PATIENT IN FORMATION RP. PORT STATUS PARTIAL re)Quest Diagnostics -

PATIENT IN FORMATION RP. PORT STATUS PARTIAL re)Quest Diagnostics - WEST DIAGNOSTICS INCORPORATED CLIENT' SERVICE 866.697.8378 SPECIMEN INFORMATION SPECIMEN: RE232401 REQUISITION: T928160000752 LAB REF ID: 00000008430 COLLECTED: 07/27/2016 RECEIVED: 07/27/2016 REPORTED: 07/29/2016 11:24 14:10 09:16 EPSTEIN, JEFFREY DOB: 01/20/1953 AGE: 63 GENDER: M ID: 101513 PHONE: 212.750.9895 ORDERING PHYSICIAN KLINE , MITCHELL A CLIENT INFORMATION T92816 MITCHELL KLINE, III. 700 PARK AVE NEW YORK, NY 10021 Hit- 7/vile .40203925 Teat Name In Range Out of Range Reference Range CHEM-SCREEN PANEL GLUCOSE 103 65-139 mg/dL The glucose reference range is based on a non-fasting state. SODIUM 139 135-146 mmol/L POTASSIUM CHLORIDE CARBON DIOXIDE UREA NITROGEN 4.7 3.5-5.3 mmol/L 100 98-110 mm01/L 26 19-30 mmol/L 21 7-25 mg/dL CREATININE 1.11 0.70-1.25 mg/dL The upper reference limit for Creatinine is approximately 13t higher for people identified as African -American. BUN/CREATININE RATIO NOTE 6-22 (talc) Bun/Creatinine ratio is not reported when the Bun and Creatinine values are within normal limits. URIC ACID 6.6 4.0-8.0 mg/dL Therapeutic target for gout patients: <6.0 mg/dL PHOSPHATE (AS PHOSPHORUS) 3.7 2.5-4.5 mg/dL CALCIUM 8 6-10 3 mg/dL kVtiOtata0( 440.:. traq=a1.1314 -ac raMaTafklad AatrIK-1012,51474102=1 ,- tilial*****00.14016MIMIMMINAMMKOWAVICiirSOMMINESERM PROTEIN, TOTAL 7.4 6.1-8.1 g/dL ALBUMIN GLOBULIN ALBUMIN/GLOBULIN RATIO BILIRUBIN, TOTAL BILIRUBIN, DIRECT ALKALINE PHOSPHATASE GGT AST ALT LD IRON, TOTAL EGFR NON APR AMERICAN EGFR AFRICAN AMERICAN 4.8 3.6-5.1 g/dL 2.6 1.9-3.7 g/dL (talc) 1.8 1.0-2.5 (talc) 0.8 0.2-1.2 mg/dL 0.1 < = 0.2 mg/dL 69 40-115 U/L 21 3-70 U/L 17 10-35 U/L 24 9-46 U/L 185 120-250 U/L 88 50-180 mcg/dL 70 >=60 mL/min/1.73m2 81 >=60 mL/min/1.73m2 EPSTEIN,JEFFREY - RE232401 On*Dw!D or ,g.s.om Page 1 - Continued on Page 2 aria assoma (Lai timinti., rails au tit ussniAs Glity :arfru‘s C Cant Di n.c.c. I.C4rpyr-t.) Ai rye, rAin-nd citcrn hit ilmnstin.“24 wen EFTA00298586 ro,Quest Diagnostics QUEST DIAGNOSTICS INCORPORATED SPECIMEN INFORMATION SPECIMEN: RE232401 COLLECTED: 07/27/2016 11:24 REPORTED: 07/29/2016 09:16 PATIENT INFORMATION EPSTEIN,JEFFREY DOB: 01/20/1953 AGE: 63 GENDER: M REPORT STAINS PARTIAL ORDERING PHYSICIAN KLINE,MITCHELL A CLIENT INFORMATION T92816 Test Name CBC (INCLUDES DIFP/PLT) In Range Out of Range WBC 6.7 REC 5.34 HEMOGLOBIN 15.2 HEMATOCRIT 45.7 MCV 85.6 MCH 28.4 MCHC 33.2 RDW 14.4 PLATELET COUNT 303 MPV 7.7 TOTAL NEUTROPHILS,% 57.7 TOTAL LYMPHOCYTES,t 31.4 MONOCYTES,% 6.4 EOSINOPHILS,t 3.9 BASOPHILS,t 0.6 NEUTROPHILS,ABSOLUTE 3866 LYMPHOCYTES, ABSOLUTE 2104 MONOCYTES, ABSOLUTE 429 EOSINOPHILLABSOLUTE 261 BASOPHILS,ABSOLUTE 40 DIFFERENTIAL An instrument differential was performed. ANA IFA SCR W/REFL TITER PENDING Reference Range 3.8-10.8 Thous/mcL 4.20-5.80 Mi11/mcL 13.2-17.1 g/dL 38.5-50.0 V 80.0-100.0 fL 27.0-33.0 pg 32.0-36.0 g/dL 11.0-15.0 % 140-400 Thous/mcL 7.5-11.5 fL 38-80 % 15-49 t 0-13 t 0-8 % 0-2 t 1500-7800 Cells/mcL 850-3900 Cells/mcL 200-950 Cells/mcL 15-500 Cells/mcL 0-200 Cells/mcL EPSTEIN,JEFFREY - RE232401 Page 2 - Continued on Page 3 Olost OsiDevosit.iht aemAtnbtometallaismots004•004Molt. Wit an II • Iffillmaraid iN Nyman. CONN DatimIcs l'alOata Ang ht. 1. WX0:0 kit RD.., VILITn' l"r1 EFTA00298587 re)Quest Diagnostics QUEST DIAGNOSTICS INCORPORATED SPECIMEN INFORMATION SPECIMEN: RE232401 COLLECTED: 07/27/2016 11:24 REPORTED: 07/29/2016 09:16 PATIENT INFORMATION EPSTEIN, JEFFREY ORDERING PHYSICIAN DOB: 01/20/1953 AGE: 63 KLINE,MITCHELL A GENDER: M REPORT EVAT11$ PARTIAL CLIENT INFORMATION T92816 Test Name LYME DISEASE,EIA W/RFL WE LYME DISEASE SCREEN In Range Out of Range Reference Range 0.90 0.00-0.90 Index Value Index c or . 0.90 0.91-1.09 > or = 1.10 Interpretation Negative Equivocal Positive The use of purified VlsE-1 and PepC10 antigens in this assay provides improved specificity compared to assays that utilize whole cell lysates of B. burgdorferi, the causative agent of Lyme disease, and slightly better sensitivity compared to the C6 antibody assay. As recommended by the Food and Drug Administration (FDA), all samples with positive or equivocal results on the Borrelia burgdorferi antibody screen will be tested by Western Blot/Immunoblot. Positive or equivocal screening test results should not be interpreted as truly positive until verified as such using a supplemental assay (e.g., B. burgdorferi blot). The screening test and/or blot for B. burgdorferi antibodies may be falsely negative in early stages of Lyme disease, including the period when erythema migrans is apparent. BABESIA M/CROTI (IGG,IGM) PENDING A.PHAGOCY+E.CHAFFEE AB PL PENDING IN,YNINt EPSTEIN,JEFFREY - RE232401 Page 3 - Continued on Page 4 04. IIALIN..)36.10, the era° oral Op ad aissc Ind Neat INapestcs rat,a an to iffaihrturint Oa ner...}aill 4PlImstDin,,wcs•utporinei AllrywasInad USA) Mt Rwmal,15 SO( in.:0 EFTA00298588 PATIENT INFORMATION REPORT STATUS PARTIAL 41) Quest Diagnostics QUEST DIAGNOSTICS INCORPORATED SPECIMEN INFORMATION SPECIMEN: RE232401 COLLECTED: 07/27/2016 11:24 REPORTED: 07/29/2016 09:16 EPSTEIN,JEFFREY DOB: 01/20/1953 AGE: 63 GENDER: M ORDERING PHYSICIAN rirr„ t.eke KLINE,MITCHELL A CLIENT INFORMATION T92816 tA010,1c4 st.be • . -,6tria4 Test Name Allergen kti/L D. PTERONYSSINUS (D1) IGE <0.1C (D2) IGE <0.10 CAT EPITH/DANDER(E1) IGE CAT DANDER taiimilvL 7.61 H 1.14 H iione-00-*-0407041-7:470249151.1 •• TIMOTE )C-VMS W6) )49‘taignira4lat iental COCKROACH (I6) IGE (M1) IGE C. HERBARUM (M2) IGE A. FUMIGATUS (M3) IGE ALLERGEN, A. ALTERNATA A.ALTERNATA (M6) IGE MAPLE (BOCZBDER) (T1)-1O2. BIROH ASTALIGE - i;.=NtA*itdEDAE Madtt/144.0 - P1044005110gtaleiliWalf#P 0.53 H 0.36 H <0.10 <0.10 <0.10 <0.10 <0.10 • 3014ti;•. 0.56 H 0.50 H 2.09 H 0.55 H 0.37 H 0.72 H NtIRE,:t 0.51 H Class 0 0 f5tatifiaR 1WiliNt:24Pitrz gr1,3710.Bfi TBR 1BR TES THE EPSTEIN,JEFFREY - RE232401 awe. fh•ItKv .W4 Opp onel 01 orco.04 :mill D., Page 4 - Continued on Page 5 ..b valetarls✓Zakst3sionnks. a. U u Duren:l, IN tonal AS iris COSMO lilt at.m.12,15 SOK MVP EFTA00298589 PATIENT INFORMATION REPORT STATES PARTIAL (0)Quest Diagnostics QUEST DIAGNOSTICS INCORPORATED SPECIMEN INFORMATION SPECIMEN: RE232401 COLLECTED: 07/27/2016 11:24 REPORTED: 07/29/2016 09:16 EPSTEIN, JEFFREY DOB: 01/20/1953 AGE: 63 GENDER: M ORDERING' PHYSICIAN KLINE , MITCHELL A CLIENT INFORMATION T92816 Teat Name Allergen kU/L Claus MCOnVITY 10011::121141£X#A0M iaga54FfilEIMIIIMMlitarglhTasmraa1 Oil t Ott Zti010,.92 Oritt killgITWASn“TIS)Plet4tlaWYggitaraggigaiggingeing#03:1*NWL 2,H .24841018MM saajtv: WHITE MULBERRY (T70) IGE iii:00040.0004040.AggaOkaaralit -4MagitiaRtMiar "rtnnt4LINIMItt<0.10 41a EigifttiartiftlititaaftiMattitglitingfinaMiliVaWi*. MOUSE UR PROT (E72) IGE 11314:11iittittitinlitr- Allergen <0.10 0 H 0/1 H C TEL stattalINSPAil TBR In Range Out of Range Reference Range 4AMINgraliliat irtrallE IC 2 ALLERGY,ANIMAL PROFILE gtagal.k*WW44.00a latM,17 ragtidigt.0 044. 7:49}1172 . §:11.1Mtiao".•SikarEVatlataltr),ZSZINIMEirr LT0400.1CSIStMage7dEalf 7.6.1 H 0.23 H 1.14 H 0.27 H EPSTEIN,JEFFREY - RE232401 Oat Outs, Joimact. We solo Pe4 Op al el amm.iltd 04.4 Popoititi rift, in is O.MnW 10th ['Kogan° Wan IliNmstc LP, cal Agree. lesinel COMM tat Pew-4 L1V Page 5 - Continued on Page 6 EFTA00298590 40) Quest Diagnostics QUEST DIAGNOSTICS INCORPORATED SPECIMEN INFORMATION SPECIMEN: RE232401 COLLECTED: 07/27/2016 11:24 REPORTED: 07/29/2016 09:16 PATIENT INFORMATION EPSTEIN, JEFFREY DOB: 01/20/1953 AGE: 63 GENDER: M REPORT STATUS PARTIAL ORDERING PHYSICIAN KLINE, MITCHELL A CLIENT INFORMATION 292616 Test Name ALLERGEN SPECIFIC REF. RANGE Specific IgE Class kU/L Level of Allergen Specific IgE Antibody 0 < 0.10 Absent/Undetectable 0/1 0.10 - 0.34 Very Low Level 1 0.35 - 0.69 Low Level 2 0.70 - 3.49 Moderate Level 3 3.50 - 17.49 High Level 4 17.5 - 49.9 Very High Level 5 50 - 100 Very High Level 6 > 100 Very High Level The clinical relevance of allergen kU/L are undetermined and intended results of 0.10-0.34 for specialist use. PERFORMING LABORATORY INFORMATION: TBR Quest Diagnostics Ono Malcolm Avenue Teterboro NJ 07608 Laboratory Director, Lawrence Tsao. III• CL1A No: 3100696246 "110103925 EPSTEIN,JEFFREY - RE232401 Page 6 - End of Report Oat OsitesraNirs. •• onecom Cc* • 014.5041110 Ow OMB. aris neve.. of Ono Dorm° ID lull 0•1•00€1.C•Mrstd km Mira estni.0,20:CO-n hingedWM SOX. EFTA00298591 4,-) Quest Diagnostics QUEST DIAGNOSTICS INCORPORATED CLIENT SERVICE 866.497.8178 SPECIMEN INFORMATION SPECIMEN: RE230123 REQUISITION: T928160000751 PHONE: 212.439.0883 COLLECTED: 07/27/2016 08:40 RECEIVED: 07/27/2016 14:10 REPORTED: 07/29/2016 09:16 COMMENTS: FASTING PATIENT INFORMATION ICURTZBERG , HOLLY B DOB: 04/30/1969 AGE: 47 GENDER: F FASTING: Y ID: 61350 Test Name CALL TEST REPORT STATUS PARTIAL ORDERING PHYSICIAN KLINE 'MITCHELL A CLIENT INFORMATION T92816 MITCHELL KLINE, III. 700 PARK AVE NEW YORK, NY 10021 it I:414.4.03925 ca In Range Out of Range Reference Range Processing of this specimen(s) was delayed in order to ensure correct test order interpretation. CHEM-SCREEN PANEL GLUCOSE,FASTING 78 SODIUM 140 POTASSIUM 4.0 CHLORIDE 107 CARBON DIOXIDE 26 UREA NITROGEN 11 CREATININE 0.72 BUN/CREATININE RATIO NOTE Bun/Creatinine ratio is not reported when the Creatinine values are within normal limits. URIC ACID 2.6 Therapeutic target for gout patients: <6.0 mg/dL PHOSPHATE (AS PHOSPHORUS) 2.9 CALCIUM CHOLESTEROL, TOTAL TRIGLYCERIDES PROTEIN, TOTAL ALBUMIN GLOBULIN ALBUMIN/GLOBULIN RATIO BILIRUBIN,TOTAL BILIRUBIN,DIRECT ALKALINE PHOSPHATASE GGT AST ALT LD IRON, TOTAL EGFR NON AFR AMERICAN EGFR AFRICAN AMERICAN 9.2 186 56 6.5 4.1 2.4 1.7 0.5 0.1 50 14 16 15 134 80 100 116 65-99 mg/dL 135-146 mmol/L 3.5-5.3 mmol/L 98-110 mmol/L 19-30 mmol/L 7-25 mg/dL 0.50-1.10 mg/dL 6-22 (calc) Bun and 2.5-7.0 mg/dL 2.5-4.5 mg/dL 8.6-10.2 mg/dL 125-200 mg/dL <150 mg/dL 6.1-8.1 g/dL 3.6-5.1 g/dL 1.9-3.7 g/dL (calc) 1.0-2.5 (calc) 0.2-1.2 mg/dL < e 0.2 mg/dL 33-115 U/L 3-55 U/L 10-35 U/L 6-29 U/L 100-200 U/L 40-190 mcg/dL '.60 mL/min/1.73m2 ›=60 mL/min/1.73m2 KURTZBERG,HOLLY B - RE230123 Page 1 - Continued on Page 2 Otwil.Oirel Darwin lioancemic bee $ neer fey auto therrien set as re e ?dens el 3.er rrt•euet :bra ra:nrsa:s ranee WI Air the envy[ C03110 %IL kerne LIS I I EFTA00298592