Report Status: Final TEST, PATIENT

Patient Information Specimen Information Client Information Specimen: BH047903A Client #: 97502840 AARRSSS TEST, PATIENT Requisition: 0422196 COLMENAR, ANTONIO DOB: 01/01/1965 AGE: 50 Lab Ref #: 0422196 TEST CLIENT (HQ) AH1 1 MALCOLM AVE Gender: F Fasting: Y Collected: 04/07/2015 / 11:28 EDT TETERBORO, NJ 07608-1011 Phone: NG Received: 04/07/2015 / 11:29 EDT Patient ID: BH047903A Reported: 04/07/2015 / 14:13 EDT

COMMENTS: TEST PATIENT Fibrosis, FibroTest™ ActiTest™ Panel Fibro Test Acti Test Fibro Test assesses the fibrosis of the liver Acti Test assesses activity (inflammation in chronic viral or B)

Score : 0.62 Score : 0.18 ( F3 ) ( A0-A1 ) advanced fibrosis no activity Biomarkers Lab: EZ Analyte Result Reference Range/Comments Analyte Result Reference Range/Comments Alpha2 Macroglobulin 301 H 106-279 mg/dL Total 0.4 0.2-1.2 mg/dL 47 43-212 mg/dL Gamma GT 63 3-70 U/L Apolipoprotein A1 104 101-198 mg/dL ALT 26 6-29 U/L

Liver Fibrosis History Previous Results

No historical results currently available. Only includes results that meet strict identification matching. Historical values represent Fibrotests performed at Quest Diagnostics only; previous results from tests performed at other laboratories have not been included.

Reference ID for internal report tracking 14072 Lab: EZ

Precautions of use and interpretability Lab: EZ • The reliability of results is dependent on compliance with the preanalytical and analytical conditions recommended by BioPredictive. • The Tests have to be deferred for: acute , acute hepatitis, acute inflammation, extra hepatic cholestasis. • The advice of a specialist should be sought for interpretation in chronic hemolysis and Gilbert's syndrome. • The Test interpretation is not validated in liver transplant patients. • Isolated extreme values of one of the components should lead to caution in interpreting the results. • In case of discordance between a biopsy result and a Test, it is recommended to seek the advice of a specialist. The causes of these discordances could be due to a flaw of the Test or to a flaw in the biopsy: i.e. a has a 33% variability rate for one fibrosis stage • FibroTest is interpretable for chronic and C, alcoholic and non alcoholic steatosis. • ActiTest is interpretable for chronic hepatitis B and C.

The performance characteristics have been determined by Quest Diagnostics Nichols Institute, San Juan Capistrano. It has not been cleared or approved by the U.S. Food and Drug Administration. Performance characteristics refer to the analytical performance of the test.

CLIENT SERVICES: 866-MyQuest SPECIMEN: BH047903A PAGE 1 OF 2 Quest, Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics. Report Status: Final TEST, PATIENT

Patient Information Specimen Information Client Information Specimen: BH047903A Client #: 97502840 TEST, PATIENT Collected: 04/07/2015 / 11:28 EDT COLMENAR, ANTONIO DOB: 01/01/1965 AGE: 50 Received: 04/07/2015 / 11:29 EDT Gender: F Fasting: Y Reported: 04/07/2015 / 14:13 EDT Patient ID: BH047903A

Effective April 6, 2015 FibroSure (17611) was discontinued and replaced with an in-house version Liver Fibrosis, FibroTest-ActiTest panel (92688). These tests are equivalent.

Quest, Quest Diagnostics, the associated logo, Nichols Institute and all associated Quest Diagnostics marks are the registered trademarks of Quest Diagnostics. All third party marks - ® and ™ - are the property of their respective owners. © 2000-2014 Quest Diagnostics Incorporated. All rights reserved.

PERFORMING SITE: EZ QUEST DIAGNOSTICS/NICHOLS SJC, 33608 ORTEGA HWY, SAN JUAN CAPISTRANO, CA 92675-2042 Laboratory Director: JON NAKAMOTO, MD PHD, CLIA: 05D0643352 LIST OF RESULTS PRINTED IN THE OUT OF RANGE COLUMN: ALPHA 2 MACROGLOBULIN 301 H 106-279 mg/dL EZ

CLIENT SERVICES: 866-MyQuest SPECIMEN: BH047903A PAGE 2 OF 2 Quest, Quest Diagnostics, the associated logo and all associated Quest Diagnostics marks are the trademarks of Quest Diagnostics.