Jul. 11. 2016 10:41AM

Jul. 11. 2016 10:41AM No 4285 P. 1 MEDICAL RECORDS INVOICE Manhattan: a ir Astoria: IF: en orrespon ence to the Manhattan office Date: n h1 0011r) Patient:beffrei Er Q Meirl DOB: at.) 53 Sent to: Fax: Pages: Fee: Make heck Payable to: NY Neurological Associates, P.C. tog (O- 350- 03(1,6 _3 This is certification that all copies to follow are true and accurate copies of medical records from our office. For itemized billing, please call our billing department at Please note we do not physically require or store any MRI/CT Scan/X-ray FILMS or DISKS in our office. You will need to request tests from the facility where performed. Any further inquiries please call our office at An extensive search has been made for medical records claimant, at this time we have no such patient on file. If the patient was seen by one of our physicians in a should be obtained from that facility. pertaining to the above named hospital setting, then records ""CONFIDENTIALITY NOTICE*" This email/facsimile communication and any attachments may contain confidential and privileged Information for the use of the designated recipients named above. If you are not the intended recipient(s). or the employee or agent responsible for the delivery of this message to the intended recIplent(s), you are hereby notified that any disclosure. copying, distribution, or use of this email/facsimile message Is prohibited. If you have received this message in error, please notify the sender immediately and delete this email from your computer or destroy the documents associated with this facsimile. Thank you. EFTA00282966 Jul. 11. 2016 10:41AM No. gin r, L Name: Date of Exam: Referring Physician: Examining Physician: N. Y. Neurological Associates, P.C. Diego J. Herbstein, MD David H. Snyder, MD Emilio Oribe, MD. FACP Tanya Fatimi, MD Yvonne Zaharakis, MD Epstein. Jeffrey Date of Birth; 0I/20/1953 21 Nov2011 R. Shimony, MD T. Fatimi. MD Reason for study: leg paresthesias Patient History: Fifty eight year old man referred with bilateral leg paresthesias on exertion. Symptoms are most prominent in the calves. Strength, sensation and reflexes are normal. Description: Motor nerve conduction studies of the right peroneal and right tibial nerves show normal amplitudes, conduction velocities, distal latencies. and F-wave minimal latencies. Sensory nerve conduction study of the right sural nerve shows normal amplitudes and conduction velocities. Needle EMG examination of selected muscles in the right leg shows no spontaneous activity, normal motor unit configuration, and recruitment consistent with effort. Bilateral lumbosacral paraspinal muscles show no spontaneous activity. Conclusi ns: This is a normal stu• without ele iologic evidence of lumbosacral radiculopathy. large-fiber polyneuropathy, lumbosacral plex Tanya Fatimi, MD Page EFTA00282967 Jul. 11. 2016 10:41AM Epstein, Jeffrey No 4285 P. 3 21 Nov 2011 Motor Nerve Conduction: Nerve and Site Latency Amplitude Segment Latency Distance Conduction Difference Velocity PeroneaLR Ankle 19 ms 43 mV Extensor dighorom brevi,- Ankle 3.9 ms 75 mm m's Fibula (head) I LS MS 4.4 mV Ankle-Fibula head 7.9 ms 320 mm 41 m/s Nitrate& roma 13.9 ins 4.2 niV Fibula htmdt•P liteal fossa 2.1 ms 110 nun 52 nits ibis Ankle 6.7 ins " 4.2 rrV Abductor hallecis-Ankle R . 6.7 rat 75 nun ni/s l'opliteal fossa I I 5.4 tits i i.ti tp V Ankle-Ninnies] fosse 8.7 ms 430 mm 49 nVs f -Wave Studies Nerve al-Latency F-Latency Peroneal R 1_ 4.7 54.2 Tibial.R 5.1 56.0 Sensory Nen e Conduction: Nerve sad Site Onset Latency Peak Latency Amplitude Segment Latency Difference Distance Conduction Velocity Sural.R Lower leg 2.7 ms 4.2 me 5 p9 I Ankle-Lower leg L2 mN 130 mm I 49 m/s eedle E.N.16 Examination; IanlRY sae yeeee acivin Valoasfla • Male InseSORII fog . Win I Fn. Dundee ARON PcK C Pmen. Effori g l•ottrIni I ,.. N •.,33_ N....t Mee* it, elm] mar 1.4a,t. . I /..D•its nein 1 .,' va ... ..^- TC: Nona I1/4.41911 lkinne % 4:Et N. w$: IGnitaaiin •Met al 104141 Kvm •.xa L NN: Nand NI, rtkili Mee. '.'tS 1..ema: IV.v... Waits R \nal \ :me %Sr Nan Mend Mad time N.,,ybt 1...-nt. 'T:billi. wicrio. R N.Nrul vcete ‘ . Mr Norm/ ,.....eal Mac %o-ri. ce-mol (ity.merefrpo OAS. R NV.* My., •• .... it. Semi :4. I ,......6 i 3 pi:spool R %anvil V*.e• N ... of 1.4 Pannbal R I Nun; N. '..Ase N.-4 13 S> R Normal Nine %.•se N. ,c 14 pained L 1‘V to Nnm •oe: N. .e 1-- . i A fernIvW c ..4ZA.. Nrm 'a S, • IJ J. al l \w.gl Nome %um C.• Page 2 EFTA00282968