydroxybupropion <10

Negative Consistent ResultNong/mLClomipramine <5

Negative Consistent ResultNong/mLN-Desmethyl-Clomipramine

<5

Negative Consistent ResultNong/mLDesipramine <5

Negative Consistent ResultNong/mLFluvoxamine <5

Negative Consistent ResultNong/mLImipramine <5

Negative Consistent ResultNong/mLNortriptyline <5

Negative Consistent ResultNong/mLMirtazapine <5

Negative Consistent ResultNong/mLNormirtazapine <1

Printed: 4/25/2018 5:57 PMPage 4 of 11

Accession: 80139 Patient ID: 1-49505Lab Results For: Sample report COMP

Originally Reported On: 4/24/2018 1:03 PM

STAT[S] Corrected [C] Added [A]

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 5: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

APPROVAL REQUIRED

Collection Date:Patient #:

COMP, Sample report Birth:

Acc #: 1-49505

Age: Doctor, Test4/5/196355 years

80139

Doctor: 4/17/2018 1:27 PMGender: Male Received in Lab: 4/17/2018 1:27 PM CT

Patient:

Test Name Outcome Measured Result StatusCutoff Illicit?Units

4.ANTIDEPRESSANTS Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLParoxetine <10

Negative Consistent ResultNong/mLMethysticin <5

Negative Consistent ResultNong/mLD-L-Kavain <10

Negative Consistent ResultNong/mLDihydrokavain <50

Negative Consistent ResultNong/mLDihydromethysticin <5

Negative Consistent ResultNong/mLDesmethoxyyangonin <50

Negative Consistent ResultNong/mLSertraline <5

Negative Consistent ResultNong/mLTrazodone <5

Negative Consistent ResultNong/mLVenlafaxine <10

Negative Consistent ResultNong/mLO-Desmethyl-Venlafaxine

<5

Negative Consistent ResultNong/mLYangonin <10

Negative Consistent ResultNong/mLAmoxapine <5

Negative Consistent ResultNong/mLMilnacipran <1

Negative Consistent ResultNong/mLVilazodone <125

Negative Inconsistent ResultNong/mLVortioxetine <.5

5.DEPRESSANTS Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLDesalkylflurazepam <5

Negative Consistent ResultNong/mLFlurazepam <5

Negative Consistent ResultNong/mLMidazolam <5

Negative Consistent ResultNong/mLAlpha-Hydroxymidazolam

<5

Negative Consistent ResultNong/mLZaleplon <10

Negative Consistent ResultNong/mLZolpidem <5

Negative Consistent ResultNong/mLZopiclone-N-Oxide <125

Negative Consistent ResultNong/mLEszopiclone <1

6.ANTICONVULSANTS Run by: CT on 4/25/2018 5:43 PMPositive 650 Consistent ResultNong/mLGabapentin <5

Negative Consistent ResultNong/mLLamotrigine <10

Negative Consistent ResultNong/mLLevetiracetam <5

Negative Consistent ResultNong/mLCarbamazepine <10

Negative Consistent ResultNong/mLOxcarbazepine <10

Negative Consistent ResultNong/mL10-11-Dihydro-10-Hydroxycarbamazepine

<5

Negative Consistent ResultNong/mLLicarbazepine <5

Negative Consistent ResultNong/mLPregabalin <10

Negative Consistent ResultNong/mLTiagabine <10

Negative Consistent ResultNong/mLValproic Acid <10

Negative Consistent ResultNong/mLZonisamide <125

Negative Consistent ResultNong/mLPhenytoin <10

Negative Consistent ResultNong/mLPrimidone <5

Negative Consistent ResultNong/mLTopiramate <1

7.MUSCLE RELAXANTS Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLBaclofen <10

Negative Consistent ResultNong/mLCyclobenzaprine <5

Printed: 4/25/2018 5:57 PMPage 5 of 11

Accession: 80139 Patient ID: 1-49505Lab Results For: Sample report COMP

Originally Reported On: 4/24/2018 1:03 PM

STAT[S] Corrected [C] Added [A]

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 6: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

APPROVAL REQUIRED

Collection Date:Patient #:

COMP, Sample report Birth:

Acc #: 1-49505

Age: Doctor, Test4/5/196355 years

80139

Doctor: 4/17/2018 1:27 PMGender: Male Received in Lab: 4/17/2018 1:27 PM CT

Patient:

Test Name Outcome Measured Result StatusCutoff Illicit?Units

7.MUSCLE RELAXANTS Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLMethocarbamol <50

Negative Consistent ResultNong/mLCarisoprodol <50

Negative Consistent ResultNong/mLMeprobamate <10

Negative Consistent ResultNong/mLMetaxalone <5

8.STIMULANTS / ADHD Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLAmphetamine <5

Positive 350 Inconsistent ResultNong/mLCaffeine <125

Negative Consistent ResultNong/mLGuanfacine <5

Negative Consistent ResultNong/mLEphedrine <10

Negative Consistent ResultNong/mLMethylphenidate <5

Negative Consistent ResultNong/mLRitalinic Acid <5

Negative Consistent ResultNong/mLAtomoxetine <10

Negative Consistent ResultNong/mLLisdexamfetamine <5

9.DECONGESTANTS Run by: CT on 4/25/2018 5:50 PMNegative Consistent ResultNong/mLDextromethorphan <5

Positive 55 Consistent ResultNong/mLPseudoephedrine <10

10.APPETITE STIMULANTS Run by: CT on 4/25/2018 5:50 PMNegative Consistent ResultNong/mLMarinol <50

Negative Consistent ResultNong/mLPhentermine <10

11.ANTIDOTES Run by: CT on 4/25/2018 5:50 PMNegative Consistent ResultNong/mLNaloxone <5

Negative Consistent ResultNong/mLNaltrexone <5

12.ILLICITS Run by: CT on 4/25/2018 5:50 PMNegative Consistent ResultYesng/mL6-MAM (heroin

metabolite)<10

Negative Consistent ResultYesng/mLCocaine <5

Negative Consistent ResultYesng/mLBenzoylecgonine <5

Negative Consistent ResultYesng/mLDMT <5

Negative Consistent ResultYesng/mL5-MeO-DMT <5

Negative Consistent ResultYesng/mLMDA <125

Negative Consistent ResultYesng/mLMDEA <5

Negative Consistent ResultYesng/mLMDMA <50

Negative Consistent ResultYesng/mLMDPV <5

Negative Consistent ResultYesng/mLMephedrone <5

Negative Consistent ResultYesng/mLMethamphetamine <5

Negative Consistent ResultYesng/mLMethylone <5

Negative Consistent ResultNong/mLMitragynine (Kratom) <5

Negative Consistent ResultNong/mL7-HydroxyMitragynine(Kratom)

<5

Negative Consistent ResultYesng/mLPCP <5

Positive 55 Inconsistent ResultYesng/mLTHC (Marijuanametabolite)

<50

Negative Consistent ResultYesng/mLAcetyl-Fentanyl <5

Negative Consistent ResultYesng/mLCarfentanil <10

Negative Consistent ResultYesng/mLDidesmethyl-U-47700 <5

Negative Consistent ResultYesng/mLN-Desmethyl-U-47700 <5

Printed: 4/25/2018 5:57 PMPage 6 of 11

Accession: 80139 Patient ID: 1-49505Lab Results For: Sample report COMP

Originally Reported On: 4/24/2018 1:03 PM

STAT[S] Corrected [C] Added [A]

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 7: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

APPROVAL REQUIRED

Collection Date:Patient #:

COMP, Sample report Birth:

Acc #: 1-49505

Age: Doctor, Test4/5/196355 years

80139

Doctor: 4/17/2018 1:27 PMGender: Male Received in Lab: 4/17/2018 1:27 PM CT

Patient:

Test Name Outcome Measured Result StatusCutoff Illicit?Units

12.ILLICITS Run by: CT on 4/25/2018 5:50 PMNegative Consistent ResultYesng/mLAM2201 (Spice

Cannabinoid)<50

Negative Consistent ResultYesng/mLHU-210 (SpiceCannabinoid)

<50

Negative Consistent ResultYesng/mLJWH-019 (SpiceCannabinoid)

<50

Negative Consistent ResultYesng/mLJWH-0734-Hydroxybutyl (SpiceCannabinoid)

<10

Negative Consistent ResultYesng/mLJWH-081 (SpiceCannabinoid)

<10

Negative Consistent ResultYesng/mLJWH-122 (SpiceCannabinoid)

<5

Negative Consistent ResultYesng/mLJWH-18-5-pentanoicacid (SpiceCannabinoid)

<5

Negative Consistent ResultYesng/mLJWH-18-5-pentanyl(Spice Cannabinoid)

<5

Negative Consistent ResultYesng/mLJWH-250-5OH-pentanyl (Spice Cannabinoid)

<10

Negative Consistent ResultYesng/mL5-Fluoro-NPB-22 <50

Negative Consistent ResultYesng/mLAB-FUBINACA <5

Negative Consistent ResultYesng/mLFDU-PB-22 <10

Negative Consistent ResultYesng/mLMMB-CHMICA <5

13.BARBITURATES Run by: CT on 4/25/2018 5:50 PMNegative Consistent ResultNong/mLAmobarbital <5

Negative Consistent ResultNong/mLButabarbital <50

Negative Consistent ResultNong/mLButalbital <50

Negative Consistent ResultNong/mLPhenobarbital <5

Negative Consistent ResultNong/mLPentobarbital <5

Negative Consistent ResultNong/mLSecobarbital <5

14.DIRECT BIOMARKERS Run by: CT on 4/25/2018 5:50 PMNegative Consistent ResultNong/mL(-)-Cotinine <5

Negative Consistent ResultNong/mLEthyl Glucuronide(Ethanol)

<5

Negative Consistent ResultNong/mLEthyl Sulfate (Ethanol) <5

15. ANTI-INFLAMMATORY / NSAIDs Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLCelecoxib <50

Negative Consistent ResultNong/mLCetirizine <5

Negative Consistent ResultNong/mLChlorpheniramine <5

Negative Consistent ResultNong/mLColchicine <10

Negative Consistent ResultNong/mLDesloratadine <5

Negative Consistent ResultNong/mLDiclofenac <1

Negative Consistent ResultNong/mLDiphenhydramine <1

Negative Consistent ResultNong/mLEtodolac <5

Negative Consistent ResultNong/mLFebuxostat <10

Negative Consistent ResultNong/mLFexofenadine <10

Printed: 4/25/2018 5:57 PMPage 7 of 11

Accession: 80139 Patient ID: 1-49505Lab Results For: Sample report COMP

Originally Reported On: 4/24/2018 1:03 PM

STAT[S] Corrected [C] Added [A]

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 8: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

APPROVAL REQUIRED

Collection Date:Patient #:

COMP, Sample report Birth:

Acc #: 1-49505

Age: Doctor, Test4/5/196355 years

80139

Doctor: 4/17/2018 1:27 PMGender: Male Received in Lab: 4/17/2018 1:27 PM CT

Patient:

Test Name Outcome Measured Result StatusCutoff Illicit?Units

15. ANTI-INFLAMMATORY / NSAIDs Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLHydroxychloroquine <1

Negative Consistent ResultNong/mLHydroxyzine <10

Negative Consistent ResultNong/mLIbuprofen <1

Negative Consistent ResultNong/mLIndomethacin <5

Negative Consistent ResultNong/mLLoratadine <10

Negative Consistent ResultNong/mLMeloxicam <1

Negative Consistent ResultNong/mLMontelukast <125

Negative Consistent ResultNong/mLNaproxen <1

Negative Consistent ResultNong/mLOlopatadine <50

Negative Consistent ResultNong/mLOxipurinol <1

Negative Consistent ResultNong/mLPiroxicam <10

Negative Consistent ResultNong/mLPromethazine <1

Negative Consistent ResultNong/mLSumatriptan <1

Negative Consistent ResultNong/mLTofacitinib <1

16. CARDIOVASCULAR Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLAcebutolol <10

Negative Consistent ResultNong/mLAmiodarone <10

Negative Consistent ResultNong/mLN-Desethylamiodarone <1

Negative Consistent ResultNong/mLAmlodipine <5

Negative Consistent ResultNong/mLApixaban <50

Negative Consistent ResultNong/mLAtenolol <5

Negative Consistent ResultNong/mLAtorvastatin <5

Negative Consistent ResultNong/mLAtorvastatin Lactone <5

Negative Consistent ResultNong/mLBenazepril <5

Negative Consistent ResultNong/mLBisoprolol <1

Negative Consistent ResultNong/mLCandesartan Cilexetil <5

Negative Consistent ResultNong/mLCandesartan <1

Negative Consistent ResultNong/mLCarvedilol <5

Negative Consistent ResultNong/mLCilostazol <5

Positive 2 Consistent ResultNong/mLClopidogrel <1

Negative Consistent ResultNong/mLDabigatran <1

Negative Consistent ResultNong/mLDiltiazem <5

Negative Consistent ResultNong/mLDipyridamole <1

Negative Consistent ResultNong/mLDoxazosin <50

Negative Consistent ResultNong/mLDronedarone <50

Negative Consistent ResultNong/mLEletriptan <1

Negative Consistent ResultNong/mLEnalaprilat <1

Negative Consistent ResultNong/mLEzetimibe <1

Negative Consistent ResultNong/mLFenofibric Acid <5

Negative Consistent ResultNong/mLFlecainide <1

Negative Consistent ResultNong/mLGemfibrozil <10

Negative Consistent ResultNong/mLGlimepiride <5

Negative Consistent ResultNong/mLHydrochlorothiazide <5

Negative Consistent ResultNong/mLIrbesartan <1

Negative Consistent ResultNong/mLLabetalol <1

Printed: 4/25/2018 5:57 PMPage 8 of 11

Accession: 80139 Patient ID: 1-49505Lab Results For: Sample report COMP

Originally Reported On: 4/24/2018 1:03 PM

STAT[S] Corrected [C] Added [A]

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 9: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

APPROVAL REQUIRED

Collection Date:Patient #:

COMP, Sample report Birth:

Acc #: 1-49505

Age: Doctor, Test4/5/196355 years

80139

Doctor: 4/17/2018 1:27 PMGender: Male Received in Lab: 4/17/2018 1:27 PM CT

Patient:

Test Name Outcome Measured Result StatusCutoff Illicit?Units

16. CARDIOVASCULAR Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLLisinopril <5

Negative Consistent ResultNong/mLLosartan <5

Negative Consistent ResultNong/mLMetoprolol <5

Negative Consistent ResultNong/mLAlpha-hydroxymetoprolol

<1

Negative Consistent ResultNong/mLNadolol <1

Negative Consistent ResultNong/mLNifedipine <5

Negative Consistent ResultNong/mLOlmesartan Acid <5

Negative Consistent ResultNong/mLPentoxifylline <1

Negative Consistent ResultNong/mLPropranolol <1

Negative Consistent ResultNong/mLRanolazine <125

Negative Consistent ResultNong/mLRivaroxaban <5

Negative Inconsistent ResultNong/mLSimvastatin <1

Negative Consistent ResultNong/mLTelmisartan <5

Negative Consistent ResultNong/mLTerazosin <1

Negative Consistent ResultNong/mLTicagrelor <5

Negative Consistent ResultNong/mLValsartan <125

Negative Consistent ResultNong/mLVerapamil <.5

Positive 7 Consistent ResultNong/mLWarfarin <1

17. ANTIBIOTICS / UTIs Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLDarifenacin <50

Negative Consistent ResultNong/mLItraconazole <5

Negative Consistent ResultNong/mLNitrofurantoin <5

18. GASTROINTESTINAL / DIETARY Run by: CT on 4/25/2018 5:43 PMPositive 21 Consistent ResultNong/mLBiotin <10

Negative Consistent ResultNong/mLFamotidine <1

Negative Consistent ResultNong/mLHyoscyamine <1

Negative Consistent ResultNong/mLLansoprazole <5

Negative Consistent ResultNong/mLMetoclopramide <5

Negative Inconsistent ResultNong/mLOmeprazole <1

Negative Inconsistent ResultNong/mLPantoprazole <1

Negative Consistent ResultNong/mLRanitidine <1

19. DIABETIC Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLGlipizide <5

Negative Consistent ResultNong/mLGlyburide <50

Negative Consistent ResultNong/mLLinagliptin <50

Negative Inconsistent ResultNong/mLMetformin <5

Negative Consistent ResultNong/mLNateglinide <5

Negative Consistent ResultNong/mLPioglitazone <1

Negative Consistent ResultNong/mLRepaglinide <50

Negative Consistent ResultNong/mLRosiglitazone <1

Negative Consistent ResultNong/mLSaxagliptin <1

Negative Consistent ResultNong/mLSitagliptin <10

20. DIURETICS / INCONTINENCE Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLAcetazolamide <5

Printed: 4/25/2018 5:57 PMPage 9 of 11

Accession: 80139 Patient ID: 1-49505Lab Results For: Sample report COMP

Originally Reported On: 4/24/2018 1:03 PM

STAT[S] Corrected [C] Added [A]

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 10: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

APPROVAL REQUIRED

Collection Date:Patient #:

COMP, Sample report Birth:

Acc #: 1-49505

Age: Doctor, Test4/5/196355 years

80139

Doctor: 4/17/2018 1:27 PMGender: Male Received in Lab: 4/17/2018 1:27 PM CT

Patient:

Test Name Outcome Measured Result StatusCutoff Illicit?Units

20. DIURETICS / INCONTINENCE Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLAlfuzosin <10

Negative Consistent ResultNong/mLCanrenone <5

Negative Consistent ResultNong/mLChlorothiazide <1

Negative Consistent ResultNong/mLFurosemide <5

Negative Consistent ResultNong/mLIndapamide <5

Negative Consistent ResultNong/mLSolifenacin <5

Negative Consistent ResultNong/mLTorsemide <1

Negative Consistent ResultNong/mLTriamterene <1

21. PDE / Phosphodiesterase Inhibitors Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLSildenafil <125

Negative Consistent ResultNong/mLTadalafil <5

Negative Consistent ResultNong/mLVardenafil <125

22. CORTICOSTEROIDS / HORMONE THERAPY Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLBudesonide <10

Negative Consistent ResultNong/mLDexamethasone <1

Negative Consistent ResultNong/mLFinasteride <5

Negative Inconsistent ResultNong/mLLevothyroxine <5

Negative Consistent ResultNong/mLPrednisolone <10

Negative Consistent ResultNong/mLRaloxifene <5

23. ANTI-NEOPLASTICS / CANCER THERAPY Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLMethotrexate <5

Negative Consistent ResultNong/mLOndansetron <1

24. DEMENTIA (Parkinson's/Alzheimer's) Run by: CT on 4/25/2018 5:43 PMNegative Consistent ResultNong/mLDonepezil <1

Negative Consistent ResultNong/mLRivastigmine <5

Negative Consistent ResultNong/mLRopinirole <1

Printed: 4/25/2018 5:57 PMPage 10 of 11

Accession: 80139 Patient ID: 1-49505Lab Results For: Sample report COMP

Originally Reported On: 4/24/2018 1:03 PM

STAT[S] Corrected [C] Added [A]

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 11: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

APPROVAL REQUIRED

Collection Date:Patient #:

COMP, Sample report Birth:

Acc #: 1-49505

Age: Doctor, Test4/5/196355 years

80139

Doctor: 4/17/2018 1:27 PMGender: Male Received in Lab: 4/17/2018 1:27 PM CT

Patient:

Morphine is a commonly detected metabolite among patients taking codeine.An active molecule of Opana, Oxymorphone is a commonly detected metabolite among patients taking Oxycodone.Opana (Oxymorphone) will not metabolize to Noroxycodone or Oxycodone.Hydromorphone is a commonly detected metabolite among patients taking Hydrocodone and Morphine.Oxazepam is commonly detected metabolite among patients taking Diazepam, Nor-Diazepam or Temazepam. Temazepam and Nor-Diazepam are commonly detected metabolites among patients taking Diazepam.Alprazolam, Alpha-OH-Alprazolam, Clonazepam, and 7-amino-Clonazepam are not detected in patients taking Diazepam,Nor-diazepam, Lorazepam, Oxazepam, and Temazepam.Meprobamate is a commonly detected metabolite among patients taking Carisoprodol and its presence is consistent withthe use of Carisoprodol.An active (drug) or metabolite may be listed as a Negative Outcome, however, if either the active or any metabolite(s) arepresent (Positive), then the result is listed as Consistent for that reported prescribed medication.Metabolites can remain longer in the body than the parent drug. Sometimes only the metabolite may be detected in theurine and not the parent drug.

In case of patients consuming HYDROCODONE-containing medications: Norhydrocodone is the major metabolite ofHydrocodone indicating presence of Hydrocodone in the urine. While Hydrocodone can also be metabolized toHydromorphone, identification of just Hydromorphone by itself is not a confirmation of Hydrocodone being present, sincerecent studies suggest that urine specimens of patients taking Hydrocodone always show presence of Hydrocodone orNorhydrocodone in combination with Hydromorphone. FOR PATIENT RESULTS INDICATING JUST THE PRESENCEOF HYDROMORPHONE: THIS MAY BE DERIVED FROM MORPHINE-CONTAINING PRESCRIPTION DRUGS ORHYDROMORPHONE-ONLY PRESCRIPTIONS (FOR EXAMPLE, DILAUDID). Further reading: Valtier,S. and Bebarta,V.S.(2012) Excretion profile of hydrocodone, hydromorphone and norhydrocodone in urine following single dose administrationof hydrocodone to healthy volunteers. J. Anal. Toxicol., 36, 507–14. and Barakat,N.H., Atayee,R.S., Best,B.M. and Ma,J.D.(2014) Observations of Urinary Hydrocodone and Metabolite Distributions in Pain Patients. J. Anal. Toxicol., 38, 129–134.)

Notes: Specimen collected and processed using CleanAssure by Alcala Labs. This procedure is to determine the presence and concentration of prescription/non-prescription drugs from dried blood spot specimens collected using Mitra™ Microsampling devices by fingerpricks.

This method and associated validation is intended for patient compliance testing only (i.e. determination of the presence or absence and concentrations of prescribed and illicit drugs in dried blood spots) and is not validated for therapeutic drug monitoring (TDM) of drug plasma levels. Detection ranges may be reduced (compound-specific) versus urine toxicology test results. Mitra™ Microsampling devices improve patient comfort and increase operational efficiencies.

THC was observed.

Reviewed By: Date:

Printed: 4/25/2018 5:57 PMPage 11 of 11

Accession: 80139 Patient ID: 1-49505Lab Results For: Sample report COMP

Originally Reported On: 4/24/2018 1:03 PM

STAT[S] Corrected [C] Added [A]

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 12: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

FINAL COPY

___________________________________________________________________________________________________________ Patient: COMP, Sample report Acc #: 80139 Patient #: 1-49505 Birth: 04/05/1963 Doctor: Doctor, Test Age: 55 years Collection Date: 4/17/2018 1:27 PM

Gender: Male Received in Lab: 4/17/2018 1:27 PM CT

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 13: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

FINAL COPY

___________________________________________________________________________________________________________ Patient: COMP, Sample report Acc #: 80139 Patient #: 1-49505 Birth: 04/05/1963 Doctor: Doctor, Test Age: 55 years Collection Date: 4/17/2018 1:27 PM

Gender: Male Received in Lab: 4/17/2018 1:27 PM CT

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 14: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

FINAL COPY

___________________________________________________________________________________________________________ Patient: COMP, Sample report Acc #: 80139 Patient #: 1-49505 Birth: 04/05/1963 Doctor: Doctor, Test Age: 55 years Collection Date: 4/17/2018 1:27 PM

Gender: Male Received in Lab: 4/17/2018 1:27 PM CT

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 15: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

FINAL COPY

___________________________________________________________________________________________________________ Patient: COMP, Sample report Acc #: 80139 Patient #: 1-49505 Birth: 04/05/1963 Doctor: Doctor, Test Age: 55 years Collection Date: 4/17/2018 1:27 PM

Gender: Male Received in Lab: 4/17/2018 1:27 PM CT

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751

Page 16: Cogent Medical Laboratory 7133 Riverside Pkwy. Ste. A Tulsa, OK …€¦ · 18/09/2008  · APPROVAL REQUIRED Collection Date: Patient #: COMP, Sample report Birth: Acc #: 1-49505

FINAL COPY

___________________________________________________________________________________________________________ Patient: COMP, Sample report Acc #: 80139 Patient #: 1-49505 Birth: 04/05/1963 Doctor: Doctor, Test Age: 55 years Collection Date: 4/17/2018 1:27 PM

Gender: Male Received in Lab: 4/17/2018 1:27 PM CT

Cogent Medical Laboratory7133 Riverside Pkwy. Ste. A

Tulsa, OK 74136Main 918-561-6896Fax 866-988-4887

CLIA # 37D2069751