EFTA00311355.pdf

Statement of Account EMD PC Date Account No. I Page # I 01/28/2015 0000008048 1 JEFFREY EPSTEIN Last.Payment 9 EAST 71ST STREET Date Amount NEW YORK, NY 10021 // 0.00 Paid by Paid By Date Procedure Description Charges Insurance Patient Adj. Balance 01/22/2015 99205 New Pt High Complexity 500.00 500.00 01/22/2015 11100 Biopsy/Skin, 1st 250.00 250.00 01/22/2015 17000 Dest Ben/Premalig 1st 175.00 175.00 01/22/2015 17003 Dest Ben/Premal 2-14 350.00 350.00 0 - 30 Days `31 - 60 Days d 61 - 90 Days 91 - 120 Days ›. 120 Days Parent Past Due Balance Due j Current i Past Due Past Due Past Due L $1275.00 $0.00 1 so.00 $0.00 CUT ON DOTTED LINE AND SEND WITH PAYMENT $0.00 $1275.00 Notes: EPSTEIN. JEFFREY ACCOUNT NO. FOR BILLING INQUIRIES CONTACT 0000008048 For your convenience, you may transfer this balance to your credit card account. To pay with your credit Statement Date: 01/28/2015 card, please complete the information below: 0 Olt E Lac payable to: MITCHELL A KLINE, MD PC Amt. No. Exp. Date Security Code Amount Signature EFTA00311355  Statement of Account ERD PC Date I Account No. J Paget' 01/22/2015 f 0000008048 1 JEFFREY EPSTEIN Last Payment 9 EAST 71ST STREET Date Amount NEW YORK, NY 10021 0.00 Paid by Paid By Date Procedure Description Charges Insurance Patient Adj. Balance 01/22/2015 99205 New Pt High Complexity 500.00 500.00 01/22/2015 11100 Biopsy/Skin, 1st 250.00 250.00 01/22/2015 17000 Dest Ben/Premalig 1st 175.00 175.00 01/22/2015 17003 Dest Ben/Premal 2-14 50.00 50.00 y .AA 1 g 1‘ So 0 - 30 Days 31 - 60 Days 61 - 90 Days 91 - 120 Days > 120 Days I Patient Current Past Due Past Due Past Due Past Due Balance Due $975.00 $0.00 $0.00 $0.00 $0.00 $975.00 CUT ON DOTTED LINE AND SEND WITH PAYMENT Notes: EPSTEIN, JEFFREY ACCOUNT NO. FOR BILLING INQUIRIES CONTACT 0000008048 Statement Date: 01/22/2015 Please remit payment of $975.00 payable to: , MD PC EFTA00311356 You have an appointment with dermatologist, Dr. on friday Dec. 9th at 3pm. He does not accept any insurance. (i have cancelled the appt w r. Dr. Jojo, Jeffrey will probably walk but will need you to take him to his haircut at Fekkai salon afterwards...be sure to have the car out. Fri. Jan, 9, 2015 PB-NY Reminder: to fly from PB to NY via Jet Blue#544 at 11:04am, arrive Newark 1:49pm (booked w/Jet Blue Confirm#MQU$BA) TBD Depart PB TBD Arrive NY TBD Hardeep 3:00pm Appt w/Dr. Mitchell Kline 4:30pm Haircut w/Patrick at salon EFTA00311357  From Subject: Dr. Mitchell Kline-Dermatologist Date: December 313, 2014 at 12:20 PM To: Jeffrey Epstein eevaca* nn.:. rna Cc: EFTA00311358