EFTA00609801

BioReference LABORATORI ES FINAL REPORT en C2FeBel:Imeaks Company ORSHER, STUART EPSTEIN, JEFFREY Specimen ID: 104364919 DOB: 01/20/1953 Age: 64 V Sex: M Date Of Report: 09/04/2017 11:3* - STUART ORSHER, K.D. U/FL: Bed; Date Collected: 08/30/2017 11:58 Rn: Date Received: 08/30/2017 23:12 9 EAST 79TH ST, Patient ID: NEW YOR 21 Address:0 EAST 71ST STREET, Ac • NEW YORK, Ii? 10821 P: North Amrr-::co Ejitcrp rime: Notes: NON FASTING CLINICAL REPORT linital Abnormalities Eannmary (May not contain all abnormal results; narrative results may not have abnormal flags. Please review entire resift.) Glucose 185 HI LD 235 HI Cholesterol 226 HI Triglycerides 1510 HI IgG BAND 41 Positive • Hemoglobin A1C 5.7 HI HERPES I Ab.(IgG) 7.40 MI HERPES II 5.70 HI Ab.(IgG) CK 346 HI 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 PNLUMO Ab TYPE 9 (9N) 0.4 LO PNEUMO Ab TYPE 1: (58) (58) (58) PNEUMO Ab TYPE 19 (19F) 0.8 LO PNEUMO Ab TYPE 23 (23F) PHELPS° 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 6:4 . ITY41 edt 1.7-3.7 g/dL IA/6 Ratio . . .. 103 HI 70-99 mg/dl. :Sod' . . 140 135-147 mool/L . Potassium 4.8 3.5-5.5 mmol/L . MMol/L ii229 - —naafi ' . BUN 20 8-23 creatinine • • 0.31 6:664.1e e-EFR ' 88 >or=66 fe-6FR„ -African American - ' 102 . . mt/min ....... . . >or-60 mt/min /Yea Cli -. 9.7 8.8-18.4. resjciL' 'Uric Acid i : . -Y:4 3.4-8.5 66/dl - Iron 82 . • ss.ste vi/di friliratt-Totr e.s <1.2 . mg/dt . LD 235 NI 195.225 U/L ETAiss • • '46-134 BioReference Laboratories, Inc. James Weisberger M.D. Page 1 of 15 481 Edward H. Ross Dr I Elmwood Park, NJ 07407 I Laboratory Director Printed 09/08/2017 16:22 EFTA00609801 BioReference APCRAT OR . E FINAL REPORT d- OPKO Henn Company OeSHER, STUART EPSTET4, 3EFFREY Specimen ID: 204304919 BOB: 31;2n/1153 Age: 64 r sex: M Date Of Report: 09/00/7017 11:30 U/FL: Bee: - STUART ORSHER, M.D. A Date Collected: 08/30/2017 11:$6 Re: Date Received: e3/30/2017 23:12 9 EAST 79TH ST, Patient ID: Nt..4 YO4 Addrecs: 4 PAST 71ST STREET, MD R.: YORK, NY 10021 E P: North Patrice Eastern Ti.. CLINICAL REPORT 7 U/L . . PmospHosus 'ALT_ 3.i 2.7-4.5 mg/dL — -- <5 • 01. Oil NOTE: The -esult for ALT has been confined by repeat analysis. GGTP 23 10-71 U/L —e CARDIOVASCULAR/LIPIDS *-- Cholesterol 226 HI <200 mg/dL :Trilbl!w4de 151.1—Irt <150 ii7ac NOTE: The result for Triglycerides has been confirmed by repeat analysis. CHOL., DIRECT TNP >40 mg/dL Test Not Performed: Unable to perform HDL test due to elevated Triglycerides (>1290). INDL a r t:of diolesterol . TNP Y14 • Chol/HDL Ratio TNP <7.4 ilIDL/HDL' Ratio <3.56 COL'thOiesterol 'dee sox NOTE: Unable to calculate us. due to a Triglyceride level of greater than 400 mg/dL. Anic-ektillAYib . ceeCtili •1;li" trigich: i . . • . can't Cale: one or nbre components was outside the measurable range. We are unable to calculate. I • Test Not Performed: One or more conponents were not available to perform calculation. *. 1184ATOLOGY * WBC 6.10 3.66-11.99 x18(3)/uL we ...DVS 5.li 4:24:37017- 'AiRi5774. HEB 15.4 12.3-17.6 gm/di- ' ' 4171 MCV 85.4 80.8.180.0 fL ---..,....- NCH . 29.9 if.0-34.1 pg 35.0 29.0-3S.O. • gill Em. ileir7 --..-- ---- .. POLYS 46.9 36.648.4i. t ;LYNPHS . • . 39.0 . .... ' ---- . . .5411:9 :Alois 7.7 .. . 0.0-13.0 S Bioneference Laboratories, Inc. Jamesionaisberporato. Page 2 of IS 401 Edward H. Ross Dr I Elmwood Park. ND 07407 I Laboratory Director Printed 09/68(2617 16:22 EFTA00609802 BioReference LAB ORATOR I ES FINAL REPORT on OPKOHHamh Compeny EPSTEIN, 3EFFREY • Specimen ID: 104364919 I DOD' 01/20/1953 Age: 64 x Sex: M Date Of Report:09/0872017 11:38 U/FL: Bed: Date Collected: 08/30/2017 11:58 Ra: Date Received: 08/30/2017 23:12 Patient ID: egss:9 EAST 71ST STREET, NEW YORK, NY 10021 P: North Americo Foltern rime • • CLINICAL REPORT -e,-.2...Z:2-Ä-z"v":-7:7.77:17.. • EOS 5.4 0.0-8.8 !ubs 0.0-2.0 "fitialiet EtidateberES 0.2 >t70.4.6 Platelet Count 240 isteitee xie(i)/uL MPV 9.6 8.2-11.9 . -e JRINALYSIS Co or YELLOW YELLOW, STRAW, AMBER Character CLEAR CLEAR .Specific OriVitY Or. " '1.019 1.003-1.039 Urine 6.5 5.0-8.6 Oreiern;-üani - - • NEGATIVE WOW ketone, Urine • NEGATIVE • NEGATIVE ru o6iinölten urine 0.2 0.2-1.0 rag/dt ;Bilirenii, urine • NEGATIVE NEGATIVE !elecet.urine NEGATIVE NEGAeir • • •• NEGATIVE NEGATIVE XiüköZirli este-vTi— e: NEGATIVE NEGATIVE !Crystals Urine NONE NONE NONE NONE PER ter tWine 6-4 0.4 PER HPF NONE SEEN ;Epithelial Cel7.s, Br NONE NONE-FEW ;cast, nyeline, urine 8-4 0-4 PER LPF Itait; NONE SEEN 0-1 PER LPF lust, ROC, urine. • . NONE SEEN 0-1 PER LPF • rinek-terii•; Urine - NONE • ' NONE:FEW ' I ROBIOLOGY 'CULTURE, URINE NO GROWTH NO GROWTH • SITE: URINE LyrE WS, IgG W/BANDS T --- 'IRA BAND 18 Negative Negative kDa ,100 EIAND.28 wegatge kDa rig& BAND 28 'Negative ' NegatiVe kDa lie BAND 30 Negative Negative kDa IgG BAND 39 Negative Negative kDa IgG RAND 41 Positive • Negative kDa IgG BAND 45 Negative Negative kDa rfge. BAND 58 kDa 01oReference Laboratories, Inc. JamosIdNe;s6wrpor160. Rage 3 of 15 481 Edward N. Roes Dr I Elmwood Park, N3 07407 I Laborstory Director printed 09/06/2017 16:22 EFTA00609803 BioReference E$ FINAL REPORT on OPKOHasith Company ORSHER, STUART PSTEIN, JEFFREY Specimen ID: 204364919 P DOB: 01/20/1953 Age: 64 V Sex: .M Date Of Report: 09/08/2017 11:30 A U/FL: Bed: - STUART ORSMER, M.D. A Date Collected: 08/36/2017 ii:se Rm: Date Received: 08/30/2017 23:12 9 EAST 79TH ST, I atient ID: NEW YORK, NY 10021 E Address:9 EAST 71ST STREET, N NEW YORK, NY 10021 Acct k: MO P: P: North Amerit0 Ehnen, Time CLINICAL REPORT IgG BAND 66 Nogativr Negative kDa Negative Negative . ' NOTEt LYME ANFUMOY (Igo) by WESTERN BLOT is considered to be positive if any 5 but ofthe-following 20 bands are present: 18, 23, 28, 36, 39, 41, 45, 58, • 66,93 k00. '• Lyme Ig6 INTERPRETATION' 410 Negative Negative -" LYME WR, IgM W/BANDS •--- IBM BAND 23 Negative Negative kDa lgm SAND 39 Negative Negailve kDa IgM BAND 43. 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 ~IITERPNETATIOPI {d8 • Negative Negative IgE, SERUM _ . . TNP <or=13.4.0 Test Not Performed: Specimen is LIPEMIC. ALLERGEN INTERPRETATION: CONCENTRATION (kUA/L) INTERPRETATION <0.10 Absent 0.10 - 0.34 Very Low 0.35 • 0.69 LOW 0.70 - 3.49 Moderate 3.50 - 17.49 High 17.30- >200.80 Very High Hemoglobin Alt i HEMOGLOBIN Ale AM) eA6 REFERENCE RANGES ale(%) DIMETeS CATEGORY* <5.7 Normal (non-diabetic) 5.7-6.4 Increased risk of diabetes v>6.5 consistent with diabetes A2c(%) aNMESTIMATED AVERAGE PLASMA GL00061)(mg/dL) 6 126 7 154 8 183 9 212 10 240 11 269 22 298 aioReference Labora₹ories, Inc. James Weisberger M.D. Page 4 of IS 481 Edward H. Ross Dr I Elmwood Park, NJ 07407 I Laboratory Director Printed 09/08/2017 16:22 EFTA00609804 BioReference A & ORATOR I ES FINAL REPORT OPKOHAnIth Company ORSHER, STUART PSTEIN, 3EFFREY Specimen ID: 104364919 DOB: 01/20/1953 Age: 64 V Sex: H Date of Rdport:e9/08/201711:39 - STUART ORSHER, A /FL: Bed: Date Collected: 08/30/2017 11:Sa it: Date Received: 08/30/2017 23:12 9 EAST 79TH ST, I atient ID: NEW YORK, NY 10021 Address:9 EAST 71sT STREET, N KEW YORK, NV 10021 Aeet *: ".0 P: V: Worth 4morico EOltcrm Tlme CLINICAL REPORT 4evia:oas *recommended ranges-American Diabetes Association(2eao) NOTE: The amount of glycated hemoglobin as measured by the HbAlc test say be overestimated in African Americans and should not be used as the sole parameter of enceinte 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 Pos .. . TNP . . . . . .UnwiL. Test Not Performed: Specimen rejected for testing due to moderate or marked hemolysis. THYROXINE(TI5 ?HP 4.9-12.9 ug/WL rti UprAki " TNP • 114YROXINE, FREE VIC TNP • 8.80-1.73 ng/dL FREE T4 INDEX TAP 1.5-3.8 rictilffitofaluOrlIWAL TNP neal !Tiiiiiiiii-(5PEP) • • -• :ALPHA-1-GLOB.('SPEP) . . . TNP . 8.17-6.41 • sidE7 TNP 6.42-6.99 i6EAGL6W.(SPE1ir'"" — TNP i4lNk4iLdi7.(s0pS;j g/dL •-• •• TNP 0.6S-1.67 • 'REOIRE TNP iSPEP GRATA TNP See Graph • ' NOTE: Specimen submitted is LIPEMIC. This may cause inaccurate results. Please RIR:OMIT a fasting specimen at your earliest convenience. I ; .. TNP 22-312 • mg/mL ' tut •Noe- .Performed: Specimen rejected for testing due to moderate or marked . • hemolysis. :. — • NEP. A Al.. TOTAL TNP • • Non-Reactive .91-S `Wriesif flEP- Nosilleactive HEP. B SURF. AB. Non-Reactive . 71Qr ThSi . . . . . . .. . Negative pip. BE AG.. — TNP Non-Reactive !Igok. SERUM 225 70-408 • Ng/di • rig% 18RSM • 1047 --- 46 •• 40-230 mg/dL . IRPR Non- Non-Riattive Titer Reactive PioReference Laboratories, Inc. JamesVhdsbefgerM.D. Page 5 of 15 481 Edward H. ROSS DP I Elmwood Park, N3 e7407 I LmboretorfESOCIOr Printed 09/08/2017 16:22 EFTA00609805 BioReference FINAL REPORT OPICO Health Company PSTEIN, 2EFFREY Specimen ID: 164364919 DOG: 01/20/1953 Age: 64 Y Sex: m Date Of Report: 09/08/2017 luse S /FL: Bed: Collected: 08/30/2817 11:58 A Date T RM: Date Received: 08/38/2017 23:22 Patient ID: p Address:9 EAST 71ST STREET, N NEW YORK, NY 10021 E T P: sionth America Eastern rue HERPES I Ab.(IgG) 7.40 NI <0.90 INTERPRETATION OF RESULTS FOR H5V-1 AND HSV-2 Ig6 ANTIBODY Antibody Index Result Interpretation <0.90 AI Negative No mSV-IgG antibody detected 0.90-1.89 AI Equivocal Equivocal result. Repeat in 4-6 weeks >or=1.10 AI Positive IRO 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 inaunocompromised. HERPES II Ab.(IgG) 5.7e HI 20.90 Al I INTERPRETATION OF RESULTS FOR HSV-1 AND NSV-2 IgG ANTIBODY Antibody Index Result Interpretation <e.g. AI Negative No HSV-Ig6 antibody detected 0490-1.09 AI Equivocal Equivocal result. Repeat in 4.6 weeks >or-1.10 Al Positive Ig6 antibody detected **.*Conwrant: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 pediatrit populations, far neonatal screening or for testing the lemunocompromised. 193.e7744.9 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 free the drug. Clinicians are asked to request Testosterone, Total by LC/HS/NS (test code 3451-6) for these patients. a. WC. 346 N2 10-3es IN.PYLORI Ab.,Ige 0.34 See Below iN.PYLORI Ab-,IgA ...... 9.49 - wee Below H.PYLOR2 Ab.,IgM Tripird- fkal Ab. 1.44 <0.41 rEiebeSia mitratniiiIVA06) <1:20 --- - . .. anilb sinsceac iej • <1:64 <1:64 Sera frbm patients aboon to have been infected by other tick-borne , pathogens, tabeeii4uncanl, Rickettsia rickettsii and &invite burgdorfiri, were screened end found negative by the B. micron Ig6 IFA. This test was, developed and its performance characteristics determined by 1 Viracor:Eurefins. It has not been cleared or approved by the U.S. FOX and - DrugAMOniitretion. Tosting!PerfOrmed At: Viracor Sureties' _. BloReforence Laboratories, Inc, James Welsberger M.O. Page 6 of 15 481 Edward H. Ross Or I Elphood Park, a7 07407 Laboratory Director Printed 09/98/2017 16:22 EFTA00609806 BioRe ference I 4908470R FINAL REPORT I CS on OPKO Health Conwieny ORSHER, STUART - STUART ORSHER, M.D. 9 EAST 79TM ST, NEW YORK, NY 10021 EPSTEIN, 3EFFREY DOB: 01/20/1953 Age: 64 V Sex: m U/FL: Rm: Patient ID: Bed: AddreSS:a EAST 71ST STREET, specimen ID: 104364919 Date Of Report: 00/0S/2912 11:30 Date collected: 08/30/2017 11:58 Date Received: 08/30/2017 23:12 1 Acct 4: NO NEW YORK, NY 10021 P: IIIII--- NOrth Amcrica Eastern Tiett CLINICAL REPORT 1001 NW Technology Drx e Lee's Stmuit, MO 64086 Tetanus Antibody IgG (SO) 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 O.S. Food and • Drug Administration. ' Testing Performed At: Viracor Eurofins 1001 NW Technology Drive 64006 ULAN 60- 3 0.31 r >0.1 IUML Testing Performed At: Viracor Eurofins 2001 NW Technology Drive Lee's Summit MO 64086 ”k MA il .4 . 983643 'HD/ Ag/Ab TNO 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 Deminodeficiency Virus Type i,including Group 0 (HIV-1 + "0") and/or Type 2 (HIV-2) Method: Chemiluminescence (Siemens Healthcare Diagnostics) CMIANYDIKAN:116itin.tier SEE BELOW • C. pneumonia, IgM Titer <1:20 <1:20 C. track 1g21 Titer <1:20 <1:20 C. psittaci IgM Titer <1:20 <1:20 C. pneumoriae Iv Titer 1:121 H <1164 E. tract' IgG Titer el:64 <1:64 • C. psittaci IgG Titer <1:64 <1:64 -INTERPRETIVE INFORMATION: C. psittaci IgG Titer --The chiamydia antibody test contains both species- and genus- --specific antigens, and strategical cross-reactions may be seen in sioReference Laboratories, Inc. Page 7 of James Wriobercier M.D. 15 411 Edward H. Ross Or I Elmwood Park, NJ 07407 Laboratory Director printed 09/08/2027 16:22 EFTA00609807 BioReference ASC .T ATPR I ES FINAL REPORT nn OPKO Mnnhth Company ORSHER, STUART EPSTEIN, JEFFREY Specimen ID: 104364929 DOB: 81/20/1953 Age: 64 y Sax: m Date Of Report: 09/00/2017 11:30 - STUART ORSHER, M.O. U/FL: Bed: Date Collected: 08/30/2017 11:Sa Rm: Date Received: a8/30/2017 23:12 9 EAST 79TH ST, Patient ID: NEW YORK, NY 10021 ress:9 EAST 71ST Meat, Acct m: NEW YORK, Ny 10021 P: north Asorft0 &deem rtot oth acute and conva escent samp es (less t an 1:128 . A C. --pneomonlae-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 microimminofluOrescent assay slides utilize C. --psittaci, C. pOtymoniae, and nine serotypes of C. trachomatis. The --LGV strains of C. trachtmatis 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 IgM 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 IgM antibodies may occasionally persist for more than 12 --months post-infection. --Test developed and characteristics determined by AAUP --Laboratories. See Compliance statement A: aruplab.com/cS --mvw.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 may indicate recent or current infection, but is --inconclusive for diagnosis. Serocorversion between acute and BioReference Laboratories, Inc. JarnmeMftnabersperlAIL Page 8 Of 15 481 Edward H. Ross Or I !Inwood Park, N3 07407 I LaboratoryDbettor printed 09/08/2017 16:22 EFTA00609808 FINAL REPORT _AscRAference BioRe TOR I Es an OPKO Hent Comonny imen ID: 104364919 ORSHER, STUART EPSTEIN, 3EFFREY DOS: 01/29/1953 Age: 64 Y Sex: M to Of Report: 09/08/2017 11:30 U/FL: Bed: Date collected: 08/30/2017 11:58 - STUART ORSHER, M.D. Rs: Date Received: 08/30/2017 23:12 9 EAST 79TH ST, Patient ID: Address:9 EAST 71ST STREET, NEw YO 21 New YORK, NY 10021 acct 4: P: North America Eastern Vise 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: aruplab.con/CS C • TWO Non-Reactive Test Not Performed: ile were unable to perform the Hepatitis test(s) requested due to lipimia. Please resubmit a fasting specimen. NEP 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 66086 . 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 Biogeference Laboratories. It has not been cleared by the U.S. rood 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 ELM 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)*. <0.91 . Negative 0.91-1.09 = Equivocal JanwmcNielsbergerNUD. Page 9 of 15 lioReference Laboratories. Inc. Laboratoryterector Printed 09/08/2017 16:22 481 Edward H. Ross Dr I Elmwood Park. N3 07407 I EFTA00609809 BioReference a scRA - ) R . ES FINAL REPORT OFIKO Heal: Cornoany -1 ORSHER, STUART EPSTEIN, 7EFFREY Specimen ID: 104364919 DOS: 02/2e/1953 Age: 64 y Sex: m Date Of Report:09/08/2017 11:30 - STUART ORSHER, M.D U/FL: Bed: Date Collected: 08/30/2017 11:58 km: 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 ACC: n: MO p. P: North America Eastern Time >1.09 = Positive Hepatitis 8 Result Interpretation (for reference use only) Marker LX/EA• Acute Past Chronic HBV Vice. ib3sAg HBeAg +/- HEP.R.CORE Agar HEP.B.CORE AB. H8eAb HBsAb m/- 'Late Incubation/Early Acute NOTE: In remote past infection, HBsAb level may be Negative or Non-Reactive in sore patients. AikBdOEEN Positive • Neg,<1:80 !dip ' - 0.2 <0.5 mg/dL ,ESR (Std,-Rate,' 15 <21 an/hr FeCiC''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 3.38-3.3S Deficient 0.35-3.37 Excessive >24.00 iii-912 pgJEL . . . ! Test Nat PerfOrBed! Specimen rejected for testing due to moderate or marked .p hemolysis. 250X, VITAMIN D TNP Test Not Performed: unable to perform testing, specimen is ilagNIC. VITAMIN 0,25-OH TEST INFORMATION Range (ng/mL) Suggested Interpretation <20.0 Deficient 20.0-31.9 Insufficient 32.0.100.0 Sufficient )109.0 Possible Adverse Effects ,747 171;WOHYDROBY TNP 29.9-79.3 pgfial . Test Not Performed: Unable to perform testing, specimen is LIPEMIC. BioReference Laboratories, Inc. JammsWeisbergmrk10. Page 10 of 15 481 Edward H. Ross Dr I Elmwood Park, N7 07407 I LabormoryDirector Printed 09/88/2017 16:22 EFTA00609810 Bio Reference - A 9 09ATOR i ts FINAL REPORT en C7SaPCC3 Health Ccrnpnny EPSTEIN, JEFFREY Specimen ID: 104364919 MiNER, STUART DOS: 01/20/1953 Age:64y Sex: M Date or Report: 09/88/2017 11:Je U/FL: Bed: Date Collected: e8/30/2017 11:58 - STUART ORSHER, M.D. Date Received: 08/30/2017 23:12 Rm: 9 EAST 79TH ST, Patient ID: NY 10021 AddresS:D EAST 71ST STRICT, NEW YORK NEW YORK, NY 16021 ACCt *: ND P: P: North Americo Eastern Time IIIII mUMPS VIRUS Ab.(igG) 3.07 Immunem>1.09 IICOOTTerICD1 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 and younger. NOTE: All Lead results m/>5.0 ug/dL are confirmed by repeat analysis. NOTE: Capillary and microtainer blood levels =/>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. BloReference 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 IMP Negative NOTE: Specimen submitted is LIPEMIC. This may cause inaccurate results. Please RESUBMIT a fasting specimen at your earliest convenience. AERainii; 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 20 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 50 ug/L. Test developed and characteristics determined by ARUP Laboratories. 5te Compliance Statement aruplab.Com/CS www.aruplab.00M, Julio Delgado, MD - Lab. Director RUBEOLA/MEASLES(IgG) 1.81 Immunem>1.09 James Welsbner M.D. Page 21 of 15 BioReftrence Laboratories, Inc. Laboratory Director printed 09/03/2017 16:22 481 Eduard H. Ross Dr I Elmwood Park, NJ 07407 I EFTA00609811 BioReference FINAL REPORT IMPKO vff t• .•••. .. . . RSHER, STUART EPSTEIN, JEFFREY Specimen ID: 104364919 DOB: 82/20/1953 Age: 64 V Sex: M Date Of Report: 09/80/2017 11:30 - STUART ORSHER, MAL U/FL: Bed: Date Collected:OE/30/2017 11:53 0 Rm: Date Received: 00/3e/2017 23:12 C EAST 79TH ST, Patient ID: 0 NEW YORK N. AddneSS: 9 EAST 71ST STREET, Acct 4: ND .VW YORK, NY 10821 P4 P: North America Eastern Time CLINICAL REPORT VARICELLA ZOSTER,Ig REFERENCE RANGE for Varicella.zoster Ip1 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 IgN 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 EOS.(IgG) 3.46 Immune=>1.09 INP 13.0-85.0 Dg/ml Test Not Performed: Specinen rejected for testing due to moderate or marked hemolysis. .RHEUMATOID 04 TITER <le <IA Wet i ONDELLAAG . TNP Immurtes>9.9. Test WIdt Performed: Specimeisrefected for testing due to moderate or marked 1117iL J . .• . hemOlyils. liTSFISTATEN OF RESULTS FOR RUBELLA 10 ANTIBODY I . *mita IZU/mL) Interpretation 4.9.0 Negative Non-Immune 5;0 r 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 Suggistbd tv assess antibody response after a booster shot or a viral Syndrome... • ASSAYINRINgilblit ;Hotbed Chemilumipescence (Siemens Diagnostics) :ANA TITER (IFA) 1:160 III 0.:00 Titer ANA PATTERN = HOMOGENEOUS MD SPECKLED Antibodies To Association Frequency ate Screening test for SLI In symptomatic patients. 95.100% (Antinuclear Ab, BioReference Laboratories, Inc. JarnesVeniabergerMn. Page 12 of 15 Ass Edward H. Ross Dr I Elmwood Park, N1 07407 I Laboratory Director Printed 09/08/2017 16:22 EFTA00609812 FINAL REPORT Bio Reference LAIORATOR IES en CiPNCCRrieafth Compeny EPSTEIN, 7EFFREY 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:08/30/2817 11:58 - STUART ORSHER, M.O. Date Received: 08/30/2017 23:12 Rm: 9 EAST 79TH ST, Patient ID: Address:9 EAST 71ST STREET, NEW YORK NY 1.0021 NEN YORK, m' 10021 Acet 9: MO P: P: North America fasten, rime CLINICAL REPORT re assay 60-S0% ANA Assist with diagnosis of Scleroderna (Systemic Sclerosis). 40-78% ANA Sjogren's Syndrome. Idiopathic Inflammatory Polymyositis or Dereatemyositis• 38.80% ANA Antibodies to specific (Extractable) Nuclear Antigens (ENA)/Proteins Characteristic of SLE. Rare in other CTDs. Highly 25-85% dsONA associated with active disease. 15-301 Sm(Smith) Highly specific for SLE. Uncommon in other diseases. 35-60% SS A (Ro) Associated with SLE, Neonatal Lupus and 5jogren's Syndrome. 15% 55 8 (La) Associated with SLE. 44-6(ed 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-Centrowere Abs which are associated with Limited SchrOderme 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 (MCTD). High Correlation U1 nRNP 90.100% Nistone Proteins (Chromatin) Associated with drug induced LE. Test and Tests for . ref:Krranaugh,A(et al.):Guldelines for Clinical Use of the Antinuclear Antibody Specific Autoantibodies to Nuclear Antigens. Arch.Pathol Lab Med. Vol.124,2an 2000. PPIEUND 91Y.V931"(39) <0.3 Lii >1.3 PNEUMO Ab fliiii.i - liii ' - -- 1.4 ' - - '›i'i. ' --.. '' . ugiii. -.- PNEUMO Ab TYPE 4 (ill— • . LE LO itli . . . — . ugniL . . >1.3 ugint PNEUMO Ab TYPE 8 (58) 0.4 10. PNELNO Ab TYPE 9 UN(F (58) 0.4 LO >1.3 ONEUMO Ab TYPE 12(120 (58).. .. '' 40.0 0 >1.3 '' '' - PHEW Ab ISIPE.I.M5g5 23.2 >1.3 ugh& ONEU710 Milti91-13. tisirj• (58) . • • • 0.8 Lo >I:3 • - - • T.91.rio:Th'itiirbTarr (91) .. 49.3 LA 31:1- ughst 1PALuno Ab TYPEidiSei) (Sii - • - i3:5. LO >1;3 . - - ug/iL Pmatimark 'TYPE 5 (58) 7.8 >1.3 ug2ML . . . .. . • • • 51 (7P) (58) ioNEUMD- Ab TYPE sutr 1.5 >1.3 ug/n1 - - wasp Ab ienisT _ :_".......irw .r" 4.."51.7C =...... " iiigir 7..7U. .... TYPE 0.4 LO >1.3 ug/mL :PNEUMO Ab TYPE 68 (9V) (58) Testing Performed At: ' Viracor Eurofins 1001 NW Technology Drive " 64386 LLc -. 43 .Atistilit,"315393" ug/L 1 . T James Weisberger M.D. Page 13 of is BioReeeeeeee Laboratories, Inc. 87407 Laboratory Director printed 00/08/2017 16:22 481 Edward H. Ross Dr I Elmwood Park. EFTA00609813 BioReference LABORATOR ES FINAL REPORT an ['PAC(' Health Company ORSHER, STUART EPSTEIN, JEFFREY Specimen ID: 104364919 DOB: 01/20/1953 Age: 64 Y Sex: M Date Of Report: 09/08/2017 11:S0 C3070 - STUART ORSHER, M.D. U/FL: Bed: Date Collected: 08/30/2017 11:58 Rm: Date Received: 00/30/2017 23:12 9 EAST 79TH ST, Patient ID: NEW YORK, NY 10021 Address:9 EAST 71ST STREET, Acct NEw YORK, NY 20021 0: 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 ICI Ab (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 cleared 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 phagocytophilum is the tick-borne agent causing Human Granulocytic Ehrlichiosis (HGE). HGE Is distinct and separate from Hunan Monocytic Ehrlichiosis (HMI), caused by Ehrlichia chaffeensis. Serologic crossreactivity between A. phagocytophilue 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 336498 Ortega Hwy (3) Performed by: Quest Diagnostics Nichols Institute of Valencia 27027 Tourney Road Valencia, CA 91355-5306 (24) Performed by: Quest Infectious Disease 33608 Ortega Highway San Juan Capistrano, CA 92675 "medical Director Hollis J. Batterman, MD (30) Performed by: AMP 580 Chipeta Way Salt Lake City, UT 84108 (58) Performed by: Viracor EuroFins Clinical Diagnostic BioReference Laboratories, Inc. JmnesehAsbereirat0. Page 14 of 15 481 Edward H. Ross Dr I Elmwood Park. ft 07407 Lebonmorypeechw Printed 09/08/2017 16:22 EFTA00609814 BioReference LABOtarpR I ES FINAL REPORT mr OPKO Hawn Cempony ORSHER, STUART EPSTEIN, SEFFREY cimen ID: 184364919 DOB: 01/20/1953 Age: 64 V Sex: N Date Of Report: 09/00/2017 12:38 - STUART ORSHER, H.D. U/FL: Bed: Date Collected: 08/30/2017 12:58 Rm: Date Received: 08/30/2617 23:12 9 EAST 79TH ST, Patient /0: NEW YORK, NY 1:3021 dreSS:9 EAST 71ST STREET, Acct ♦; MD NEW YORK, NY 10021 P: P: North America Eastern Time 1001 im Technology Drive Lees Summit, MO 66086 INTERPRETATION OF RESULTS FOR RUOEOLA(MEASLES),MUMPS,VARICELLA VIRUS ABS. Range Interpretation < or . 0.90 Negative Non-Immune 0.91 - 1.09 Equivocal Retest > or 1.18 Positive Immune Results interpreted as EQUIVOCAL indicate a level of antibody below the positive (Immune) cut 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 BLOOD and CADMIUM 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/PEM1C. This may cause inaccurate results. Please resubmit a fasting specimen at your earliest convenience. 82oReferonco Laboratories, Inc. JernesweiabergeflA.D. Page 15 of 15 601 Edward H. Ross Dr I Elmwood Park, NS 07487 I LaboudoniCHreeter printed 89/08/2017 16:22 EFTA00609815