DS9 Document EFTA00592821

FINAL Patient Information Epstein,Jeffrey SSN: DOB: 01/20/1953 Patient Id: Phone: Specimen # 11383160F b a 137115 iel Brook N link 1120.5 Eat Medical Director Patricia R Romano M I) 0 l at.... IP tints:, t: Account Information City MD New York, NY 10028 Mazer,Gary Dwetaikcird 10/09/2011 09:53PM Datclicrehed 10/09/2011 DMcRquwted 10/12/2011 Scx M Age 58 Chemistry TESTS RESULTS REFERENCE VALUES Cr i-• Glucose H 111 65 - 99 mg/dL Criteria for the diagnosis of diabetes: [Fasting Glucose] <100 mg/dL: Normal fasting glucose 100-125 mg/dL: Impaired fasting glucose >125 mg/dL: Indicative of diabetes Ref: Diabetes Care 29:543-548, 2006 Urea Nitrogen 23 7 - 25 mg/dL Creatinine H 1.55 0.5 - 1.3 mg/die EGFR L 46 >60 - For African-Americans, multiply EGFR result x 1.2 BUN/Creat Ratio 14.8 5.3 - 50.0 Sodium 140 135 - 146 mEq/L Potassium 4.1 3.5 - 5.5 mmol/L Chloride 103 98 - 110 mEq/L Carbon Dioxide 27 21 - 33 mEq/L Calcium 9.5 8.6 - 10.4 mg/c1L Protein, Total 7.1 6.2 - 8.3 g/dL Albumin 4.5 3.6 - 5.3 g/dL Globulin 2.6 2.1 3.7 g/dL A/G Ratio 1.7 Ratio Alkaline Phosphatase 60 40 - 115 IU/L AST (SOOT) 38 10 - 40 IU/L ALT (SGPT) 49 9 - 60 IU/L Bilirubin, Total 0.6 0.2 - 1.2 mg/dL Hematology White Blood Count 7.4 4.0 - 11.0 xl0A3/uL Red Blood Count 4.82 4.2 - 6.0 xl0A6/uL Continued on Next Page Page 1 of 3 EFTA00592821 Patient Information Epstein.Jeffrey SSN: DOB: 01/20/1953 Patient Id: Phone: SN.cmwilz 171383160F I ab 137115 irsTs #41,1 let Brit 11205 Medical Director Patricia R Romano. NI I) / A 4 FINAL ACC011 nt Information City MD New York. NY 10028 Mazer.Gary DwelAketed Dale Itecri% et] I Date Reported 1 10/09/2011 I 09:53PM 1 ommo 1 1 10/12/2011 Sex M Ate 58 RESULTS REFERENCE VALUES Hemoglobin 14.4 12.5 - 16.1 g/dL Hematocrit 40.8 38 52 3 MCV 85 78 102 fL MCH 29.9 27 - 31 pg MCHC 35.3 31 - 37 g/dL Neutrophilst 53.8 40 - 70 * Lymphocytes* 33.2 20 - 40 3 Monocytes% 7.5 2 - 10 * Eosinophils% H 4.8 1 - 4 % Basophilst 0.6 0 - 1 % Neutrophils, Abs 4.0 1.6 - 7.8 x10"3/uL Lymphocytes, Abs 2.5 1.0 - 4.5 x10"3/uL Monocytes, Abs 0.6 <1.0 x10"3/uL Eosinophils, Absolute 0.4 <0.7 x10"3/uL Basophils, Abs. 0.1 <0.3 x10"3/uL RDW-CV 13.5 11 - 16 3 Platelets 333 150 - 450 x10"3/uL 'eV L 7.7 8.0 - 13 fL ESR-Westergren 15 0 - 20 mm/hr Special Chemistry Calcium, Ionized 5.2 <8 months: No Reference Range Established 8 months-10 years: 4.9-5.4 mg/dL 11-17 years: 4.8-5.3 mg/dL Endocrinology Thyroxine [T41 9.0 4.5 - 10.9 ug/dL T3-Uptake 33.1 22.5 - 37.0 3 TSH 3rd Generation 2.18 0.545 - 4.784 uIU/mL T3, Total 102 60 - 181 ng/dL 4.8 - 5.6 mg/dL Continued on Next Page Page 2 of 3 EFTA00592822 Patient Information Epstein,Jeffrey SSN: 008: 01/20/1953 Patient a Phone: Specimen a T1383160F labW 137115 iel coo vn.. 'ex brk 11205 Fax Medical Direcier R Romano. M 0 /tune ix 41 FINAL Account Information City MD New York, NY 10028 Mazer.Gary Dace Collected Date Retch ed Date Reported 10/09/2011 09:53PM 10/09/2011 10/12/2011 Sex M Ate 58 TESTS RESULTS REFERENCE VALUES T4, Free PTH-/ntact *Performed By Nichols Institute 1.32 H 107 0.8 - 1.8 14 - 72 ng/dL pg/aL End of Final Report Page 3 of 3 EFTA00592823