From: Lesley Groff <1

From: Lesley Groff <1 To: Rich Kahn >, Bella Klein Subject: Fwd: Medicare ABN Date: Thu, 04 Oct 2018 12:06:48 +0000 Attachments: 10-3-18_MEDICARE_ABN_Form.pdf Please see below form...Jeffrey has asked me to sign it...but do y'all know which option I should check off? This is for Medicare coverage of lab work...If you don't know which option I should check off, I will ask Jeffrey...just thought I would start with you two. Begin forwarded message: From: Ilse <I Subject: Medicare ABN Date: October 3, 2018 at 4:51:01 PM EDT To: Lesley Groff < Cc: Admin Assistant < Dear Lesley, Please see attached Medicare ABN form for Mr. Epstein to complete, sign and return to us. This is for Medicare coverage of lab work. Thank you. Have a nice day! Sincerely, Lisa Perez Clinical Coordinator to Dr. Woodson Merrell 44 East 67th Street, Suite 18 New York, NY 10065 EFTA00482770