To: 
Cc: Shimony, Roni
Bebe Avdija
From: Lara, Mary
Sent: Fri 4/6/2018 5:04:38 PM
Subject: RE: [EXTERNAL] Injectable medication

Hi [ ]

I need to obtain an authorization from the insurance. Now for 04/10 I only have a 2:30pm and for 04/11I have a 1:30 or 2:30pm. Let me know what works best.

Mr. Epstein can’t eat 3 hours before the test and no caffeine 12 hours before. Water and medication is ok.

Thank you,

Mary

From: [mailto
Sent: Friday, April 06, 2018 12:44 PM
To: Kaw, Kristine
Cc: Shimony, Rony; Lara, Mary; Bebe Avdiu
Subject: Re: [EXTERNAL] Injectable medication

Great. HI Mary....May we please schedule a CTA scan for Jeffrey Epstein On Tues. April 10 or Wed. April 11? You may coordinate with me today...if we do not confirm something today, you will need to coordinate with  or Bebe who will be sitting in for me next week when I am on holiday (they are cc'd here) Our office number is .

thank you,

███████

Assistant to Jeffrey Epstein

On Apr 6, 2018, at 12:39 PM, Kaw, Kristine <█████████@█████████>
wrote:

Mary helps us schedule CTAs. She is cc'd here and will contact you. Please provide best contact info

Thanks, KK

From:

[mailto:

mail.com]

Sent: Friday, April 06, 2018 12:35 PM

To: Kaw, Kristine

Cc: Shimony, Rony

Subject: Re: [EXTERNAL] Injectable medication

- HI KK...Thanks for following up! Jeffrey says Dr. Shimony wants to do a scan first....can we schedule the scan for Tues April 10 or Wed. April 11?

On Apr 6, 2018, at 11:48 AM, Kaw, Kristine
> wrote:

Good morning . It's been a while since I heard from you. Any update on what Mr. Epstein has decided for Repatha, self pay or try insurance approval which means he needs new set of lipid profile. Please let us know so we can help him with the process of getting medication that will help him lower risk for cardiac events.

KK

From:

Sent: Thursday, January 25, 2018 5:37 PM

To: Kaw, Kristine

Subject: Re: [EXTERNAL] Injectable medication

Hi Kristine...1 received an email from Repatha to "learn how to fill your Repatha

prescription"...did Jeffrey finally decide what he wanted to do? He has not been back to me with any news, but certainly doesn't mean he hasn't spoken to Dr. Shimony or you about it! Just wondering if I need to do something!???

<u>On Jan 19, 2018, at 7:30</u> AM,
> wrote:

Ok super

## Sent from my iPhone

On Jan 18, 2018, at 5:26 PM, Kaw, Kristine <█████████████████> wrote:

Great thank you for the update. Dr. Shimony communicated with him

KK

From:

Sent: Thursday, January 18, 2018 3:58 PM

To: Kaw, Kristine

Subject: Re: [EXTERNAL] Injectable medication

The nurse just left…they had a good talk…hoping Jeffrey will decide
how he wishes to proceed soon! thanks,
█████

On Jan 17, 2018, at 10:42 AM,
Kaw, Kristine
<████████████████████████████████>
wrote:

## Sent from my iPhone (cont.)

From:

Sent: Wednesday, January 17, 2018 8:11 AM To: Kaw, Kristine Subject: Re: [EXTERNAL) Injectable medication

Morning! Jeffrey has said yes to training tomorrow with Nurse Kristine. Do we know for sure if Jeffrey will be doing one dose a month or two? It should hopefully be one right? The nurse knows Jeffrey won't have the actual drug but says she can train without it. He has still yet to answer RE self pay or insurance.

Sent from my iPhone

- Date/time: Jan 16, 2018, 10:47 AM
- Sender: [name/email redacted]
- Visible header/footer: "Sent from my iPhone"; "From: [redacted]" (large redaction block)
- Quoted message:
  - "Great. Just didn't want to delay the process since I know it is difficult to find time in his very busy schedule."
  - Signature: "KK"

Sent: Tuesday, January 16, 2018 10:46
To: Kaw, Kristine
Subject: Re: [EXTERNAL) Injectable medication

## Sent from my iPhone (cont.)

## Morning Kristine! Thank you so much for following

up...1 am still
waiting for Jeffrey's
response on all of
this...Hoping to
hear today but he is
traveling...will let
you know the
minute I hear
something.

On Jan 16, 2018, at 10:38 AM, Kaw, Kristin wrote:

wrote:

Good mornin g. Just followi ng up regardi ng Mr. Epstein's decisio n on how to procee d. I believe the

## Morning Kristine! Thank you so much for following (cont.)

<table><tr><th>nurse is
schedul
ed to
come in
this
week
for
teachin
g and
ideally
it
would
be
great if
she can
teach
and
observe
his first
medica
tion
adminis
tration.
Please
let me
know
so I can
prescri
be
accordi
ngly.

KK</th></tr></table>

From:

[mailto:

Sent: Thursday, January 11, 2018 6:10 PM To: Kaw, Kristine Subject: Re: [EXTERNAL] Injectable medication

## Morning Kristine! Thank you so much for following (cont.)

Hi Kristine. Thank you for this! I actually sent
jeffrey
a note
about
this
earlier
but still
ha e
not
heard
back
from
him.
He is
been in
consta
nt
meetin
gs
himself
. I will
ask
him
again
howev
er and
use
your
much
more
well
versed
paragr
aph
tomorr
ow
mornin
g
early!
Hope
to have
an
answer
soon.
Thanks
and

## Morning Kristine! Thank you so much for following (cont.)

have a
great
evenin

g.

Sent from my iPhone

- Date: Jan 11, 2018
- Time: 6:03 PM
- Sender name: shown in header (redacted)
- Header text: "wrote:"
- Profile image: black rectangular/blacked-out avatar to the right of header
- Surrounding message text (context): "Sent from my iPhone" and "Sorry for the late response. Just finished with patients."

Sorry for the late response. Just finished with
patients.

-Looking a labs sent from early this month, Lipids done was calculated as opposed to direct LDL. Insurance companies look for the direct 101 when approving medications because this is a more accurate count, therefore, representing a more accurate cardiovascular risk equivalent. When the triglycerides is high, such as in the case of Mr. Epstein, the lab cannot provide an accurate LDL count. As you can see there was no 101value given

-If you want to proceed with insurance approval, he will need to re-take labs with direct 101. He cannot start Repatha prior to rechecking labs because it will not be an accurate reflection of his baseline without medications.

-If he wants <u>to self a ,</u> Century Specialty Pharmacy is willing to give him a 10% discount if he purchases minimum of 6 months. They will ship the medication over as soon as it's ordered and have it virtually the next day.

-Here is the breakdown of cost:

For the once a month injection $1,250/month (with 10% discount if he buys minimum of 6 months)

## Morning Kristine! Thank you so much for following (cont.)

For the twice a month injection $1,150/month (with 10% discount if he buys minimum of 6 months)

Hope that answers all your questions. I will be available tomorrow if you have any questions. Please let me know what his decision is prescription to the pharmacy is pending his ok. Thanks

KK



Sent: Thursday, January 11, 2018 12:34 PM To: Kaw, Kristine Subject: Re: [EXTERNAL] Injectable medication

Hello Kristine! I wanted to let you know I DID get Jeffrey's approval confirmed with Repatha and have been able to speak with a nurse on Jeffrey's behalf! A registered nurse is to call me within 1-2 business days to set up his training...truly hoping for next We, Th or Fri! I will be sure to let you know.

Some more questions:

-I understood from Dr. Shimony you will be contacting Jeffrey's insurance to find out about coverage and getting the $5 co-pay card?

-Once insurance approves the medication, when will Jeffrey receive his mods? Hoping he can get 3 months of the medication at a time....let me know if his insurance approves this or how many months we can receive at a time...maybe it is more!?

## Morning Kristine! Thank you so much for following (cont.)

-will you order Jeffrey a Sharps Container? The nurse was asking me with type of injection he will be getting and I do not know...she said there are 3 different ones...

I know you are busy and will <u>et ck</u> to me when you can!! Thank you!

On Jan 10, 2018, at 4:08 PM, Kaw,
Kristine
wrote:

I am so sorry if I can't respond right away since I am seeing patients with Dr. Shimony. I am on the  now with Repatha. It must have been a misunderstanding, they need the patient, Mr. Epstein, to give permission for you to set up his appointment. Repatha needs to be called again and choose reimbursement services for Mr. Epstein to give you permission moving forward with his training. I will also be faxing you a form to fill out and for Mr. Epstein to sign. This gives Repatha permission to assist him. Are you free to talk to avoid misunderstandings? Thanks

KK

From:

2018 2:43

PM
To: Kaw, Kristine
Subject: Re: [EXTERNAL] Injectable
medication

## Morning Kristine! Thank you so much for following (cont.)

Hi Kristine.

-I found Erica Peltz so no worries
there! :)

-I called REPATHA to organize training, but they do not have him registered (which I did) and they tell me you must call them to give me permission to schedule the appointment?! Sounds like silliness to me, but what can I do!? She let me register Jeffrey so when you call give them his Acct #PP02BW57 and tell them Jeffrey Epstein's personal assistant, may coordinate the training session for him. Once you do this let me know and I will call them back. Would greatly appreciate it.

Thanks,

On Jan 9, 2018, at 5:37 PM,
Kaw, Kristine
<blackened out>
wrote:

Great thank you. Dr. Shimony states he had recent labs just don't know what his definition of "recent" is. Should be within the past 30 days. Please let me know if any issues and contact by email or office number.

KK

From:

## Morning Kristine! Thank you so much for following (cont.)

Sent: Tuesday, January 09, 2018
5:27 PM
To: Kaw, Kristine
Subject: [EXTERNAL] Re:
Injectable medication

Hi Kristine. Thank you so much for this. Let me find out from Jeffrey if he has lab work that includes cholesterol within past 30 days. I don't think he does but he has gone without me knowing before A. I'll call the number below to set up training. Have a good evening.

Sent from my iPhone

On Jan 9, 2018, at 5:10 PM, Kaw,
Kristine

wrote:

Hi . Before we get started with the process, I need a copy of Mr. Epstein's recent labs including cholesterol with in the past 30 days. Please let me know if he does not have one so I can send an rx to get it done. We will try to get approval for his medication to avoid paying out of pocket and the company is willing to provide samples while working on his approval.

Please call 1-844-REPATHA to
set up a training session and
also $5 copay card if
medication approved.

Please let me know if you
have any questions. Thank
you

## Morning Kristine! Thank you so much for following (cont.)

Kristine

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