Epic Build / Desired Build Test Compendium
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Methotrexate Polyglutamates Epic Compendium  

▶ Desired Epic Build * = editable field  

Actual Epic Build 12/04/2025

PROCEDURE ID 193917
PDM 255283
ORDER DISPLAY NAME Methotrexate Polyglutamates
PROCEDURE NAME METHOTREXATE POLYGLUTAMATES
PROCEDURE MASTER NUMBER LAB14610
SHORT PROCEDURE NAME METHOTREXATE POLYGLUTAMATES
CATEGORY CODE 1.0
CATEGORY CODE RECORD NAME LAB BLOOD ORDERABLES
SYNONYMS
CLINICALLY ACTIVE Yes
ORDERABLE Yes
PERFORMABLE Yes
FILTER GENOMICS
REFERENCE LINK URL
ORDERING INSTRUCTIONS
DEFAULT SPECIMEN TYPE Blood
SPECIMEN TYPE PICK LIST Blood
SPECIMEN TYPE LIST
OP SPECIMEN TYPE LIST
SPECIMEN SOURCE PICK LIST Blood, Arterial
Blood, Capillary
Blood, Central Line
Blood, Venous
SPECIMEN SOURCE DEFAULT - MALE Blood, Venous
SPECIMEN SOURCE DEFAULT - FEMALE Blood, Venous
SPECIMEN SOURCE LIST
OP SPECIMEN SOURCE LIST
IP LAB TEST COMPONENTS FOR REPORT MTXPG
OP LAB TEST COMPONENTS FOR REPORT MTXPG
ORDER QUESTIONS ["3045300170", "3045300171", "3045300173"]
ORDER QUESTIONS RECORD NAME NH IP HOME COLLECT DATE
NH IP HOME COLLECT DAYS
NH IP HOME COLLECT MEDICALLY NECESSARY
INPATIENT ORDER QUESTIONS []
INPATIENT ORDER QUESTIONS RECORD NAME
ORDER SPECIFIC QUESTION OVERRIDE Yes
INPATIENT QUESTION OVERRIDE
LOCATION RESTRICT LIST IP
LOCATION RESTRICT LIST IP RECORD NAME
LOCATION RESTRICT LIST INCLUDE IP
LOCATION RESTRICT LIST OP
LOCATION RESTRICT LIST OP RECORD NAME
LOCATION RESTRICT LIST INCLUDES OP
EDP AMB ORDER SPECIFIC QUESTIONS RECORD NAME
EDP IP ORDER SPECIFIC QUESTIONS RECORD NAME
EDP IP SPECIMEN SOURCE Blood, Venous
Blood, Central Line
Blood, Arterial
Blood, Capillary
Blood, Peripheral
EDP OP SPECIMEN SOURCE
EDP IP SPECIMEN TYPE Blood
EDP OP SPECIMEN TYPE
DERIVED EDP IP BUTTONS S Blood, Central Line
Blood, Arterial
Blood, Venous
Blood, Capillary
DERIVED EDP IP BUTTONS T Blood
DERIVED EDP OP BUTTONS S
DERIVED EDP OP BUTTONS T
IP ORDERABLE 1
OP ORDERABLE 1
STANDARD LAB COMPONENTS
STANDARD LAB COMPONENTS RECORD NAME
COMPONENT DATA REQUIREMENT
EPIC OP AOEs

Question IDQuestion NameQuestionResponse TypeResponse ListRequire Response
3045300170 NH IP HOME COLLECT DATE Start Date Date Yes
3045300171 NH IP HOME COLLECT DAYS Days Custom List Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday		 Yes
3045300173 NH IP HOME COLLECT MEDICALLY NECESSARY Medically Necessary? Yes/No Yes
EPIC IP AOEs

EPIC Components (results - crosswalked through Cerner)

Component IDComponent NameBase NameCommon NameExternal NameCerner Result PDM
3047808430.0 METHOTREXATE PG TOTAL MTXPG METHOTREXATE PG TOTAL Methotrexate PG Total 255283A
3047808432.0 METHOTREXATE PG2 MTXPG METHOTREXATE PG2 Methotrexate PG2 255283C
3047808436.0 METHOTREXATE INTERPRETATION MTXPG METHOTREXATE INTERPRETATION Interpretation 255283G
3047808431.0 METHOTREXATE PG1 (PARENT DRUG) MTXPG METHOTREXATE PG1 Methotrexate PG1 (parent drug) 255283B
3047808433.0 METHOTREXATE PG3 MTXPG METHOTREXATE PG3 Methotrexate PG3 255283D
3047808435.0 METHOTREXATE PG5 MTXPG METHOTREXATE PG5 Methotrexate PG5 255283F
3047808434.0 METHOTREXATE PG4 MTXPG METHOTREXATE PG4 Methotrexate PG4 255283E