PPSLR Pathology Lab Waste Disposal

Surgical pathology report (D) Invoice for pathology services for June

(E) and July (F) 2015

Waste tracking document (stamped with disposal certification) (J)

Invoice for waste disposal services (K)

Contract for pathology services (B) Surgical pathology requisition (C) Payment for pathology services (G)

Contract for pathology waste disposal (H) Waste tracking document (pre-disposal) (I)

Procedure list (A)

1

Surgical Abortion Procedures at PPSLR from 6/1-2015 - 6/30/2015 Type Procedure 1st Tri Surgical Procedure

Service Item Description Induced abortion, by D & C 9 wk

Accession # R15-08120

Date of Service06/02/2015

1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08135 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08128 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08121 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08134 06/02/2015 2nd Tri Surgical Procedure Induced AB by D&E 15 wk R15-08137 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08133 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08125 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11wk R15-08139 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08123 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 5 wk R15-08130 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08131 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-08138 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08132 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08122 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08127 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08129 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-08136 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08126 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08119 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08124 06/02/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08152 06/03/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08141 06/03/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08144 06/03/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08145 06/03/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08148 06/03/2015 1st Tri Surgica I Procedure Induced abortion, by D & C 8 wk R15-08140 06/03/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08149 06/03/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08143 06/03/2015 1st Tri Surgical Procedure Induced Abortion, by D & C 13 wk R15-08150 06/03/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08151 06/03/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08142 06/03/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08146 06/03/2015 2nd Tri Surgical Procedure Induced AB by D&E 17 wk R15-08153 06/03/2015 1st Tri Surgical Procedure Induced abortion, by D & C 5 wk R15-08147 06/03/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08235 06/05/2015 2nd Tri Surgical Procedure Induced AB by D&E 14 wk R15-08238 06/05/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08233 06/05/2015 1st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-08242 06/05/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08236 06/05/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08234 06/05/2015 1st Tri Surgical Procedure Induced Abortion, by D & C 13 wk R15-08240 06/05/2015

Procedure list (A)

2

1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08237 06/05/20152nd Tri Surgical Procedure Induced AB by D&E 15 wk R15-08239 06/05/20151st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08241 06/05/20151st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08232 06/05/20151st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08230 06/05/20151st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08231 06/05/20151st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08208 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08213 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08226 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08209 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08224 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-08223 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08225 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08214 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08206 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08221 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08204 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08215 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 11wk R15-08220 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08216 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-08218 06/06/20152nd Tri Surgical Procedure Induced AB by D&E 17 wk R15-08228 06/06/20151st Tri Surgical Procedure Induced Abortion, by D & C 13 wk R15-08227 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 11wk R15-08222 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08212 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08207 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08219 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08211 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08217 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08210 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08205 06/06/20152nd Tri Surgical Procedure Induced AB by D&E 20 wk R15-08229 06/06/20151st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08471 06/09/20151st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08477 06/09/20151st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08474 06/09/20151st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08465 06/09/20151st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08461 06/09/20151st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08458 06/09/20151st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08469 06/09/20151st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08459 06/09/20151st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08462 06/09/20151st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08475 06/09/20151st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08472 06/09/20151st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08460 06/09/2015

Procedure list (A)

3

1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08473 06/09/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08479 06/09/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08467 06/09/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08463 06/09/2015 2nd Tri Surgical Procedure Induced AB by D&E 15 wk R15-08478 06/09/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08466 06/09/2015 1st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-08480 06/09/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08464 06/09/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08476 06/09/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08468 06/09/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08490 06/10/2015 2nd Tri Surgical Procedure Induced AB by D&E 17 wk R15-08492 06/10/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08484 06/10/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08488 06/10/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08486 06/10/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08487 06/10/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08482 06/10/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08485 06/10/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08483 06/10/2015 2nd Tri Surgical Procedure Induced AB by D&E 21wk R15-08491 06/10/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08504 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08497 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-08508 06/12/2015 2nd Tri Surgical Procedure Induced AB by D&E 15 wk R15-08510 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08500 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 5 wk R15-08496 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08494 06/12/2015 2nd Tri Surgical Procedure Induced AB by D&E 17 wk R15-08511 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08503 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08509 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08501 06/12/2015 1stTri Surgical Procedure Induced abortion, by D & C 8 wk R15-08505 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08502 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08499 06/12/2015 1st Tri SurgicaI Procedure Induced abortion, by D & C 6 wk R15-08493 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08507 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-08506 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08498 06/12/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08523 06/13/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08516 06/13/2015 2nd Tri Surgical Procedure Induced AB by D&E 20 wk R15-08526 06/13/2015 1st Tri Surgical Procedure Induced abortion, by D & C 5 wk R15-08519 06/13/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08521 06/13/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08515 06/13/2015

Procedure list (A)

4

2nd Tri Surgical Procedure Induced AB by D&E 20 wk R15-08527 06/13/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08513 06/13/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08520 06/13/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08518 06/13/2015 1st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-08524 06/13/2015 2nd Tri Surgical Procedure Induced AB by D&E 17 wk R15-08525 06/13/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08522 06/13/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08514 06/13/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08512 06/13/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08517 06/13/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08770 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08769 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-08786 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08761 06/16/2015 1st Tri Surgical Procedure Induced Abortion, by D & C 13 wk R15-08781 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08772 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08784 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08771 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08773 06/16/2015 1st Tri Surgical Procedure Induced Abortion, by D & C 13 wk R15-08776 06/16/2015 2nd Tri Surgical Procedure Induced AB by D&E 16 wk R15-08789 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08774 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08782 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08763 06/16/2015 2nd Tri Surgical Procedure Induced AB by D&E 15 wk R15-08783 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08764 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08767 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08768 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08785 06/16/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08779 06/17/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08777 06/17/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08760 06/17/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08756 06/17/2015 1st Tri Surgica I Procedure Induced abortion, by D & C 6 wk R15-08775 06/17/2015 2nd Tri Surgical Procedure Induced AB by D&E 20 wk R15-08788 06/17/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08759 06/17/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08780 06/17/2015 1st Tri Surgical Procedure Induced Abortion, by D & C 13 wk R15-08778 06/17/2015 2nd Tri Surgical Procedure Induced AB by D&E 16 wk R15-08787 06/17/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08758 06/17/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08757 06/17/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08833 06/19/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08830 06/19/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08836 06/19/2015

Procedure list (A)

5

1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08826 06/19/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08828 06/19/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08829 06/19/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08832 06/19/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08835 06/19/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08837 06/19/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08825 06/19/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08838 06/19/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08831 06/19/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08827 06/19/2015 2nd Tri Surgical Procedure Induced AB by D&E 14 wk R15-08834 06/19/2015 2nd Tri Surgical Procedure Induced AB by D&E 21wk R15-08865 06/20/2015 2nd Tri Surgical Procedure Induced AB by D&E 19 wk R15-08868 06/20/2015 2nd Tri Surgical Procedure Induced AB by D&E 18 wk R15-08866 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08849 06/20/2015 2nd Tri Surgical Procedure Induced AB by D&E 17 wk R15-08869 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08839 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08848 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11wk R15-08863 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08842 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08851 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-08847 06/20/2015 2nd Tri Surgical Procedure Induced AB by D&E 15 wk R15-08857 06/20/2015 2nd Tri Surgical Procedure Induced AB by D&E 14 wk R15-08860 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08861 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08843 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08844 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11wk R15-08856 06/20/2015 2nd Tri Surgical Procedure Induced AB by D&E 17 wk R15-08867 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08859 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08864 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08850 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-08852 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08840 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-08862 06/20/2015 1st Tri Surgical Procedure Induced Abortion, by D & C 13 wk R15-08858 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-08854 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-08846 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-08855 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-08841 06/20/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-09100 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09105 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-09097 06/23/2015 2nd Tri Surgical Procedure Induced AB by D&E 16 wk R15-09109 06/23/2015

Procedure list (A)

6

1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-09111 06/23/2015 1st Tri Surgical Procedure Induced Abortion, by D & C 13 wk R15-09114 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-09116 06/23/2015 1st Tri Surgical Procedure Induced Abortion, by D & C 13 wk R15-09113 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09099 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 5 wk R15-09108 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-09106 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-09112 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09101 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-09115 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09103 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-09104 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09107 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09102 06/23/2015 2nd Tri Surgical Procedure Induced AB by O&E 15 wk R15-09110 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-09098 06/23/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-09093 06/24/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-09092 06/24/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-09090 06/24/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-09094 06/24/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-09089 06/24/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-09086 06/24/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-09087 06/24/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-09091 06/24/2015 2nd Tri Surgical Procedure Induced AB by D&E 16 wk R15-09096 06/24/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-09084 06/24/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-09088 06/24/2015 1st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-09095 06/24/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-09160 06/26/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-09166 06/26/2015 2nd Tri Surgical Procedure Induced AB by D&E 17 wk R15-09173 06/26/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-09172 06/26/2015 2nd Tri Surgical Procedure Induced AB by D&E 15 wk R15-09175 06/26/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-09169 06/26/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09163 06/26/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-09165 06/26/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09171 06/26/2015 2nd Tri Surgical Procedure Induced AB by D&E 16 wk R15-09174 06/26/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-09170 06/26/2015 2nd Tri Surgical Procedure Induced AB by D&E 17 wk R15-09176 06/26/2015 1st Tri Surgical Procedure Induced abortion, by D & C 10 wk R15-09167 06/26/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-09164 06/26/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-09159 06/26/2015 2nd Tri Surgical Procedure Induced AB by D&E 14 wk R15-09168 06/26/2015

Procedure list (A)

7

1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-09161 06/26/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-09162 06/26/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09192 06/27/2015 2nd Tri Surgical Procedure Induced AB by D&E 20 wk R15-09190 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-09256 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-09191 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 5 wk R15-09186 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09179 06/27/2015 2nd Tri Surgical Procedure Induced AB by D&E 18 wk R15-09198 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09187 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-09181 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09184 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-09196 06/27/2015 2nd Tri Surgical Procedure Induced AB by D&E 18 wk R15-09199 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-09188 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-09182 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-09180 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-09189 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-09185 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 4 wk R15-09177 06/27/2015 2nd Tri Surgical Procedure Induced AB by D&E 16 wk R15-09197 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 5 wk R15-09178 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-09193 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09183 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-09194 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-09195 06/27/2015 1st Tri Surgical Procedure Induced abortion, by D & C 12 wk R15-09426 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-09428 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-09417 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-09423 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 8 wk R15-09420 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-09429 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09424 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09416 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 6 wk R15-09422 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11 wk R15-09425 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09421 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 7 wk R15-09415 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 5 wk R15-09418 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 9 wk R15-09414 06/30/2015 2nd Tri Surgical Procedure Induced AB by D&E 14 wk R15-09432 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 11wk R15-09427 06/30/2015 1st Tri Surgical Procedure Induced abortion, by D & C 5 wk R15-09419 06/30/2015

Procedure list (A)

8

Other Surgical Procedures from Reproductive Health Services from 6/1-6/30/15 Type Procedure Post Surg Evac Procedure

Service Item Description Post Surg AB Surg Mgmt

Accession # R15-08118

Date of Service 06/19/2015

Miscarriage Procedure Treatment Of Missed AB 1st Tri 4-11Wk R15-08470 06/09/2015 Post Med Evac Procedure Post Med AB Surg Mgmt R15-08481 06/10/2015 Post Med Evac Procedure Post Med AB Surg Mgmt R15-08489 06/10/2015 Miscarriage Procedure Treatment Of Missed AB 1st Tri 4-11 Wk R15-08495 06/12/2015 Post Med Evac Procedure Post Med AB Surg Mgmt R15-08765 06/16/2015 Miscarriage Procedure Treatment Of Missed AB 1st Tri 4-11 Wk R15-08766 06/16/2015 Miscarriage Procedure Treatment Of Missed AB 1st Tri 4-11 Wk R15-08762 06/16/2015 Miscarriage Procedure Treatment Of Missed AB 1st Tri 4-11Wk R15-08824 06/19/2015 Miscarriage Procedure Treatment Of Missed AB 1st Tri 4-11Wk R15-08853 06/20/2015 Post Med Evac Procedure Post Med AB Surg Mgmt R15-08845 06/20/2015 Post Med Evac Procedure Post Med AB Surg Mgmt R15-09085 06/24/2015

Procedure list (A)

Contract for pathology services (B)

Contract for pathology services (B)

Surgical pathology requisition (C)

Surgical pathology report (D)

Invoice for pathology services for June 2015 (E)

Invoice for pathology services for June 2015 (E)

Invoice for pathology services for June 2015 (E)

Invoice for pathology services for June 2015 (E)

Invoice for pathology services for June 2015 (E)

Invoice for pathology services for June 2015 (E)

Invoice for pathology services for June 2015 (E)

Invoice for pathology services for June 2015 (E)

Invoice for pathology services for June 2015 (E)

Invoice for pathology services for June 2015 (E)

Invoice for pathology services for June 2015 (E)

Invoice for pathology services for June 2015 (E)

Invoice for pathology services for June 2015 (E)

Invoice for pathology services for July 2015 (F)

Invoice for pathology services for July 2015 (F)

Invoice for pathology services for July 2015 (F)

Invoice for pathology services for July 2015 (F)

Invoice for pathology services for July 2015 (F)

Invoice for pathology services for July 2015 (F)

Invoice for pathology services for July 2015 (F)

Invoice for pathology services for July 2015 (F)

Invoice for pathology services for July 2015 (F)

Invoice for pathology services for July 2015 (F)

Payment for pathology services (G)

Contract for pathology waste disposal (H)

Contract for pathology waste disposal (H)

Waste tracking document (pre-disposal) (I)

Waste tracking document (stamped with disposal certification) (J)

BILL TO:

MedAssure1013 S. Girls School RoadIndianapolis, IN 46231(317) 635-8000

Customer Number

Invoice Date

Invoice Number

06/30/2015

002088698

PATHOLOGY SERVICES INCORPORATE 2916 S BRENTWOOD BLVDBRENTWOOD, MO 63144-2714

001101

SERVICE DATE

TERMS DUE DATE SALES REP

DESCRIPTION QTY/WGHT UNIT PRICE AMOUNT

06/30/2015Due Upon Receipt

CONT. COUNT

001 - PATHOLOGY SERVICES INCORPORATE - 2916 S BRENTWOOD BLVD

1.00 570.00 570.00INCINERATE WASTE SERVICE06/01/15 - 06/30/15

6,161.00 570.00 0.00 570.00

OVER 90 DAYSCURRENT 30 DAYS 60 DAYS 90 DAYS

570.00 570.00Invoice Amount

Payment CouponPlease detach and enclose this portion with your payment - do not send cash.

MedAssure1013 S. Girls School RoadIndianapolis, IN 46231(317) 635-8000

Customer Number

Your Invoice NumberInvoice Date

Amount PaidTotal DueDue Date

Upon Receipt

06/30/2015

$7,871.00

002088698

MedAssure149 Yellowbrook RoadSuite 100Farmingdale, NJ 07727

PATHOLOGY SERVICES INCORPORATE 2916 S BRENTWOOD BLVDBRENTWOOD, MO 63144-2714

001101

Invoice for waste disposal services (K)