Statement of Account MD PC Date |__ Account No. | Page # | | 01/28/2015 0000008048 | 1 | JEFFREY EPSTEIN Last Payment 9 EAST 71ST STREET NEW YORK, NY 10021 - Paid by Paid By . Date Procedure Description Charges Insurance _ Patient Adj. Balance ! 01/22/2015 |99205 |New Pt High Complexity 500.00 01/22/2015 | 11100 | Biopsy/Skin, 1st 250.00 | 01/22/2015 | 17000 | Dest Ben/Premalig ist 175.00 01/22/2015 | 17003 | Dest Ben/Prema! 2-14 350.00 { 0-30Days 31-60 Days | 61 -90 Days |91- 120 Days) > 120 Days Patient Current | PastDue | PastDue | PastDue — Past Due | Balance Due $1275.00 | $0.00 | $0.00 $000 | = $0.00 $1275.00 CUT GN DOTTED LINE AND SEND WITH PAYMENT "7 Notes: EPSTEIN, JEFFREY] FOR BILLING INQUIRIES CONTACT _ACCOUNTNO. | | 0000008048 Statement Date: 01/28/2015 payable to: MITCHELL A KLINE, MD PC EFTA00311355

--=PAGE_BREAK=--

Statement of Account DPC — — — _ Date |__Account No. _| Page # | 01/22/2015 0000008048 | 1 JEFFREY EPSTEIN Last Payment | 9 EAST 71ST STREET Amount | NEW YORK, NY 10021 0.00 Paidby 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 ist 175.00 175.00 01/22/2015 | 17003 Dest Ben/Premal 2-14 50.00 | 60,00 | i ae’ ; ---— T ry | 0-30 Days | 31-60 Days | 61-90 Days 91 - 120 Days! > 120 Days Patient Current Past Due Past Due PastDue | PastDue | Balance Due $975.00 $0.00 $0.00 $0.00 | $0.00 | $975.00 i _ 4 L —-——_1 proccss sre esses CUTON DOTTEDLINEAND SENDWITHPAYMENT = siti‘<C; RDtéC<S;S;S;S*;*;:C:S*S Notes: [ EPSTEIN, JEFFREY FOR BILLING INQUIRIES CONTACT [I |____ ACCOUNT NO, 0000008048 Statement Date: 01/22/2015. | Please remit payment of $975.00 payable to: a. MD PC EFTA00311356

--=PAGE_BREAK=--

You have an appointment with ia dermatologist, Dr. on friday Dec. 9th at 3pm. He does not accept any insurance. (i have cancelled the appt w/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 wiJet Blue Confirm#MQUSBA) TBD Depart PB TBD Arrive NY TBD Hardeep 3:00pm Appt w/Dr. Mitchell Kline 4:30pm Haircut w/Patrick at salon EFTA00311357

--=PAGE_BREAK=--

From Subject: Date To: Ce: Dr. Mitchell Kline-Dermatologist December 30 Jefirey Epstein jeevac anon@< 2014 at 12:20 PM mail cor EFTA00311358