% Hoodson They KEP mi ODEO vivhks Urax x _ el a <LabCo TD eee wien st ae 0800.2: “can * New_y NY 10065 a NYN To = D8Z31143092 D8Z31143092 DEZ31143092 LABCORP (888-522-2677), 31142092~0 D8Z31143092 D&Z31142092 D8Z31143092 O8Z31143092 SIRELE_ ORE L “AB2553-AERREIL, ¥0 a Nerne (Last, First ha) — Sex DatectBirh an: Fasting ColectonDate—_Urinehesiva CK OWE ‘a (C2 K al 22 tj i {} TESURARCE XP ORD APBS( JEAPIAY ELUF CR CREPE ( Hh HE ARE C LIBRA SETWA( DAETHA NOK RAD sETPL( RETRO PLUS HPI WINT( JNEALTIWET RVPH( USE A WATAES JHRTA TIES MITE RLTRORE AGRAC JLAGNA CARE- RY SLOCH{ }HURAMA AC PETS “FRAP JEATSER PERRANE Hospital Patient Status: () In-Patient Some D Nor-Patient — Tet SyRee-™ 2-150 Fe City x4 pas 4 = ~ insurance Address Name of insured Person Relasonship to Patient 371044 1 J LyseAD{TQG/R) *Babesia(1gh/h... . : * = - 00(7 371068 [ ) CAPLAHFe+CBC/D/PitiAgtlihet... aufod 00% 371195 £1 FSEALINP PO 5p0b34. A, Iokst as, hnde. Sci EFTA00287148

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La HOCUSOMTHerheo i Qo vivo UFax “LabCorp y OCall ere ——— lenbur———|,... x 44 € 6¢th St 7 stray Copoaton Aneta” ay NY 10065 OMe ee rr To find the nearest patient ‘a NYN - service center, visit www. EGU31143092 EGU31143092 EGU31143092 LASGOnP gusaanasrn 31143092-0 ; EGU31143092 EGU31143092 £0U31143092 EGU31143092 ; creshe Out L - AG2SSS-KERRELL, YO tient’s Legal Name (Last, First, Ml) M ) 80 1c ; Collection Time Fasting Collection Dale Urine hrs/vol x one Bost SN EFREY ett “" —_ PY PATIENT BILL = at { } Tasurance ONFHP( DOXFGRD Hospital Patient Status: (] in-Patient ([] Out-Patient — () Non-Pationt Sie Him Pa an Ree =P-7p-AY a7” ONY VY tv URITEC DURITED BLTHCRE A ‘Name of Policy Haider (F different from patient) COCPFE eh HE WE C CLORH( DE IGHA ACCFLE = AEDICARE UNRFS( )UAK METPLC DMETRO PLUS RPL] UHCMC( DHHC-MEDICORE C ENPES( DEMPIRE BLUE CK MACHR DELTHREPUL WALCT( RALC 371044 [ J LymeAb(Ig6/M)thabesiatIgG/m... 371068 { ] CHPL4+Fet+C OC /D/Pit+HgtTIBC+... 371195 € J) FSHALA+Pro { } Estroner LENS Endo §ci 86703 Ge) + 10/2 Anitodies"- WY ONLY 66703 EFTA00287149

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Hoodsor ‘Hareeri * '** 44 £ 47th St NY 10065 NYN labcorp.com or call 888- LABCORP (888-522-2677). 31143092-0 EBC31143092 mead Se tT L. WD (fatears Legal Name (Last First, Ml HECK Epstcin Tr) oe TTEW BILL P S € 3 REGICARE IRSURARTE DKF DAD VEAPTAL RLUT CR JEIGNA HE ARE E ILIERA JSETHA NDR HAD VETRD PLUS HPI HEAL TARE? )RTATH/ AFT JONITED Hi TUCRE {AGKA( JGABRA CARE: RY SLOCHS JURANA AC PFFS J P= bea} = ss ”* S5YU Gos54 owe 272 iio # Group @ 371044 [ 2) LyseAbtIgh/M)+Badesis{IgG/f... 371068 [ ] CAPIA+Fe+CRL/D/PLteNgs TIC... S71195 £ H FSU+LU Pro: 5006341 1 Estrope, oL DAS: bad. Sci, uasconr wi fee EY Pie Be Urax OCalt O Mail — : ws aa 143092 EBCI1143092 £BC31143092 EBC31143092 EBC31143092 EBC31193092 Hospital Patient Status: 1 Patient C Out-Patient CD Non-Patient ¢ " ET Seer = 375-772-9b Refer to Determining Necessity of ABN Completion on reverse. C. abbicans 6 C. glabrats, NAA 87481 pe (Candida So-species Profle, NAA 87481(x5, EFTA00287150

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<LabCorp HEAVY METALS rev. erreuie 3 i 07039 i ARSENIC EXPOSURE PROFILE, URINE tere Serres one ce ewe se weqees were ra \aboratory Corporation of America To find the nearest patient ” , visit Yoodson Merrell labcorp.com or call 888- 44 E 67th St LABCORP (888-522-2677). i RY 10055 ~ HYR 3 31143992-90 DLW31143092 CUEEK_OWE 64 [ J PATIENT BIEL OS C 2 NEDICARE QRFHP( 2OXFORD ENPRS( DEMPIRE BLUE CR Aepty Labels FR — UWITE UML FED HLYHCRE Patent Contr No. mb DZW31143092 DZW31143092 DZUS1 143092 ACTNAC DAETHA NON HHO mg RROOS( DRSBC OUT OF ST RDCKY( BS OF CENTRAL DZW3i143092 DZW31143092 DZWF1143092 TFCIG¢ TUFTS CIGNA 717009 | | LEAD, aL000 D (Pediatric) 3} 717033 | | LEAD & PROTOPORPHYRIN (Pediatric) (RYB} 007492 |i HEAVY METALS |, RINE (, As Ha) 82175, 82900, 82495, 82525, 83655 83825, 83885, 69018, 62570 EFTA00287151