The NMR LipoProfile ® test may be covered 1447 York Court by one or more issued or pending patents, Burlington, NC 27215 including U.S. Patent Nos. 6,518,069; 800-788-9223 The6,576,471; NMR LipoProfile 6,653,140; ® and test 7,243,030. may be covered www.labcorp.com1447 York Court CLIA: 34D0655059 Medical Director: William F Hancock, MD Theby one NMR or moreLipoProfile issued ® or test pending may be patents, covered Burlington,1447 YNCork 27215 Court byincludingPatient one or Name U.S.more Patent issued Nos. or pending 6,518,069; patents, Gender Age Burlington,800-788-9223Page NC 27215 1 of 2 including6,576,471;SAMPLE U.S. 6,653,140;REPOR PatentT, Nos.123810 and 6,518,069;7,243,030. F 57 Account Information www.labcorp.com800-788-9223 6,576,471;CLIA: 34D0655059 6,653,140; and 7,243,030. Account # Medical Director: Williamwww.labcorp.com F Hancock, MD Physician Information Medical Director: William F Hancock, MD CLIA:Patient 34D0655059 Name Gender Age Test Account Page 1 of 2 3060 South Church Street PatientSAMPLE Name REPORT, 123810 GenderFAge 57 Account Information Page 1 of 2 Patient ID DOB Specimen ID Burlington, NC 27215 SAMPLE REPORT, 123810 F 57 Account # Account Information Physician Information Phone: (336) 436-8645 Fax: (336) 436-8645 AccountTest Account # Physician Information Date Collected Date Entered Date Reported T3060est Account SouthControl Church Number Street Fasting Patient07/17/2015 ID 07/21/2015DOB 07/21/2015Specimen 2:03ID PM 3060Burlington, South NC Church 27215 Street NO Patient ID DOB Specimen ID Burlington,Phone: (336) NC 436-8645 27215 Fax: (336) 436-8645 Phone: (336) 436-8645 Fax: (336) 436-8645 DateNMR Collected LipoProfile Date ® testEntered Date Reported ReferenceControl Range Number¹ Fasting Understanding the NMR LipoProfile®Date07/17/2015 Collected Test Report Date07/21/2015 Entered 07/21/2015Date Reported 2:03 PM Control Number FastingNO 07/17/2015 07/21/2015Percentile¹ 07/21/201520th 2:03 PM 50th 80th 95th NO LDL-P NMR LipoProfile nmoI/L® test Low ModerateReference Borderline Range¹ High Very High • LDL-P is the direct measure of low density lipoprotein NMR LipoProfile ® test ReferenceHigh Range¹ 1600 Percentile¹ 20th 50th 80th 95th particles - the causal link between high levels of LDL-P LDL-P < 1000 1000 - 1299 1300 - 1599 1600 - 2000 > 2000 (LDL Particle Number) Percentile¹ 20th 50th 80th 95th and development of cardiovascular disease (CVD) is well nmoI/L Low Moderate Borderline High Very High 1. Reference population (5,362 men and women) not on lipid medication enrolled in the Multi-Ethnic Study of AtherosclerosisHigh (MESA). Mora, et al. Atherosclerosis 2007. established. nmoI/L Low Moderate Borderline High Very High LDL-P 1600 < 1000 1000 - 1299 1300High - 1599 1600 - 2000 > 2000 • Studies have demonstrated per-particle cholesterol amount (LDL Particle Number) 1600 < 1000 Near1000 or - Above1299 1300Borderline - 1599 1600 - 2000 > 2000 LipidsLDL-P mg/dL Optimal High Very High varies in patients with type II diabetes, statin-treated 1.(LDL Reference Particle population Number) (5,362 men and women) not on lipid medication enrolled in the Multi-EthnicOptimal Study of AtherosclerosisHigh (MESA). Mora, et al. Atherosclerosis 2007.

patients, and those with cardiometabolic risk factors (CMR) LDL-C1. Reference population (5,362 men and90 women) not on lipid medi< cation100 enrolled in the Multi-Ethnic100 - 129 Study of Atherosclerosis130 - 159 (MESA). Mora,160 et al. -Atherosclerosis 189 2007. ≥ 190 1,2,3 (calculated) listed below: Near or Above Borderline 4 Lipids mg/dL Optimal High Very High Age: men ≥45 yrs, women ≥ 55 yrs) NearOptimal or Above BorderlineHigh Lipids mg/dL Optimal High Very High Elevated BP: (≥130/≥85 mmHg; on antihypertensive LDL-C mg/dL90 < 100 100Optimal - 129mg/dL 130High - 159 160 - 189 mg/dL≥ 190 medication)5 LDL-C(calculated) 90 < 100 100 - 129 130 - 159 160 - 189 ≥ 190 HDL-C 48 Triglycerides 78 Total Cholesterol 198 Abdominal obesity/waist circumference: (calculated) MANAGINGDesirable ≥ TO40 AN LDL-P GOALDesirable CAN < 150 BE ACCOMPLISHEDDesirable < 200 male ≥ 40” (Asian ≥ 35”), female ≥ 35” (Asian ≥ 31”)5 mg/dL mg/dL mg/dL LDL-C is inaccurate if patient is non-fasting. WITHIN EXISTINGmg/dL THERAPEUTIC STRATEGIESmg/dL AND GUIDELINESmg/dL Elevated triglycerides: (≥150 mg/dL), low HDL HDL-C 48 Triglycerides 78 Total Cholesterol 198 (men < 40 mg/dL, women < 50 mg/dL), increased HistoricalHDL-C ReportingDesirable48 ≥ 40 Triglycerides Desirable78 < 150 Total Cholesterol Desirable198 < 200 2,5 numbers of small dense LDL particles, on drug LDL-C is inaccurate if patient is non-fasting. • OutcomeDesirable study data ≥ 40 has shown when measures ofDesirable < LDL-P150 and LDL-C Discordance inDesirable MESA 14< 200 treatment for elevated triglycerides or HDL-C LDL-C is inaccurate if patient is non-fasting. 5 LDL-C and LDL-P agree (concordance), risk factor Relationship with Incident CVD Events (n=319) Elevated fasting blood glucose: (≥ 100 mg/dL), on HistoricalLDL-P Reporting drug treatment for elevated glucose Historicalprofiles Reporting are favorable. However when LDL-C and Insulin resistance: (IR)2 LDL-P disagree (discordance), CVD risk tracks with 9 ►1600 (07/17/2015) • Many expert panels recommend use of LDL-P values to LDL-P LDL-P or Apo B. optimize treatment decisions in these at-risk patients.2,6 LDL-P • Since LDL-C may be an unreliable measure in • NMR LipoProfile® Test is FDA cleared for use in conjunction ►1600 (07/17/2015) with other lipid measurements and clinical evaluation to aid patients with type II diabetes, statin-treated ►1600 (07/17/2015) in the management of lipoprotein disorders associated patients, and those with CMR factor due to 7 per-particle cholesterol variability, expert panels with CVD. LDL-C recommend use of LDL-P or Apo B to optimize treatment decisions in these patients.4,5,8,11,12,13 Lipids ►90 (07/17/2015) LDL-C • Traditional lipid panel includes LDL-C, HDL-C, triglycerides LDL-C and total cholesterol. ►90 (07/17/2015) • Whether calculated or measured directly, LDL-C is an Personalized LDL Management►90 (07/17/2015) estimate of the amount of cholesterol contained within Targets of Therapy (Adapted with permission from International Guidelines Center2) 1 This document contains private and confidential health information protected by state and © 1995-2015 Laboratory Corporation of America® Holdings LDL-P. HIGH federal law. If you have received this documentLOW in error, please call 800-222-7566. BORDERLINE All Rights Reserved - Enterprise Report Version: 1.00

LDL-P 1000 1300 This document containsranges private* and confidential health information protected by state and © 1995-2015 Laboratory Corporation of America® Holdings federal law. If you (nmol/L):have received this document in error, please call . All Rights Reserved - Enterprise Report Version: 1.00 Historical Reporting This document contains private and confidential health information protected800-222-7566 by state and © 1995-2015 Laboratory Corporation of America® Holdings Patient LDL-P and LDL-C values and dates of services are federal law. If you have received this documentTarget infor error, high–risk please callpatients 800-222-7566. Target for moderate-risk patientsAll Rights Reserved - Enterprise Report Version: 1.00 tracked over time, providing opportunities for clinician/patient LDL-C discussions regarding treatment strategies ranges* 100 130 (mg/dL):

Reduce LDL Particle Production By: Improve LDL Particle Clearance By:

• Diet • Exercise • Weight Loss • More potent Statins 35% to 55%  LDL-P • Glycemic Control • Gut agents • Marine Omega-3 Ezetimibe - 15% to 25%  LDL-P DHA + EPA - no consistent effect on  LDL-P Resins/Bile Acid Sequestrants - 15% to 30%  LDL-P EPA Only - 4% to 15%  LDL-P • Statin + Gut, Statin + Niacin 50% to 70%  LDL-P • Statin + Gut + Niacin >60%  LDL-P The NMR LipoProfile ® test may be covered 1447 York Court by one or more issued or pending patents, Burlington, NC 27215 including U.S. Patent Nos. 6,518,069; 800-788-9223 6,576,471; 6,653,140; and 7,243,030. www.labcorp.com1447 York Court CLIA: 34D0655059 Medical Director: WilliamBurlington, F Hancock, NC 27215 MD 800-788-9223 Patient Name Gender Age Page 2 of 2 Medical Director: William F Hancock, MD SAMPLE REPORT, 123810 F 57 Specimen Number Patient ID Account Number AccountAccount Information Phone Account Fax Account # Physician300-001-0094-0 Information 90000999 (336) 436-8645 (336) 436-8645 Patient Last Name Patient First Name Test Account Account Address SAMPLE REPORT 123638 3060 SouthLabCorp Church Test Street Master Test Account PatientAge ID Date of Birth DOBSex SpecimenFasting ID Burlington, NC 27215 00 N/A NOT SPECIFIED 3060 South Church Street Phone: (336) 436-8645 Fax: 1447(336) York 436-8645 Court Control Number NPI Burlington, NC 27215 Burlington, NC 27215 Understanding the NMR LipoProfile®Date Collected Test Report Date Entered Date Reported Control Number Fasting Date Collected Date Entered Date and Time Reported Physician ID & Name Page Number 07/17/2015 07/21/2015 07/21/2015 2:03 PM 800-788-9223NO 10/25/2015 10/26/2015 11/13/2015 11:48 AM ET Medical Director: William 2F Hancock,of 2 MD PARTICLESpecimen CONCENTRATION Number AND SIZEPatient ID Account Number Account Phone Account Fax LDL and HDL Particles PARTICLE300-001-0094-0 CONCENTRATION AND SIZE 90000999 (336) 436-8645 (336) 436-8645 Lower CVD Risk Higher CVD Risk Patient Last Name Patient First Name Account Address • HDL-P is the direct measure of high density lipoprotein LDL and HDL Particles Lower CVD Risk Higher CVD Risk SAMPLE REPORT 123638 Percentile in Reference Population particles; it has been shown to be more strongly and LDL and HDL Particles Percentile in ReferenceLabCorp Population Test Master Test Account Age Date of BirthμmoI/L Sex high Fasting 75th 50th ① 25th low 00 * μmoI/L N/A highNOT SPECIFIED75th 50th3060 South Church25th Street low independently related to atherosclerotic risk than high HDL-P (total) * 31.3 34.9 30.5 ① 26.7 density lipoprotein cholesterol (HDL-C).8 HDL-P Control(total) Number 30.2 NPI 34.9 30.5 Burlington, NC26.7 27215 nmoI/L low 25th 50th 75th high • Many with CMR factors have increased numbers of small Date Collected Date Entered Date and Time Reported Physician ID & Name Page Number nmoI/L low 25th 50th 75th high lipoprotein particles (Small LDL-P) and other atherogenic 10/25/2015SMALL LDL-P 10/26/2015187 11/13/2015 11:48 AM ET 117 527 839 2 of 2 SMALL LDL-P 187 117 527 839 9,10 lipoproteins. PARTICLE CONCENTRATIONnm AND SIZE nm 21.2 23.0 Large (Patern A) 20.6 20.5 Small (Patern B) 19.0 LDL SIZE Lower CVD Risk Higher CVD Risk LDL SIZE 21.2 23.0 Large (Patern A) 20.6 20.5 Small (Patern B) 19.0 Insulin Resistance (IR) Score LDL and HDL Particles Percentile in Reference Population Small LDL-P and LDL Size are associated with CVD risk, but not after LDL-P is taken into account. • A laboratory developed index that has been associated μmoI/L high 75th 50th ① 25th low SmallThese LDL-P assays and were LDL developed Size * are and associated their performance with CVD characteristics risk, but not determined after LDL-P by is LipoScience. taken into account. These assays have not been cleared by 30.2 34.9 30.5 26.7 with IR and diabetes risk, the IR Score can be used TheseHDL-Pthe US Food assays (total) and were Drug developedAdministration. and The their clinical performance utility of these characteristics laboratory determinedvalues has not by been LipoScience. fully established. These assays have not been cleared by the US Food and Drug Administration. The clinical utility of these laboratory values has not been fully established. as one component of clinical assessment. * nmoI/L Insulin Sensitive Insulin Resistant Insulin Resistance Score②③ low 25th 50th 75th high • Insulin resistance (IR) is the precursor to type 2 diabetes * LipoProtein Markers Associated with Insulin Sensitive Insulin Resistant SMALL LDL-P 187 117Percentile in Reference 527 Population 839 (T2DM) and manifests its earliest measureable Insulin Resistance & Diabetes Risk②③ Percentile in Reference Population nmoI/L ① abnormalities though changes in lipoproteins.11 0-100nm lowinsulin sensitive 25th25th 50th 50th ① 75 7th5th insulin resistant high LARGE VLDL-P 1.437 0.9 2.7 6.9 • The IR score may be an early alert to a heightened risk LDLLP-IR SIZE SCORE 21.2 23.0 Large (Patern27 A) 20.6 45 20.5 Small (Patern 63 B) 19.0 11 of developing T2DM. ** nmoI/L low 25th 50th 75th high SmallLP-IR ScoreLDL-P is and inaccurate LDL Size if patient are associated is non-fasting. with CVD risk, but not after LDL-P is taken into account. SMALL LDL-P 187 117 527 839 TheseThe LP-IR assays score were is developed a laboratory and developed their performance index that characteristics has been associated determined with by LipoScience. insulin resistance These and assays diabetes have risk not and been should cleared be usedby the as USone Food component and Drug of aAdministration. physician's clinical The clinicalassessment. utility of The these LP- laboratory IR score has values not hasbeen not cleared been fullyby the established. US Food and Drug Administration . Test Name Test No μmoI/L high 75th 50th 25th low ** LipoProtein Markers Associated with Insulin Sensitive Insulin Resistant NMR LipoProfile(R) With Insulin Resistance Markers 123638 * LARGEClinician HDL-P Notes 7.0 7.3 4.8 3.1 (With Graph) Insulin Resistance & Diabetes Risk②③ Percentile in Reference Population nmoI/L NMR LipoProfile(R) With Insulin Resistance Markers 123497 nm smalllow 25th25th 50th50th ① 75th large high Without Lipids (With Graph) VLDLLARGE SIZE VLDL-P 42.91.4 42.40.9 46.62.7 52.56.9

NMR LipoProfile® (With Graph) 123810 nmoI/Lnm largelow 25th75th 50th50th 7525th small high NMR LipoProfile® (Without Graph) 884247 LDLSMALL SIZE LDL-P 21871.2 21.2117 20.8527 20.4839

For the most current information regarding test options, including specimen μmoI/L high 75th 50th 25th low requirements and CPT codes, please consult the online Test Menu at www.LabCorp.com. nm large 75th 50th 25th small HDLLARGE SIZE HDL-P 9.17.0 9.67.3 9.24.8 8.93.1 References 1. Toth PP, Grabner M, Punekar RS et al. Cardiovascular risk in patients achieving lowdensity lipoprotein cholesterol and particle targets. Atherosclerosis. 2014 (235)585-591. nm small 25th 50th 75th large 2. Brunzell JD, Davidson M, Furberg CD, et al. Lipoprotein management in patients with Insulin Resistance Score 42.9 42.4 46.6 52.5 cardiometabolic risk. Consensus statement from the American Diabetes Association and the VLDL SIZE 0-100 insulin sensitive 25th 50th 75th insulin resistant American College of Cardiology Foundation. Diabetes Care. 2008 April; (31)4:811-82. 3. Sniderman AD, Williams K, Contois JH et al. A meta-analysis of low-density lipoprotein cholesterol, 33 27 45 63 non-high-density lipoprotein cholesterol, and apolipoprotein B as markers of cardiovascular risk. LP-IR SCORE nm large 75th 50 th 25th small Circ Cardiovasc Qual Outcomes. 2011;4:337-345. 4. National Heart, Lung, and Blood Institute. Executive Summary. The Third Report of the National LDL SIZE 21.2 21.2 20.8 20.4 Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High LP-IR Score is inaccurate** if patient is non-fasting. Blood Cholesterol in Adults (Adult Treatment Panel III), National Institutes of Health. May 2001. NIH publication 01-3670; 1-28. The LP-IR score is a laboratory nm developed index large that has been associated 75th with insulin resistance50 th and diabetes risk and 2 5th should be used assmall one 5. Grundy SM, Cleeman JI, Daniels SR et al. Diagnosis and management of the metabolic syndrome: An component of a physician's clinical assessment. Neither the LP-IR score nor the subclasses listed above have been cleared by the US Food HDL SIZE 9.1 9.6 9.2 8.9 American Heart Association/ National Heart, Lung, and Blood Institute scientific statement: Executive andLiposcience Drug Administration. reference population comprises 4,588 men and women without known CVD or diabetes and not on lipid medication. Summary, Circulation. 2005; 112 e285-e290. ** 6. Garber AJ, Abrahamson MJ, Barzilay JI, Blonde L, Bloomgarden ZT, Bush MA, Dagogo-Jack S, ① Shalaurova I et al., Metab Syndr Relat Disord 2014; 12:422-9. Mackey RH et al., Diab Care 2015; 38:628-36. DeFronzo RA, Einhorn D, Fonseca VA, Garber JR, Garvey WT, Grunberger G, Handelsman Y, Henry RR, InsulinLipoScience Resistance reference Score population comprises 4,588 men and women without known CVD or diabetes and not on lipid medication. Hirsch IB, Jellinger PS, McGill JB, Mechanick JI, Rosenblit PD and Umpierrez GE. Consensus Statement ② ③ by the American Association of Clinical Endocrinologists and American College of Endocrinology on ① Shalaurova I et al., Metab Syndr0-100 Relat Disord 2014; 12:422-9.insulin sensitive 25th Mackey RH et al., Diab 50 Careth 2015; 38:628-36. 75th insulin resistant the Comprehensive Type 2 Diabetes Management Algorithm - 2016 Executive Summary. Endocrine ② ③ practice : official journal of the American College of Endocrinology and the American Association of Clinical EndocrinologistsThis documentLP-IR .SCORE 2016;22:84-113. contains private and confidential33 health information protected by state 27and 45 © 1995-2015 Laboratory 63 Corporation of America® Holdings 7. NMR LipoProfile® [package insert]. Raleigh, NC: Laboratory Corporation of America; 2015. federal law. If you have received this document in error, please call 800-222-7566. All Rights Reserved - Enterprise Report Version: 1.00 8. Mora S, Glynn RJ and Ridker PM. High-density lipoprotein cholesterol, size, particle number, and residual vascular risk after potent statin therapy. Circulation. 2013;128:1189-97. 9. Otvos JD, Jeyarajah EJ, Cromwell WC. Measurement issues related to lipoproteinheterogeneity. Amer J Cardiol.LP-IR 2002 Oct;Score 90(8A):22i-29i. is inaccurate** if patient is non-fasting. 10. Mora S, Otvos JD, Rosenson RS, Pradhan A, Buring JE, Ridker PM. Lipoproteinparticle size and concentration by nuclear magnetic resonance and incident type 2 diabetes in women. Diabetes. 2010 May;59(5):1153-1160. 11. Frazier-Wood AC., Garvey WT., Dall T, et al. Opportunities for using lipoprotein subclass profile by nuclear magneticThe LP-IR resonance score spectroscopy is a laboratory in assessing developed insulin index resistance that hasand diabetes been associated prediction. Metab with Syndr insulin Reatl resistance Disord 2012;10:244–251. and diabetes risk and should be used as one ©2016 Laboratory Corporation of America® Holdings All rights reserved. L15035-0616-2 component of a physician's clinical assessment. Neither the LP-IR score nor the subclasses listed above have been cleared by the US Food and Drug Administration. ** LipoScience reference population comprises 4,588 men and women without known CVD or diabetes and not on lipid medication.

① Shalaurova I et al., Metab Syndr Relat Disord 2014; 12:422-9. Mackey RH et al., Diab Care 2015; 38:628-36. This document② contains private and confidential health information protected by state and③ © 1995-2015 Laboratory Corporation of America® Holdings federal law. If you have received this document in error, please call 800-222-7566. All Rights Reserved - Enterprise Report Version: 1.00