Diagnostics ,

Quest Diagnostics , QUEST DIAGNOSTICS INCORPORATED CLIENT SERUICE 800.631 .1390 SPECIMEN INFORMATION SPECIMEN: X46712534 REQUISITION: COLLECTED: 03/03/2010 11:50 RECEIUED: 03/03/2010 21:07 REPORTED: 03/09/2010 17:30 PATIENT INFORMATION EPSTEIN,JEFFREY DOB: 01/20/1953 AGE: 57 GENDER: M FASTING: PHONE: 212.750.9895 REPORT STATUS PARTIAL REPRINT ORDERING PHYSICIAN CLIENT INFORMATION T11886 WOODSON MERRELL, M D. 44 E 67TH STREET NEW YORK. NY 10065 10013650 The original copy of this report was printed on: 03/09/2010 at 08:16 Patient results contained In a facsimile or electronic medical report are provided only upon the request of the physician or authorized person. Facsimile or electronic medical reports that are created before the final results aro reported are considered to be INTERIM RESULTS ONLY and are subject to change by the laboratory. Test Name In Range 1GF-I 151 FSH 3.7 LH 4.1 PROLACTIN 2.6 PROGESTERONE 1.1 DHEA SULFATE 182 TESTOSTERON,FR/TOT,LCMSMS TESTOSTERONE, TOTAL 188 L 250-1100 ng/dL Out of Range Reference Range 87-Z25 ng/mL 1.6-8.0 mIU/nL 1.5-9.3 miU/mL 2.0-18.0 ng/nL <1.4 ng/nL 25-240 mcg/dL Total Testosterone was measured by LCMSMS. The LCMSMS method correlates well with our extraction/RIA method. % FREE TESTOSTERONE 1.94 TESTOSTERONE, FREE ,36.5-) MTHER,DNA MUTATION,NY see note A RESULT: POSITIUE FOR 2W0 COPIES OF THE C677T ) MUTATION DNA testing indicates this individual is homozygous for the C6777 mutation and does not have the A1298C mutation. This has been associated with an increased risk for hyperhomocysteinemia and vascular diseases. Consider genetic counseling and DNA testing for at-risk members. 1.5-2.2 h 35.0-155.0 pg/mL Lab TBR TBR TBR 7BR TBR TBR QNI EPSTE1N,JEFFREY - K4671284 Page 1 - Continued on Page 2 lint, ken liassistics, Ins nil •I anictotnt hint /tannins ,,,,, art thr it hilt auy.Nal Inentsgan4 Ill save. er 11N1 AMD CM, aveva P b Iltitillt6 2/3 EFTA00727570 Quest Diagnostic QUEST DIAGNOSTICS INCORPORATED PATIENT INFORMATION EPSTE1N,JEFFREY DOB: 01/20/1953 AGE: 57 REPORT STATUS PARTIAL REPRINT ORDERING PHYSICIAN GENDER: M FASTING: SPECIMEN INFORMATION CLIENT INFORMATION SPECIMEN: X4671284 T11686 10013650 COLLECTED: 03/03/2010 11:50 REPORTED: 03/09/2010 17:30 Test Name In Range Out of Range Reference Range Laboratory testing supervised and results monitored by U.M. Pratt, Ph.D., FACIIIG. Director. Molecular Genetics. Hyperhomocysteinemia is a risk factor for arterial disease and venous thrombosis. Homocystelne levels are affected by nutritional and genetic factors. Since NTHFR is involved in methyiation of homocysteine to methionine, individuals with MTHFR gene mutations that reduce enzyme activity may develop hyperhoncystelnemia and thus be at risk for vascular disease. The C677T and A1298C mutations are detected by signal amplification of the MTHFR gene by allele - specific hybridizations and cheniluninescent detection of hybridized probes. Since genetic variation and other factors can affect the accuracy of direct mutation testing, these results should be interpreted in light of clinical and familial data. This test was developed and its performance characteristics have been determine -it by Quest Diagnostics Nichols Institute, Chantil ly, UA. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. Performance characteristics refer to the analytical performance of the test. ESTRADIOL.ULTRASEN.LCKSMS PENDING PERFORMING LABORATORY INFORMATION: AMD Quest Diagnostics Nichols Chantilly 14225 Newbrook ➢rive Chantil ly UA 20151 Laboratory Director: Kenneth Sisco. MD,PhD CLIA No: 4900221801 QNI Quest Diagnostics, Nichols Institute 33608 Ortega Highway San Juan Capistrano CA 92690 Laboratory Director: Dr. Jon M. Nakamoto CLIA No: 05110643352 IBR Quest Diagnostics One Malcolm Avenue Teterboro NJ 07608 Laboratory Director: William E. Tarr, M.D. CLIA No: 3100696246 EPSTEIN,JEFFREY - K4671284 Page 2 - End of Report twit Loll Oily..ha, tie iiiitsilr1 Iry1 lit ill isseittilii.11 Ciiiicsipti arks in 1$ IntInarli *I twit DIIIMIIICS it Fa Il niatt Priniod IM 111X. /II Lab i141/11 1) 11 115/l/Ili 1/1 EFTA00727571 Quest Diagnostics QUEST DIAGNOSTICS INCORPORATED CLIENT SERUICE 800.631.1390 SPECIMEN INFORMATION SPECIMEN: X4666434 REQUISITION: COLLECTED: 03/03/1010 08:20 RECEIUED: 03/03/2010 20:43 REPORTED: 03/08/2010 08:32 PATIENT INFORMATION ESPSTEIN,JEFFREY DOB: 01/20/1953 AGE: 57 GENDER: M FASTING: Y PHONE: 212.772.9416 REPORT STATUS FINAL REPRINT ORDERING PHYSICIAN CLIENT INFORMATION T11886 WOODSON MERRELL, M.D. 44 E 67TH STREET NEW YORK, NY 10065 10013650 The original copy of this report was printed on: 03/05/2010 at 08:16 Test Name LEAD,BL000 In Range Out of Range Reference Range <3 <10 mcg/dL Blood lead levels in the range of 5-9 mcg/dL have been associated with adverse health effects in children aged 6 years and younger. Industrial Exposure: <40 mcg/dL ncg/dL = mcg/100g for OSHA (refer to current governmental regulations for exposure criteria) MERCURY, BLOOD ARSENIC,BL00D 5 <=10 mcg/L 4 <23 mcg/L Urine is usually the best specimen for the analysis of Arsenic in body fluids. Blood levels tend to be low even when urine concentrations are high. PERFORMING LABORATORY INFORMATION: AND Quest Diagnostics Nichols Chantilly 14025 Newbrook Drive Chantilly VA 20151 Laboratory Director: Kenneth Sisco, MD.PhD CLIA No: 49D0221801 TOR Quest Diagnostics One Malcolm Avenue Teterboro NJ 07608 Laboratory Director: William E. Tarr, M.D. CLIA No: 31D0696246 ESPSTEIN,JEFFREY - K4666434 Page 1 - End of Report It'll, lout Itiliostics, IM asseciilif 10$0 Ahl aIsociatid Putt tia,,eslu, , Ital".0", IC 14O 0,,,,,IIIrs :flOrIN ,rIt$ Ill ritIII risrtiti. OI.OPIt4 2/1I Lab TBR AMU AMD CC2 evivit BIN ionsia 7/7 EFTA00727572 ak Quest fa? Diagnostic: OMs: : ACUIOSIA CS INCORPORATED CLIENT SERVICE PO O. G31 . I j 90 SPECIMEN INFORMATION SPECIMEN: F7579815 REQUISITION: COLLECTED: 03/03/2010 RECEIVED: 03/03/2010 REPORTED: 03/05/2010 11:50 21:49 10:31 PAT I FAIT INFORMATION EPSTEIN, JEFFREY DOB: 01/20/1953 AGE: 57 GENDER: M FASTING: Y PHONE: 212.750.9895 REPORT STATUS FINAL ORDERING PHYSICIAN CL: ENT INFORMATION T11886 WOODSON MERRELL, M.D. 44 F. 67TH STREET NEW YORK, NY 10065 10013650 Test Name CALCIUM FTR,INTACT Interpretive Guide Normal Parathyroid Function Hypoparathyroidism Primary Hyperparathyroidism Secondary Hyperparathyroidism Tertiary Hyperparathyroidism Non-Parathyroid Hypercalcemia In Range Intact PT Normal Low or Low Normal Normal or High High High Low or Low Normal Out of Range H H 6) PERFORMING LABORATORY INFORMATION: YBR Ousel Diagnostics one Malcolm Avenue Teterboro MIA NO; 3100696246 Reference Range 8.6-10.2 mg/dL 10-65 pg/mL Calcium Normal Low High Normal or Low High High NJ 07608 Laboratory Director: William E. Tarr. Lab TSR TBR EPSTEIN,JEFFREY - F7579815 Page 1 - End of Report On.' OHS C.W404. 71• owe roc isso •••t ANOPNI Omatomften M, au um eyNoN•ittaume Derma • t (Wu Oontscs WOCIWOW 'Wt. taro*, =NON% knee SOB $0 1. ANN EFTA00727573 O4Quest 4 Diagnostics Date of Report 03/06/2010 Patient Name: Jeffrey Epstein Identification Number: Age: 57 Sex: M Intact Parathyroid Hormone Test No. 1222A Date Received: 03/03/2010 Accession a F7579815 Results (Please refer to the official Medical Report) Intact PTH 88.90 pg/mL (Normal Range 10 - 85 pg/mL) Total Calcium 10.40 mg/dL (Female Range 8.5. 10.3 mg/dc• Male Range 8.7 • 10.4 mg/cIL• I Legend Normal Indeterminate Secondary Hyperparathyroidism Primary Hyperparathyroidism Hypoparathyroidism Non-Parathyroid Hypercalcemia (Lest Diagnostics One Malcolm Avenue Teentoro, New Jersey 076C6- 1070 8CC1.631.B90 1-11886 10013650 WOODSON MERRELL, M.D. 44 E 67th Street New York, NY 10065 10003 0000 0000 7000 0303 5000 4000 NCO 900 000 700 NO S00 400 E 'v. 300 en a. e 200 0 I 1 os a°70 «pg 60 GO 40 ti to 9 8 Note: The reference range on the graph may 6 differ from the reference range cited for this 5 patient. The comparison data set on the back 4 of this report includes both male and female patients. The reference ranges for calcium on 3 the graph are those that would be applied to an adult patient where sex was unspecified. uest Tar ch.Intact Parathyroid Hormone Ordering Physician: Route: I001.4,50 Account Number. I'IINK6 C 10 40 60 10 10.0 140 16,0 C 9201 Quest Diagnostics Incorporated. All rights reserved. Guest Quest Diagnostics, the associated logo end NI associated Quest Dognostics marks are the vedemerks of Quest Diagnostics Margo/aced. Calcium (mg/dL) EFTA00727574 Aark Quest ‘W Diagnostics QUEST DIAGNOSTICS INCORPORATED CLIENT SERVICE 000.611.1390 SPECIMEN INFORMATION SPECIMEN: 92116012 REQUISITION: COLLECTED: 03/03/2010 08:20 RECEIVED: 03/03/2010 19:57 REPORTED: 03/08/2010 08:16 ATIHNT :NFOHMAT:ON EPSTEIN, JEFFREY DOB: 01/20/1953 AGE: 57 GENDER: M FASTING: Y PHONE: 212.772.9416 REPORT STATUS FINAL ORDERING PHYSICIAN C!JENT INFORMATION T11886 WOODSON MERRELL, M.D. 44 E 67TH STREET NEW YORK, NY 10065 10013650 Test Name MAGNESIUM TSH,3RD GENERATION THYROID PANEL T4,TOTAL Please note new reference range. T3 UPTAKE 32 T4,FREE,CALCULATED 3.0 In Range 1.8 1.77 CR, TOTAL 9.4 Out of Range Reference Range 1.5-2.5 mg/dL 0.40-4.50 mIU/L 4.5-12.5 mcg/dL 22-35 Percent 1.4-3.8 Units 44-196 U/L Lab TBR TBR TBR TBR EPSTEIN,JEFFREY - 92116012 Page 1 - Continued on Page 2 3.mt Oary On.mmc nn mm wed ov..km al onmom Cum flummt‘i mats am omPOOMMSOOmmlOmmefles C. Gant Datcrom cmommi Al miltunemd OLMMILML elm les MX SCH. MCA) EFTA00727575 link Quest Diagnostics i PAIIEN't :Nr.,RMATICti EPSTEIN,JEFFREY DIAGNOSTICS INCORPORATED ORDERING PHYSICIAN DOB: 01/20/1953 AGE: 57 GENDER: M FASTING: Y REPORT STATUS FINAL MEN INFORMATION CIHEN: 92116012 LECTED: 03/03/2010 08:20 ORTED: 03/08/2010 08:16 CLIENT INFORMATION T11886 10013650 est Name In Range Out of Range Reference Range Lab !S/HDL/TIBC W FER RFX/FRUCTOSAMINE TBR NE 246 (. 190-270 umol/L104 H 65-99 mg/dL FRUCTOSAMI GLUCOSE,PASTING SODIUM 140 135-146 mmol/L POTASSIUM 4.4 3.5-5.3 mmol/L CHLORIDE 105 98-110 mmol/L CARBON DIOXIDE 24 21-33 mmol/L UREA NITROGEN 18 7-25 mg/dL CREATININE 0.94 0.76-1.46 mg/dL BUN/CREATININE RATIO NOTE 6-22 Bun/Creatinine ratio is not reported when the Bun and Creatinine values are within normatt ld itS. URIC ACID PHOSPHORUS CALCIUM CHOLESTEROL, TOTAL HDL CHOLESTEROL CHOLESTEROL/HDL RATIO LDL CHOL, CALCULATED See footnote 1 TRIGLYCERIDES PROTEIN, TOTAL ALBUMIN GLOBULIN, CALCULATED A/G RATIO BILIRUBIN, TOTAL BILIRUBIN, DIRECT ALKALINE PHOSPHATASE GGT AST ALT LD IRON, TOTAL TIBC TRANSFERRIN SATURATION 8.6 3.3 10.0 200 111 7.4 4.6 2.8 1.6 0.7 0.1 64 12 21 19 152 70 314 22 H 4.0-8.0 mg/dL 2.5-4.5 mg/dL 8.6-10.2 mg/dL 125-200 mg/dL l?.) >=40 mg/dL 6.1 H < = 5.0 <130 mg/dL <150 mg/dL 6.2-8.3 g/dL 3.6-5.1 g/dL 2.1-3.7 g/dL 1.0-2.1 0.2-1.2 mg/dL < = 0.2 mg/dL 40-115 U/L 3-85 U/L 10-35 U/L 9-60 U/L 120-250 U/L 45-170 mcg/dL 250-425 mcg/dL 20-50 t ;TEIN,JEFFREY - 92116012 Page 2 - Continued on Page 3 O,1µ Omni Ougromk nrosioon vo •••••:(al Omni 0••••••••• van ttttt usfeowat or• Wet Permits vIlastastanias Norway! Linos eimmil ODY0110.0111. RIMS %Of Sat I IWO EFTA00727576 Ank Quest Diagnosti9 PAT I ENT INFORMATION EPSTEIN, JEFFREY QUEST DIAGNOSTICS INCORPORATED DOB: 01/20/1953 AGE: 57 GENDER: M FASTING: Y SPECIMEN I NPORMAT 70N SPECIMEN: 92116012 COLLECTED: 03/03/2010 08:20 REPORTED: 03/08/2010 08:16 REPORT STATUS FINAL ORDERING PHYSICIAN CL IN INFORMATION T11886 10013650 Teat Name In Range Out of Range Reference Range Lab CBC (INCLUDES DIFF/PLT) WBC 5.3 3.8-10.8 Thous/mcL RBC 5.06 4.20-5.80 Mill/mcL HEMOGLOBIN 15.0 13.2-17.1 g/dL HEMATOCRIT 44.8 38.5-50.0 % MCV 88.5 80.0-100.0 fL MCH 29.6 27.0-33.0 pg MCHC 33.4 32.0-36.0 g/dL RDW 13.4 11.0-15.0 % PLATELET COUNT 289 140-400 Thous/mcL MPV 7.9 7.5-11.5 fL TOTAL NEUTROPHILS,% 49.7 38-80 % TOTAL LYMPHOCYTES,% 34.9 15-49 % MONOCYTES,% 7.5 0-13 % EOSINOPHILS,% 7.2 0-8 % BASOPHILS,% 0.7 0-2 % NEUTROPHILS,ABSOLUTE 2634 1500-7800 Cells/mcL LYMPHOCYTES,ABSOLUTE 1850 850-3900 Cells/mcL MONOCYTES,ABSOLUTE 398 200-950 Cells/mcL EOSINOPHILS,ABSOLUTE 3B2 15-550 Cells/mcL BASOPHILS,ABSOLUTE 37 0-200 Cells/mcL DIFFERENTIAL An instrument differential was performed. URINALYSIS, COMPLETE COLOR Yellow Yellow APPEARANCE Cloudy * Clear GLUCOSE,QL Negative Negative mg/dL BILIRUBIN,URINE Negative Negative KETONES Negative Negative mg/dL SPECIFIC GRAVITY 1.024 1.001-1.035 BLOOD (1+) * Negative PH 5.5 5.0-8.0 PROTEIN, TOTAL,QL Negative Negative mg/dL NITRITE Negative Negative LEUKOCYTE ESTERASE Negative Negative SQUAMOUS EPITHELIAL CELLS None Seen cor=6 cells/hpf WBC None Seen <or=5 cells/hpf BACTERIA None Seen None Seen /hpf RBC HYALINE CASTS None Seen tilli) cor=3 cells/hpf None Seen /lpf TBR TBR EPSTEIN,JEFFREY - 92116012 Page 3 - Continued on Page 4 Oast Pupil Depron em stint aelev ...oat 4.etiOinsevc• nits, re in. rafoisarkt C mesa...y.4 viltest Mori CINIXONTI. P.0•01 SCX .1.05 EFTA00727577 oft Quest Diagnostics QUEST DIAGNOSTICS INCORPORATED SPECIMEN INFORMATION SPECIMEN: 92116012 COLLECTED: 03/03/2010 REPORTED: 03/08/2010 08:20 08:16 PATIENT INFORMATION EPSTEIN, JEFFREY DOB: 01/20/1953 AGE: 57 GENDER: M FASTING: Y REPORT STATUS FINAL ORDERING PHYSICIAN CLIENT INFORMATION T11886 10013650 Test Name In Range Out of Range Reference Range Lab VITAMIN B12 . FOLATE VITAMIN B12,SERUM 0/2) 200-1100 pg/mL Please note: although the reference range for Vitamin B12 is 200-1100 pg/mL, it has been reported that between 5 and 10% of patients with values between 200 and 400 pg/mL may experience neuropsychiatric and hematologic abnormalities due to occult 812 deficiency; less than 1% of patients with values above 400 pg/mL will have symptoms. FOLATE,SERUM 10.6 > 5.4 ng/mL Normal: >5.4 Borderline: 3.4-5.4 Low: <3.4 CARDIO CRP (R) 0.8 mg/L Low relative cardiovascular risk according to AHA/CDC guidelines. See footnote 2 TBR TBR PSA,TOTAL 0.54 <=4.0 ng/mL TBR See footnote 3 APOLIPOPROTEIN A-1.B TBR APOLIPOPROTEIN Al 117 _. 94-176 mg/dL APOLIPOPROTEIN B 107 52-109 mg/dL APOLIPOPROTEIN B/A1 RATIO 0.91 Below average risk: <0.29 Average risk: 0.29-1.30 Above average risk: >1.30 HEMOGLOBIN A1C H Percent TBR Reference Range: Non Diab 6.0% HOMOCYSTEINE,CARDIO TBR HOMOCYSTEINZ e_1) <11.4 MICROmol/L EPSTEIN,JEFFREY 92116012 Page 4 - Continued on Page 5 Own bag D•ren. asm.:0.000 roc 0 ,,,,, 0411,.01 0.10.0(.10,4 et 0e PeltankSO 00014.00Cs t..el0qnneis le0rwilltd AI nein Mr.*/ mom Kn. Su,: • IMP: EFTA00727578 Ain Quest CP), Diagnostics S QUEST DIAGNOSTICS INCORPORATED SPECIMEN INFORMATION SPECIMEN: 92116012 COLLECTED: 03/03/2010 REPORTED: 03/08/2010 08:20 08:16 PAT:ENT INFORMATION EPSTEIN, JEFFREY DOB: 01/20/1953 AGE: 57 GENDER: M FASTING: Y REPORT STATUS FINAL ORDERING PHYSICIAN CLIENT INFORMATION T11886 10013650 Test Name In Range Out of Range Reference Range Lab VITAMIN D,25-OH, LC/MS/MS VITAMIN D, 25-OH, TOTAL 42 20-100 ng/mL VITAMIN D, 25-OH, D3 42 ng/mL VITAMIN D, 25-OH, D2 <4 ng/mL 25-OHD3 indicates both endogenous production and supplementation. 25-OHD2 is an indicator of exogenous sources such as diet or supplementation. Therapy is based on measurement of Total 25-OHD, with levels <20 ng/mL indicative of Vitamin D deficiency, while levels between 20 ng/mL and 30 ng/mL suggest insufficiency. Optimal levels are >30 ng/mL. TBR MAGNESIUM,RBC 4.6 4.0-6.4 mg/dL AMD FOOTNOTE(S): 1 Desirable range is <100 mg/dL for patients with coronary heart disease (CHD) or diabetes, and <70 mg/dL for diabetic patients with known CHD. 2 For Ages >17 Years: 3 CCRP mg/L Risk according to AHA/CDC guidelines <1.0 Low cardiovascular risk 1.0 - 3.0 Average cardiovascular risk 3.1 - 10.0 High cardiovascular risk >10.0 Persistent elevations may represent non-cardiovascular inflammation This test was performed using the Siemens (Bayer) chemiluminescent method. Values obtained from different assay methods cannot be used interchangeably. PSA levels, regardless of value, should not be interpreted as absolute evidence of the presence or absence of disease. PERFORMING LABORATORY INFORMATION: AMD Quest Diagnostics Nichols Chantilly 14225 Newbrook Drive Chantilly VA 20151 Laboratory Director: Kenneth Sisco. PID.PhD CLIA NO: 4900221801 TBR Quest Diagnostics One Malcolm Avenue Teterboro NJ 07608 laboratory Director: William E. Tarr, M.D. CLIA No: 31D0696246 EPSTEIN,JEFFREY - 92116012 Page 5 - End of Report OWE IA.: Our,' • .inn Ohn.,..ni es • leti en u. I int *a I Ilmrats 01..ni0wortasfl Chig ertgrint.• IntetpsOln Mufumrn. xm,n RvAl•O V* SCA ,11)A3 EFTA00727579 441,lk Quest ea, Diagnostics QUEST DIAGNOSTICS INCORPORATED CLIENT SERVICE 800.631.1390 SPECIMEN INFORMATICN SPECIMEN: F7579848 REQUISITION: COLLECTED: RECEIVED: REPORTED: PATIENT INFORMATION EPSTEIN, JEFFREY DOB: 01/20/1953 AGE: 57 REPORT STATUS incbutr., ORDERING PHYSICIAN GENDER: M FASTING: Y CLIENT INFORMATION T11886 10013650 PHONE: 212.772.9416 WOODSON MERRELL, M.D. 44 E 67TH STREET 03/03/2010 08:20 03/03/2010 21:52 03/08/2010 08:16 NEW YORK, NY 10065 Teat Name INSULIN, FREE In Range Out of Range Reference Range 7.8 1.5-14.9 uIU/mL Insulin levels vary widely in specimens taken from non-fasting individuals. PREPORIRI140 LABORATORY INFORMATION: QNI Quest Diagnostics, Nichols Institute 33608 Ortega Highway San Juan Capistrano CA 92690 Laboratory Director: Dr. Jon M. Nakaaoto CLIA NO: 0500643352 Lab QNI EPSTEIN,JEFFREY - F7579848 Page 1 - End of Report Ws, Cll 04O0*(1 Pe 41.4%,•Lte NIS (fri (J•r«. Is west aro IN • vsglanaNso/ Gre0horpsocs 0.•ullirencs lwargatom Al ere NSW 0.9 00)1130SPITL Rona i as Sell una EFTA00727580