Statement of Account MITCHELL A KLINE. MD PC Date Account No. Page # 03/30/2016 0000008048 1 JEFFREY EPSTEIN 9 EAST 71ST STREET NEW YORK. NY 10021 Date Procedure Description Last Payment Date Amount 04/08/2015 675.00 Paid by Charges Insurance Paid By Patient Adj. Balance 03/30/2016 99214 Est Pt Visit Detailed 450.00 450.00 03/30/2016 11100 Biopsy/Skin, 1st 250.00 250.00 03/30/2016 17000 Dest Ben/Premalig 1st 175.00 175.00 03/30/2016 17003 Dest Ben/Premal 2-14 150.00 150.00 03/30/2016 96904 whole body integumentary photograpy 500.00 500.00 0 - 30 Days Current 31 - 60 Days Past Due 61 - 90 Days Past Due 91 - 120 Days Past Due > 120 Days Past Due $1525.00 $0.00 $0.00 $0.00 $0.00 Notes: Pat ent Balance Due $1525.00 CUT ON DOTTED LINE AND SEND WITH PAYMENT FOR BILLING INQUIRIES CONTACT EPSTEIN, JEFFREY ACCOUNT NO. 0000008048 Statement Date: 03/30/2016 Please remit payment of $1525.00 payable to: MITCHELL A KLINE, MD PC EFTA00316208

From: Subject: Jeffrey and d or WM, 2016 Date: March 29.2016 at 11:39 AM To: Bella Klein FYI...Jeffrey is going to see Dr. Magnani tomorrow at 9am and Dr. Kline at 10am (Magnani for a cavity and Kline is a dermatologist) EFTA00316209

2pa JEFFREY EPSTEIN 9 EAST 71ST STREET NEW YORK NY 10021 D PC Statement of Account Date Procedure Description 03/30/2016 99214 Est Pt Visit Detaned 03/30/2016 11100 Biopsy/Skin. 1st 03/30/2016 17000 Dest Ben/Presiali9 1st 03/30/2016 17003 Dest EieNPrema12-14 03/30/2016 96904 whole body integumentary photograpy CUT ON DOTTED LINE AND SEND WITH PAYMENT Notes: FOR BILLING INQUIRIES CONTACT Cha Paid by es Insurance Paid By Patient Adt Balance 450.00 450.00 250.00 250.00 175.00 175.00 160.00 150.00 500.00 500.00 ,JEFFREY ACCOUNT NO. 0000008048 Statement Date: 04/07/2016 Please remit payment of $0.00 payable to: MITCHELL A KLINE, MD PC EFTA00316210

ergs :// tne rcha ore e nlerc ardco lineage nilaccountIrec e p#R0984906 $: MITCHESD PC 04/07/2016 0255:28 PM Ref #. 098490653755 Authorization Code: 123648 Total: $1,525.00 use Card Number. 37Z0000000(3001 Card Holder. JEFFREY EPSTEIN Question about this receipt? Call us at O 2016 MITCHELL A KLINE MD PC . Wt rights reserved. 417120162:56 PM ( EFTA00316211

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