EFTA02726362

To: Leslie From: Kelly Daly 11-20-13 9:49am p. 1 of 1 Spine Associates Sean E. McCance, MD Peter Frelinghuysen, MD 1155 Park Avenue, NYC, NY 10128 Phone: (212) 3604500 Fax: (212)3604535 RADIOLOGY Name: EPSTEIN, JEFFERY Date 1111812013 Dx do instability 9 X-Ray US (standing) K Scoliosis Series (36", standing) • AP- Lateral K AP • Flex•Extension K Lateral 9 Obliques x 2 K Supine Bending • Lateral Ltanbosacral K Active bend left K Active bend right K X•Rays (other) K Swine hyper extension over a Bolster 9 kftay AP-Pelvis K MRI K CT K X-Ray Cervical Spine K Cervical K Cervical K Thoracic K Thorack K AP-Lateral K Lumbar K Lumbar 11 Flex-Extension n With Gadolinium n With Myelogram K Obliques x 2 K Closed K Open mouth K Open K Other K X-ray Thoracic spine K Bone Scan O AP-Lateral K Obliques x 2 K 3 Phase Bone Scan K Bone w/Spec CT SIGNATURE Kate Gumersell. RPA•C Sean E. titcCarxe, MD NYS 014654 DEA MG2336217 NYS 206265 DEA BM4915365 EFTA_R1_022 14089 EFTA02726362