EFTA00299745

BioReference LABORATORI ES FINAL REPORT en OPKO Health Cur.peny ER, STUART EPSTEIN, JEFFREY Specimen ID: 104364919 00B: 01/20/1553 Age: 64 V Sex: M Date Of Report: en/00/2017 1.1:34 C3070 - STUART ORSHER, K.D. U/FL: Bed; pate Collected: 08/10/1017 11:58 Re: Date Received: 08/10/2917 23:12 9 EAST 79TH ST, Patient ID: NEW YORK, NY 10021 IA ddress:9 EAST 71ST STREET, Acct 4: C3070 MO NEW YORK, Me 10821 P: v: North Amrr-::co Ejitcrr rime: Notes: NON FASTING CLINICAL REPORT Unita). Abnormalities Elcnnmcarif (May not contain all abnormal results; narrative results may not have abnormal flags. eicaSe review entire report.) Glucose 185 HI LD 235 HI Cholesterol 226 HI Triglycerides 1510 HI TgG HAND 41 Positive • Hemoglobin A1C 5.7 HI HERPES I Ab.(IgG) 7.40 MI HERPES II 5.70 HI Ab.(IgG) CK 346 MI CHLAMYDIA AB. IgG/IgM SEE BELOW • ANA SCREEN Positive • (38) ANA TITER (IFA) 1:160 HI PNEUMO Ab TYPE 1 PNEUMO Ab TYPE 4 0.6 LO (58) (58) PNEUMO Ab TYPE 8 0.4 LO PPFumo Ab TYPE 9 (9N) 0.4 LO PNEUMO no TYPE (58) (58) (58) PNEUMO Ab TYPE 19 (19F) 0.8 LO PNEUMO Ab TYPE 23 (23F) PRIMO Ab TYPE 2E0.5 LO (58) (58) (58) PNEUMO Ab TYPE 56 (16C) 1.3 LO PNEUMO Ab TYPE 68 (9v) 0.4 LO B.Henselae IgG At1:64 • (58) (58) (3) Total Protein 7.3 5.9-8.4 g/dL ridbuldil .. 4:4 . I TY-g: . edl. I . . . .. _ .. i 7-jY g/FIL IA16 Arlo . -1-3 ----- . ,.. . -1.17 57i----- Glucose 105 HI 70-99 • • mg/dl. :Sbifum . . 140 135-147 mmol/L .Potassiun 4.3 3.5-5.5 mmol/L fa . Amin 22-29 -' BUN 20 8-23 creatinine • • 0.91 88 Mar.00 mL/min iA-4EicAfricanCAdrican' • 102 >or-00 mumin Cilciun- • 9.7 8.4-18.4. deciL " 'Uric Acid i : . -Y:4 3.4,8.5 avdt - Iron 82 . • ss.lte • edi/di. litrlirartit- Totr e.s <1.2 . .mdidt • . LD 235 NI 195.225 E s • • Cr - *fit BioReference Laboratories, Inc. James Weisberger M.D. Page 1 of IS 481 Edward H. Ross Dr I Elmwood Park. 87 07407 I Laboratory Director Printed 09/08/2017 16:22 EFTA00299745 BioReference APORATOR . E$ FINAL REPORT OPICO Health Company ORSHER, STUART ----- • - EPSTEIY, 3EFFREY Specimen ID: 104364919 DOB: 31120/1153 Age: 64 y sex: M Date Of Report: 09/00/2017 11:30 U/FL: Bee: C3070 - STUART ORSHER, N,.D. a Date Collected:ea/xi/2017 11:$II tit Date Received: 06/300,2017 23:12 9 EAST 79TH ST, Patient ID: NE4 YORK, NV 10021 Addrecs:o PAST 71ST STRUT, SE.: YORK, NY 10021 Acct 4: (C3070) E D. North Americo Eastern Ti.. CLINICAL REPORT AST 7 .4, U/L PHOSPHORUS 3.i mg/dL — !ALT <5 • <41. NOTE: The result for ALT has been confirmed by repeat analysis. GGTP 23 10-71 U/L CARDIOVASCULAR/LIPIDS *-- Cholesterol 226 NI <200 mg/dL :Trigkmw404 151VICI <150 ii7ac i in The result for Triglycerides has been confirmed by repeat analysis. HDL CHOL., DIRECT Tup >40 mn/OL Test Not Performed: Unable to perform HDL test due to elevated Triglycerides (>1290). INDL airtof diolesterol. TNP >14 Chol/HDL Ratio TNP <7.4 0.0L/HOL' Ratio TNP <3.56 ibLthblesterol cib't tile <100 sox NOTE: Unable to calculate LDL due to a Triglyceride level of greater than 400 mg/dL. Aribc-tAtidAATE6 . CateCtillc. 14i" mg/ii i . • . can't Cale: one or more components was outside the measurable range. We are unable to calculate. • Test *Ida Perforad: One or more conponents were not available to percorm calculation. Iv HEMATOLOGY * WBC 6.10 3.66-11.99 x10(3)/uL we ...DVS 5.15 4:24:37017- .kligi57E1 H6B 15.4 12.3-17.6 gm/di-'' 417/ MCV 85.4 08.8.100:0 fL ---..,....- f4CH 29.9 if.0-34.1 PR 35.0 29.0-35.8. ' glitch. Em. ileir7 — -..!-- -*--- .. POLYS 46.9 36.0-T6S t ;OHMS . • . 39.0 .--- :54/1:9 _.. . . . :Alois 7.7 0.0-13.0 S .. . BioReference Laboratories, Inc. JamosVhaisboroorbeD. Page 2 of IS 401 Edward H. Ross Dr i Elmwood Park: ND 07407 Laboratory Director printed 09/68(2617 16:22 EFTA00299746 BioReference I. A B ORATOR I ES FINAL REPORT on OPKOHHamh Company GUSHER, STUART EPSTEIN, 3EFFREY • Specimen ID: 104384919 I DOO! 81/20/1953 Age: 04 Y Sex: M Date Of Report:09/0812017 11:38 D U/FL: Bed: Date Collected: 08/30/2017 11:58 0 03870 - STUART 'ASHER, N.D. Rs: Date Received: 88/30/2017 23:12 C 9 EAST 79TH ST, Patient ID: 0 NEW YORK, NY 10021 eess:9 EAST 71ST STREET, NEW YORK, NY 10021 R Acct #: 03070) MO P: P: North Americo Foltern Time CLINICAL REPORT -43:-.22:2-Ä-z-11":-777•77137: . • EOS 5.4 0.0-8.0 . BASOS 0.6-2.B leeet 6RANULOCYiES 0.2 >(.10.4.6 Platelet Count • 248 144.400 xi0(5)/uL MPV 9.6 8.2-11.9 .-e URINALYSIS Co or YELLOW YELLOW, STRAW, AMBER character CLEAR CLEAR .Specific Ori4.4,Y Or. " .1.019 1.003-1.039 Urehe 6.5 5.0-8.0 Oreteie- ,-Üani •- • - - • 'iüdkiie-- • NEGATIVE WOW ketone, 'urine • NEGATIVE • NEGATIVE ru o6iinölten urine 0.2 0.2-1.0 wg/dt ;Bilirunii, urine ' NEGATIVE NEGATIVE !eleceet.urile NEGATIVE NEGATTir • • •• NEGATIVE • NEGATIVE aate -vTi— e: NEGATIVE NEGATIVE !Crystals Urine NONE NONE NONE NONE PER fer :Wit; tWine 0;4 8.4 PER HPF NONE SEEN ;Epithelial Cel7.s, Br • NONE NONE-PEW ;cast, Nyaline, urine 8-4 0-4 PER LPF !teat; NONE SEEN 0-1 PER LPF • • lust, ROC, urine. • . NONE SEEN 0-1 PER LPF • rinek-teria; Urine - NONE • • • NONE:FEW ' "‚i ir ROBIOLOGY !CULTURE, URINE NO GROWTH NO GROWTH • SITE: URINE LyrE W6, IgG W/BANDS T --- alp BAND 18 Negative Negative kDa ,IgG RAND-26 NegatfUe kDa rig& BAND 28 'Negative • NegatiVe kDa lie BAND 30 Negative Negative kDa IgG BAND 39 Negative Negative kDa IgG BANCO 41 Positive • Negative kDa IgG BAND 45 Negative Negative kDa rfge. BAND S8 NegitIVO kDa Olt/Reference Laboratories, Inc. Jamms1NoWsorgorht0. Pap 3 of 15 481 Edward M. Roes Or I Elmwood Park, N) 07407 I Laborstory Director printed 00/011/2017 16:22 EFTA00299747 BioReference LABORATORI E $ FINAL REPORT tin OPKci maim, Company ORSHER, STUART PSTEIN, JEFFREY Specimen ID: 204364919 P DOS: ex/20/1953 Age: G4 V Sek:M Date Of Report: 09/88/2017 11:30 A U/FL: Bed: C3070 - STUART ORSHER, M.D. A Date Collected: 08/30/2017 11:58 Rm: Date Received: 88/30/2017 23:12 9 EAST 79TH ST, I atient ID: NEW YORK, NV 10021 E Address:9 EAST 71ST STREET, N NEW YORK, NY 10021 Acct e: (C3670) MO P. P: North Amerit0 Ehnen, Time CLINICAL REPORT • — •-.F77:-7., 7: IgG WINO 66 togatIve Negative kDa Negative Negative . ' NOTEt LYMI ANTSCOY (Ige) by WESTERN BLOT is considered to be positive if any 5 but of the-following 20 bands are present: 18, 23, 28, 36, 39, 41, 45, 58, • 66,93 1070. • Lyme Ig6 INTERPRETATION' WE Negative Negative LYME WB, 1gM W/BANDS /81 BAND 23 Negative Negative ItDa le WO 39 Negative Negative kDa IgM BAND 4a Indetermin Negative kOa NOTE: LYME ANTIBODY (18K) by WESTERN BLOT is considered to be positive if any 2 out of the following 3 bands are present: 23, 39, 41 kDa. Lyme Iglu ~IITERPIIETATIOPI {d8 • • glegative Negative IgE, SERUM _ TNP Kor=114.0 kU/L . . Test Not Performed: Specimen is LIPEMIC. ALLERGEN INTERPRETATION: CONCENTRATION (kUA/L) INTERPRETATION <0.10 Absent 0.18 - 0.34 Very Low 0.35 • 0.69 LOW 0.70 - 3.49 Moderate 3.50 - 17.49 High 17.50- >200.80 Very High Hemoglobin Alt i HEMOGLOBIN Ale AM) eA6 REFERENCE RANGES Ale(%) 0148ETES CATEGORY* ‹S.7 Normal (non-diabetic) 5.7-6.4 Increased risk of diabetes e>6.5 Consistent with diabetes Alc(%) aNEESTDATED AVERAGE PLASMA GL00061)(mg/dL) 6 126 7 154 8 183 9 212 10 240 11 269 298 81oReFerenee Laboratories, inc. James Weisberger M.D. Page 4 of IS 481 Edward H. Ross Dr I Elmwood Park, Hl 07407 I Laboratory Director Printed 09/08/2017 16:22 EFTA00299748 BioReference _ABORATOR I FINAL REPORT ES OPKOHAnith Company .... _ ORSHER, STUART EPSTEIN, 1EFFREY Specimen ID: 104364919 P DOB: 01/20/1953 Age: 64 V Sex: M Date of Report:69/08/201711:39 C3070 - STUART ORSHER, M.D. A /FL: Bed: Date Collected: eS/30/2017 11:S0 m: Date Received: 03/B9/2017 23:12 9 EAST 79TH ST, I atient ID: NEW YORK, NY 10021 Address:9 FAST 71ST STREET, N NEW YORK, uY le021 cet 4: (C3070) T P: I Mort' , 4morico Eoltcrm Tlmr CLINICAL REPORT *recommended ranges-American Dlabetes AssociaCion(2ea0) NOTE: The amount of glycated hemoglobin as measured by the HbAle test may be overestimated in African Americans and should not be used as the sole parameter of glycemic burden. Similarly, hemolysis, genetic hemoglobin variants and chemically modified hemoglobin derivatives (as seen in renal failure, smoking, aspirin use) may also affect glycated hemoglobin levels. A!0/Rh ltbf~ 'ME. .. . A Pas .. . Troi. . . 6.1.78:4:5Je . . . . Test mot Performed: Specimen rejected for testing due to moderato or merked heeolysis. THYROXINE(T.25 ?HP 4.9-12.9 ug/WL T3 OrrAki IF--._ " INp. • 114fROXINE; FREE terT•• -ir TNP • 8.88-1.73 ng/dL FREE T4 INDEX TNP 1.5-3.8 rictilifitofaii)rilWAL 11441- nedi !TIA.Iiiiiii-(5PEP) • • - • :ALPHA-1,61.0B.(SPEP) • . . . TNP . 8.17-6.41 • gicir Aiiiiik;i:EL66:($0E0)• TNP 8.42-6.99 iBE A GLIECOPEIT TNP WARWELWAsiii0j TNP -g/dL •-• •• 0.65-2.0 • .REiPIRE TNP iSPEP GRATA TNP See• Graph • NOTE: Specimen submitted is LIPEMIC. This may cause inaccurate results. Please RISUMMIT a fasting specimen at your earliest convenience. 'PERM* ; TNP 22-322 • ngimL ' tut .roe•Performed: Specimen rejected for testing due to moderate or marked • hemolysis. NEP. A Al.. TOTAL TNP Non-Reactive Her.-WW11-,46:-Ukr TNP NOsfleactive -- Non-Reactive • •• .TIP . . . Non:AisEfiim .. .. • g Negative • . -. • pip. BE !AG.. TNP Non-Reactive ' !INA, SERUM 225 70-488 . mg/dl. rigGi .:MIMI e .' 1047 7Ro-W.- will . • . 3 QC jiff* -' -" " 46 '' 40-230 ..mg/dl !RCM . Non- Non-RfeetiVe Titer Reactive gioReference Laboratories, Inc. JamesWeisbergerNID. Page 5 of 15 481 Edward H. Ross Or I Elmwood Park, 63 07407 LmbcwsdoriOlreclor Printed 09/08/2817 16:22 EFTA00299749 BioReference _ ,1 :7I RATOR I ES FINAL REPORT OPKO Health Company ORSHER, STUART PSTEIN, 3EPFREY Specimen ID: 164364919 D DOB: 01/20/1953 Age: 64 y Sex: ti Date Of Report: 09/08/2017 11:50 /FL: Bed: Collected: 08/30/2817 11:58 0 3870 - STUART ORSHER, M.D. A Date T Rm: Date Received: 08/30/2017 23:22 9 EAST 79TH ST, Patient ID: p 0 NEW YORK, NY 10021 Address:9 EAST 71ST STREET, N R Acct a: (C3070) MO T NEW YORK, NY 10021 E P: earth America Eastern Time CLINICAL REPORT HERPES I AD.(tic) 7.49 NI <0.99 INTERPRETATION OF RESULTS FOR MSV-1 AND HSV-2 Ig6 ANTIBODY Antibody Index Result Interpretation <0.90 AI Negative No HSV-IgG antibody detected 0.90-1.89 AI Equivocal Equivocal result. Repeat in 4-6 weeks >or=1.10 AI Positive IgG antibody detected e•ocorment:This assay is type specific and will differentiate between Herpes Simplex 1 and 2 infections. Test results should be interpreted in conjunction with clinical history. The performance of this assay has not been established for pediatric populations, for neonatal screening or for testing the imeunocompromised. HERPES II Ab.(IgG) S.76 HZ .0.9e Al I INTERPRETATION OF RESULTS FOR HSV-1 AND NSV-2 IgG ANTIBODY Antibody Index Result Interpretation <e.g. Al Negative No RSV-In antibody detected 0.90-i.09 AI Equivocal Equivocal result. Repeat in 4.6 weeks ›orm1.10 Al Positive Ig6 antibody detected **.*Conment:Thi•s else), is type specific and will differentiate between Herpes Simplex 1 and 2 • infections. Test results should be interpreted in conjunction with clinical histOry. ' The performance of this assay has not been established for pediatric populations, fer neonatal screening or for testing the lemunocompromised. . . 193.07744.e NOTE: Patients receiving the drug Nandrolone cannot be tested for TESTOSTERONE, total using the ESA method (test code 0379-8) due to a strong interference from the drug. Clinicians are asked to request Testosterone, Total by LC/F6/06 (test code 3451-6) for these patients. a. BAG 10 19-399 IH.PYLORI Ab.,Ige 0.34 See Below iN.PYLORI Ab.,IgA .... ... .... _ ...._ . 9.49 — wee Below _ H.PYLORI Ab.,Teri TE4i-d - fkAgE Ab. F.44 <0.41 riabesia isicroiriiiiiPA(9) <1:20 -.'" '-' '' areilb sinIcea si) • <1:64 <1:64 Sera free patients aboon to have been infected by other tick-borne , pathogens, tabesii4uncani, Rickettsia rickettsii and Borrelia burgdorfiri, were screened and found negative by the B. microti /gG IFA. This test was, developed and its performance characteristics determined by 1 Viraoor:EurofinS. It has not been cleared or approved by the U.S. Food and — DrugAdainiatretion. Testing!PerfOrmed At: Viracor Eurofine BioReforenbe Laboratories, Inc. James Welsbergar M.O. Page 6 of 15 481 Edward H. Ross Or I Elmhood Park, N; 07407 I Laboratory Director Printed 09/98/2017 16:22 EFTA00299750 BioReference AgoRATOR I 65 FINAL REPORT on OPKOHealUi Company ORSHER, STUART EPSTEIN, 3EFFRET Specimen ID: 104364919 1 I DOB: 01/20/1953 Ap:64 V Sex: m Date Of Report: 00/08/2017 11:30 C3070 - STUART ORSHER, H.D. U/FL: Bed: to Collected: 08/30/2017 11:58 Rm: Date Received: 08/30/2017 23:12 9 EAST 79TH ST, Patient ID: NEW YORK, NV 10921 Address:9 EAST 71ST STREET, NEW YORK, NY 10021 Acct 4: (C3070) P: north Amtrica Eastern Time 1001 NW Technology Drive Lee's Siltrit, MO 64086 (see) 385-5198 CLIAlt 26O-0983643 Tetanus Antibody IgG (58) 1.37 >0.1 • . .. "This test was developed and its performance characteristics determined by Viracor Eurofins. It has not been cleared or approved by the U.S. Food and : Drug Administration. ' Testing Performed At: • Viracor Eurofins 1001 Nw Technology Drive Lee'sSummit MO 64086 ILI J IIIIIii 20D-0983643 Diphtheria Antibody /gG(58) 0.31 >0.1 Testing Performed At: Viracor Eurofins ' 1081 NN Technology Drive Lee's Summit, MO 64086 CLIA* 26o-0983643 HIV Ag/Ab • • • TWO Non-ReaCtive Test Not Performed: Unable to perform HIV testing, specimen is LIPEMIC. • Assay Information: Assay for the detection of HIV p24 antigen and antibodies to Human IMANnodeficiency Virus Type 1,including Group 0 {HIV-1 + "0") and/or Type 2 (HIV-2) Method: Chemiluminescence (Siemens Healthcare Diagnostics) oey- SEE BELOW • C. pneumcniae IgM Titer <1:20 <1:20 C. trach IgM Titer <1:28 <1:20 C. psittaci IgM Titer <1:20 <1:20 C. pneunoniae IgG Titer 1:12* H <1:64 E. trach IgG Titer 4:64 <1:64 G. psittaci IgG Titer <1:64 <1:64 --INTERPRETIVE TIIFORMATION: C. psittaci IgG Titer --The rhlanydia antibody test contains both species- and genus- --specific antigens, and serological cross-reactions so be seen in mieeeference Laboratories, Inc. James Wrist:tenter M.D. Page 7 of 15 461 Edward H. Ross Or I Elmwood Park, N3 07407 I Laboratory Director Printed 09/0U2017 16:21 EFTA00299751 BioReference ASCaATPR I ES FINAL REPORT nn OPKO Mnnhth Company ORSHER, STUART EPSTEIN, JEFFREY Specimen ID: 104364929 DOB: 01/20/1953 Age: 64 y Sex: m Date Of Report: 09/00/2017 ii:S0 C3078 - STUART ORSHER, M.D. U/FL: Bed: Date Collected: 00/30/2817 11:58 Rm: Date Received: OS/30/2017 23:12 9 EAST 79TH ST, Patient ID: NEW YORK, NY 10021 ress:9 EAST 71ST Steer, Acct (C3070) NEW YORK, Ny 10021 P: north Anorto &deem rtot oth acute and conva escent seep es (less t an 1:128 . A C. --pneumoniae-specific reaction will exhibit titers twofold or --greater than titers observed with the C. trachomatis or C. • --psittaci serology. Any IgG titer may indicate past exposure to --that particular species. IgG titers in recently infected --indiyiduals are typically grater than or equal 1:512. --The Chlamydia microimemnefluOrescent assay slides utilize C. --psittaci, C. petymeniae, and nine serotypes of C. trachomatis. The --LGV strains of C. trachomatis are not included in this assay. --Test developed and characteristics determined by OUP --Laboratories. See Compliance Statement 4: aruplab.com/CS --www.aruplab,com, Julio Delgado, MD - Lab. Director QUINTANA Affdik (30) SEE BELOW B. quintana Ab, IgM < 1:16 --INTERPRETIVE INFORMATION: Bartonella quintana Ab, Ism -- Less than 1:16 Negative-No significant level of Bartonella quintana Igg antibody -- detected. -- 1:16 or greater Positive-Presence of IgM antibody -- to Bartonella quintana detected, -- suggestive of current or recent -- infection. --The presence of Igm antibodies suggests recent infection. Low --levels of 'gm antibodies may occasionally persist for more than 12 --months post-infection. --Test developed and characteristics determined by AAUP --Laboratories. Se. Compliance statement A: aruplab.com/CS --44w.aroPlab.com, Julio Delgado, MD - Lab. Director B. quintana Ab, IgG <1:64 --INTERPRETIVE INFORMATION: Bartonella quintana Antibody, IgG -- Less than 1:64 Negative: No significant level of Bartonella quintana IgG antibody detected. 1:64 - 1:128 Equivocal: Questionable Presence of Bartonella quintana IgG antibody detected. Repeat testing in 10-14 days may be helpful. 1:256 or greater Positive: Presence of IgG antibody to Bartonella quintana detected, suggestive of current or past infection. --A low positive suggests past exposure or infection, while high --positive results nay indicate recent or current infection, but is --inconclusive for diagnosis. Serocorversion between acute and BioReference Laboratories, Inc. JarneeMftneberimelAIL Page 8 Of 15 4S1 Edward H. Ross Dr I !Inwood Park, N3 07407 LaboratoryDbetter printed 09/68/2017 16:22 EFTA00299752 FINAL REPORT _AscRAference BioRe TOR I Es an OPKO ment Comonny imen ID: 104364919 ORSHER, STUART EPSTEIN, 3EFFREY DOS: 01/20/1953 Age: 64 Y Sex: M to Of Report: 09/08/2017 11:30 U/FL: Bed: Date Collected: 08/30/2017 11:58 C3070 - STUART ORSHER, III. Rs: Date Received: 88/30/2017 23:12 9 EAST 79TH ST, Patient ID: Address:9 EAST 71ST STREET, NEw YORK, NY 10021 NEw YORK, NY 10021 Acct 4: (C3070) P: North America Eastern lime CLINICAL REPORT --convalescent sera is cons ered strong evidence of recent --infection. The best evidence for infection is a significant change in --on two appropriately timed specimens where both tests are done -.the same laboratory at the same time. --Test developed and characteristics determined by ARUP --Laboratories. See Compliance Statement A: aroplab.cca/CS SIEP C 43. tN0 Novi-Reactive Test Not Performed: ile were unable to perform the Hepatitis test(s) requested due to lipimia. Please resubmit a fasting specimen. HEP C Ab. (S/CO RATIO) PIP <0.80 (30) Performed by: MOP 500 Chipeta Way Salt Lake City, UT 84108 (58) . Performed by: Viracor Eurofins Clinical Diagnostic 1001 NW Technology Drive Lees Summit, MO 64886 . Test Not Performed: One or more components were not available to perform calculation. H.PYLORI (IgG, IgA, IgM) REFERENCE RANGES RESULT (UNITS) INTERPRETATION <0.89 NEGATIVE 0.89.0.99 EQUIVOCAL >0.99 POSITIVE NOTE: This is a screening test for H.PYLORI. The diagnosis of gastritis and peptic ulcers should be assessed with the patients medical history and clinical symptoms. Results in the equivocal range should be rechecked with a now specimen in 2.5 weeks. NOTE: The H. Pylori, IgM test was developed and its performance characteristics were determined by BioReference Laboratories. It has not been cleared by the U.S. Food and Drug Adminis- tration. the FDA has determined that such clearance or approval is not necessary. This test is used for clinical purposes. It should not be regarded as investigational or for research. This lab has been approved by CLIA 88 and designated as a high complexity laboratory and is qualified to perform this test. ASSAY INFORMATION: Method ELISA NOTE: A result of equivocal or positive for B.burgdorferi (Lyme Ab) should not be interpreted without supplemental Western Blot testing. "Lyme Antibody ranges (IgG/IgM)*s <0.91 A Negative 0.91-1.09 = Equivocal JanwmcnielsbemperNUO. Page 9 of 15 lioReference Laboratories. Inc. Laboratorytlinctor Printed 69/08/2617 16:22 481 Edward H. Ross Dr I Elmwood Park. N3 07467 EFTA00299753 BioReference 3 R : ES FINAL REPORT A 4);71.(C7Healn Cornonny ORSHER, STUART , EPSTEIN, 3EFFREY Specimen ID: 104364919 0436: 01/24/1953 Age: 64 Y Sex: m Date Of Report:ea/es/2017 11:30 C3070 - STUART ORSHER, N.O. U/FL: Bed: Date Collected: 08/30/2017 11:58 Rm: Date Received: 08/30/2017 23:12 9 EAST 79TH ST, Patient ID: NEW YORK, NY 10021 Address:9 EAST 71ST STREET, NEW YORK, NY 10021 Acct 4: (c3070) NO P P: I North America Eastern Time CLINICAL REPORT >1. Positive Hepatitis 8 Result Interpretation (for reference use only) Marker LX/EA• Acute Past Chronic HBV Vice. HBeAg HBeAg +/- HEP.R.CORO HEP.B.CORE AB. H6eAb HBsAb +/- 'Late Incubation/Early Acute MOTE: In remote past infection, HBsAb level may be Negative or Nom -Reactive in sore patients. BikgdOEEN Positive • Neg4<1:80 !du ... 0.2 <0.5 mg/di :ESR (SNI-Rate,' 15 <21 an/hr EDUC __ '' ..Ado TNP >5.38 ng/mL .. Test Not Performed: Specimen rejected for testing due to moderate or marked hemolysis. Folic Acid Range units (ng/.L) Normal >5.38 Borderline deficient 3.38-S.88 Deficient 0.36-3.37 Excessive >24.00 iii-912 PgJEL . . . ! Test Not Performed: Specimen rejected for testing due to moderate or marked .! histolysis. 250X, VITAMIN D TNP Test Not Performed: unable to perform testing, specimen is LIPEIMIC. VITAMIN 0,25-OH TEST INPORHATION Range (ng/mL) Suggested Interpretation <20.0 Deficient 20.0-31.9 Insufficient 32.0.100.0 Sufficient )100.0 Possible Adverse Effects CV1 7 $1;WOCIPREOCT •.• Two 19.9-79.3 pg/iL . Test Not Performed: Unable to perform testing, specimen is LIPEMIC. BioReference Laboratories, Inc. JammsWeisbergmrh1D. Page 10 of 15 eel Edward H. Ross Dr I Elmwood Park, 47 07407 laborMoryDiredor Printed 09/08/2017 16:22 EFTA00299754 BioRe ference FINAL REPORT - A 9 09ATOR i ts en C7S2PCC2 Health Ccrnpnny EPSTEIN, JEFFREY Specimen ID: 184364919 ORSHER, STUART DOS: 01/20/1953 Age:64y Sex: M Date or Report: 09/88/2017 11:se U/FL: Bed: Date Collected: 08/30/2017 11:58 C1078 - STUART ORSHER, M.D. Date Received: 08/30/2017 23:12 Rm: 9 EAST 79TH ST, Patient ID: NEW YORK, NY 10021 Addresa:9 EAST 71ST STRICT, NEW YORK, NY 10021 ACCt *: (C3078) NO P: P: North Americo Eastern Time IIIII HUMPS VIRUS Ab.(igG) 3.07 Immunew>1.89 KOOTICUICD1 RANGES FOR LEAD, BLOOD Reference Range (ug/dL) Adult/Child <5.0 Occupational <40.0 NOTE: Lead risk guidelines conform to CDC Guidelines. BioReference is an OSHA-APPROVED lab for lead testing. NOTE: Blood lead levels in the range 5.0-9.9 ug/dL have been associated with adverse health effects in children aged 6 years end younger. NOTE: All Lead results m/>5.8 ug/dL are confirmed by repeat analysis. NOTE: Capillary and microtainer blood levels 2/>5.0 ug/dL may be due to contamination from lead found on the finger surface and requires confirmation on venous blood. by NOTE: This test for LEAD was developed and its performance characteristics were determined on. BioReference Laboratories. It has not been cleared by the U.S. Food and Drug Administrati TM FDA has determined that such clearance or approval is not necessary. This test Is used for clinical purposes. It should not be regarded as investigational or for research. This lab has been approved by CLIA 88 and designated as a high complexity laboratory and is qualified to perform this test. ASSAY INFORMATION: ICP-MS Immunotyping,Serum THY Negative NOTE: Specimen submitted is LIPEMIC. This may cause inaccurate results. Please RESUBMIT a fasting specimen at your earliest convenience. AeRclikii; BLOOD (30) 6-le ug/L INTERPRETIVE INFORMATION: Mercury, Blood Blood mercury levels predominantly reflect recent exposure and are most useful in the diagnosis of acute poisoning as blood mercury concentrations rise sharply and fall quickly over several days after ingestion. Blood concentrations in unexposed individuals rarely exceed 28 ug/L. The provided reference interval relates to inorganic mercury concentrations. Dietary and non-occupational exposure to organic mercury fonts may contribute to an elevated total mercury result. Clinical presentation after toxic exposure to organic mercury say include dysarthria, ataxia and constricted vision fields with mercury blood concentrations from 20 to SO ug/L. Test developed and characteristics determined by ARUP Laboratories. 5te Compliance Statement aruplab.Com/CS kuw.aruplab.c08, Julio Delgado, MD - Lab. Director 8U8EOLA/MEASLES(IgG) 1.81 Immune-)1.09 James Worsens, M.D. Page il of 15 BioReference Laboratories, Inc. Laboratory Director printed 09/08/2817 16:22 481 Edward H. Ross Dr I Elmwood Park, N) 07407 EFTA00299755 BioReference FINAL REPORT CIPKO ,.• ORSHER, STUART EPSTEIN, JEFFREY Specimen ID: 104364919 DOB: 02/70/1253 Age: 64 V Sex: M Date Of Report: 09/00/2017 11:3n 0 U/FL: Bed: Date Collected:OE/30/2017 11:53 0 C3070 - STUART ORSHER, III. Rm: Date Received: 00/3e/2017 23:12 C 9 EAST 79TH ST, Patient ID: C NEW YORK, NY 10021 Address:9 EAST 71ST STREET, 2 Acct #: (C3070) MD .VW YORK, NY 1e671 P; P: I North Americo Eastern Time CLINICAL REPORT VARICELLA ZOSTER,Ie REFERENCE RANGE for Varicella-rester IgM Abs: Less than 0.91 Negative 0.91 - 1.09 Equivocal Greater than 1.09 Positive Results from any one IgN assay should not be used as a sole determinant of a current or recent infection. Because an IgM test can yield false positive results and low levels of IV antibody may persist for more than 12 months post infection, reliance on a single test result could be misleading. Acute infection is best diagnosed by demonstrating the conversion of IgG from negative to positive. If an acute infection is suspected, consider obtaining a new'specimen and submit for both IgG and IgM testing in two or more weeks. VARICELLA ZOS.(IgG) 3.46 Immune=>1.09 INP 13.0-85.0 pg/ed. Test Not Performed: Specimen rejected for testing due to moderate or marked hemolysis. .68.144i6io 04 TITER cle i RMBELLAAG . TNP <1.4 Immuftem>9.9. Test ripe Performed: Specimeisrefected for testing due to moderate or marked IIJAIL BOA J . .• . hemblyils. liTERST/gICH OF RESULTS FOR RUBELLA 10 ANTIBODY I . *milt! 1ZU/mL) Interpretation 4.5.0 Negative Non-Immune 5;0 n 9.9 Equivocal Retest > 9;0 Positive Immune interpreted as EQUIVOCAL indicate a level of antibody below the -Positive.(Immune) cut off. Repeat testing on a new specimen is Suggistkd tv assess antibody response after a booster shot or a viral Syndrome... • ASSAYINRadgilONt %Hotbed themilualmescence (Siemens Diagnostics) :AMR TITER (IFA) 1:160 III '1:50 Titer ANA PATTERN = HOMOGENEOUS MD SPECKLED Antibodies To Association Frequency ate Screening test for SLOE In symptomatic patients. 95.100% (Antinuclear A, BioReference Laboratories, Inc. JarnenVeninberciprMI.D. Page 12 of 15 eel Edward H. Ross Dr I Elmwood Park, N] 07407 I Laboratory Director Printed 09/02/1017 14:71 EFTA00299756 FINAL REPORT Bio Reference LAIORATOR IES en C2PN<C2Heafth Company EPSTEIN, IEFFREY Specimen ID: 104364919 ORSHER, STUART IIIIIIIIII DOB: 01/20/1953 Age: 64 Y Sex: M Date Of Report: 09/08/2017 11:30 U/FL: Bed: Date Collected:08/30/2017 11:58 C3070 - STUART ORSHER, Rm: Date Received: 08/30/2017 23:12 9 EAST 79TH ST, Patient ID: Address:9 EAST 71ST STREET, NEW YORK, NY 10021 NEW YORK, NY 10021 Acct li iTh0 MO P: P: North America fasten, rime CLINICAL REPORT re assay 6e -SON ANA Assist with diagnosis of Scleroderna (Systemic Sclerosis). 40-78% ANA Sjogren's Syndrome. Idiopathic Inflammatory Polymyositis or Dereatteyositis• 38.80% ANA Antibodies to specific (Extractable) Nuclear Antigens (ENA)/Proteins 25-05% dsONA Characteristic of SLE. Rare in other CTDs. Highly associated with active disease. 15-301 Sm(Smith) Highly specific for SLE. Uncommon in other diseases. 35-60% SS A (R0) Associated with SLE, Neonatal Lupus and Sjogren's Syndrome. 15% 55 8 (La) Associated with SLE. 44-68% 55 B (La) Associated with Sjogren's Syndrome. 34-40% scl-70 (anti DNA Topoisomerase) Associated with Diffuse Scleroderma and rarely co exists with anti-Centromere Abs which are associated with Limited SchrOderee Disease. Associated with Polymyositis or Dermatomyositis. 28-25% 7o-1 88% Centromere Identified by staining pattern. Their presence is associated with CREST Syndrome (Limited Systemic Sclerosis). Used to categorize Mixed Connective Tissue Disease (MCTO). High Correlation US nRNP 98.100% Histone Proteins (Chromatin) Associated with drug induced LE. Test and Tests for . refmavanaugh,A(et al.):Guidelines for clinical Use of the Antinuclear Antibody Specific Autoantibodies to Nuclear Antigens. Arch.Pathol Lab Med. Vol.124,2an 2040. • .... PrivAO al rm€-i"(3t) <0.3 LO >1.3 PNEUMO Ab 1,10t.i-iiii ' - -- 1.4 ' - - '›i'i. ' --.. '' .ugiii. • 0.8 LO itli . . . — ug/mL -.- PNEUMO Ab TYPE 4 (ill — . . . . 0.4 LO. >1.3 ug/.L PNEUMO Ab TYPE 8 (58) MEUSE Ab TYPE 9 UN(F (58) 0.4 LO >1.3 ONEUPO Ab TYPE 12 (12F) (58).. .. '' 40.0 0 >1.3 '' '' - PHEW/ Ab ISIPE•11. 5g5 23.2 >1.3 - Ng/nn liNgD710 Mi. TYPE -iii tisirj• tisj • • • • 0.8 Lo >1:S • • - • Isilrio :'WIWI-21Sr (ii) a.s LA 31:1- tag/8i ug/iL 1PALuno Ab TYPE 26 (68) (58) • • iS:s• Lei >1i' " - Newark 'TYPE 5 (58) 7.8 >1.3 ug2mi . . . .. oNeUmo- Ati riotSi (7P) (58) 1.5 >1.3 ug/ni • •• —r-.- niitump:Ab TYPE 56-(194—(556-------:---..- 0.4 LO >1.3 ug/mL MUM° Ab TYPE 68 (9V) (58) Testing Performed At: Viracor Eurofins 1001 NW Technology Drive Lee's Summit. PO 64086 CLIA8 26D-0983643 $$- toff; Byeati 2-23. . ug/L 1 . T James Weisberger M.D. Page 13 of is eioaefereeee Laboratories, Inc. Laboratory Director printed 09/08/2017 16:22 481 Edward H. Ross Dr I Ellwood Park. NI 07407 EFTA00299757 BioRe ference LABORATOR ES FINAL REPORT an ['PAC(' Health Company ORSNER, STUART EPSTEIN, lEFEREY Specimen ID: 104364919 DOB: 01/20/1951 Age: 64 Y Sex: H Date Of Report: 09/08/2017 11:S0 C3070 - STUART ORSHER, III. U/FL: Bed: Date Collected: 08/30/2017 11:58 Rm: Date Received: 08/30/2017 23:12 9 EAST 79TH ST, Patient ID: NEW YORK, NY 10021 Address:9 EAST 7157 STREET, Acct (C3070) rev YORK, NY 20021 P. North AmartCO Eastern Timis CLINICAL REPORT A.Phagocytophila LEG Ab (24) <1:64 8.Henselae IgG Ab (3) 1:64 * < 1:64 titer B.Henvelae ICIAb (3) <1:20 < 1:20 titer ... •••••••••••••••• This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics Nichols Institute Valencia. It has not been cleaned or approved by the US Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. Interpretation (24) SEE NOTE ANTIBODY NOT DETECTED REFERENCE RANGE IgG <1:64 IgM <1:20 Anaplasna phagocytophtlum is the tick-borne agent causing Human Granulocytic Ehrlichiosis (HGE). PIGE Is distinct and separate from Hunan Monocytic Ehrlichiosis (HMG), caused by Ehrlichia chaffeensis. Serologic crossreactivity between A. phagocytophilum and E. chaffeensis is minimal (5-15%). This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics Infectious Disease. 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. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes. Quest Infectious Disease 33688 Ortega Hwy (3) Performed by: Quest Diagnostics Nichols Institute of Valencia 27027 Tourney Road Valencia, CA 91355-5386 (24) Performed by: Quest Infectious Disease 33608 Ortega Highway San Juan Capistrano, CA 92675 'medical Director Hollis I. Batterman, MD (30) Performed by: ARLIP 580 Chipeta Way Salt Lake City, UT 84108 (58) Performed by: Viracor Eurofins Clinical Diagnostic BioReference Laboratories, Inc. JmneeVielsbengera40, Page 14 of 15 481 Edward H. Ross Dr I Elmwood Park. N1 07407 I .1 .1 labonnoryDnechw Printed 09/08/2017 16:22 EFTA00299758 BioReference LABCPATOR I ES FINAL REPORT sr OPKO Hewn Company ORSHER, STUART EPSTEIN, 1EFFREY cities) ID: 184364919 0 DOB: 01/20/1953 Age: 64 y sex: m Date Of Report: 09/00/2017 11:30 0 C2870 - STUART ORSHER, H.D. U/FL: Bed: Date Collected: 08/30/2017 12:58 C Rm: Date Received: 00/30/2017 23:12 9 EAST 79TH ST, Patient /0: NEW YORK, NY 18021 dreSS:0 EAST 71ST STREET, Acct M: (C3070) MO NEW YORK, NY 10021 P: P: North America Eastern Time 1001 Nel Techno ogy Drive Lees Summit, m0 64006 INTERPRETATION OF RESULTS FOR RUOEOLA(MEASLES),MUMPS,VARICELLA VIRUS ASS. Range Interpretation < or . 0.90 Negative Non-Immune 0.91 - 1.09 Equivocal Retest > or 1.10 Positive Immune Results interpreted as EQUIVOCAL indicate a level of antibody below the positive (Immune) tut off. Repeat testing on a new specimen is suggested to assess antibody response after a booster shot or a viral syndrome. I NOTE: The following tests: SERUM SELENIUM, SERUM CHROMIUM, ARSENIC 81.000 and CADM/uM BLOOD were developed and their performance characteristics were determined by BioReference Laboratories. They have not been cleared by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. These tests are used for clinical purposes. They should not be regarded as investigational or for research. This lab has been approved by CLIA 88 and designated as a high complexity laboratory and is qualified to perform these tests. NOTE: The specimen submitted was MARKEDLY hemoly2ed. Some results may be affected. Please resubmit as needed. NOTE: Specimen submitted is L/PEMIC. This may cause inaccurate results. Please resubmit a fasting specimen at your earliest convenience. Bioneference Laboratories, Inc. Jarnesweiaberge<1411). Page 15 of 15 461 Edward H. RoSS Dr I Elmwood Park, 10 07407 I Laboudor/Direotor Printed 09/08/2017 16:22 EFTA00299759