Dr. ___________________ Our company, MedXPrime™ has initiated a new program to add as much as $30,000 or more in new monthly revenue from work you’re already doing…. but not getting paid for. As you’re already aware, doctors are not getting paid for specimen collection or for conveyance. The pharmaceutical representative gets paid as does the laboratory representative, but not you. Is this fair? Below is a very conservative example of what you could earn doing working with MedX Halo by simply obtaining 3- Pharmacogenetic DNA specimens, and 3 - urine toxicology specimens per day. This is simply collecting the specimen, which you’re already doing and not getting paid for 1. Imagine the possibility of scaling that number in your practice to 5 – 10 – 15 or more each day, or a combination of tests. Here’s what your net with MedX Halo could look like at even the lowest reimbursement levels of $372 for using the DNA Kit and $125 for the Active Medicated Toxicology Collection Kit: TEST PGx Toxicology PGx and Tox 3 Per Day $1,117 $ 375 $1,492 5 Per Day $1,862 $ 625 $2,487 10 Per Day 15 Per Day 20 Per Day Weekly $3,755 $1,250 $5,005 $5,587 $1,875 $7,462 $ 7,451 $ 2,500 $ 9,951 $ 9,310 $ 3,125 $12,435 (Based on 5 per day) Our lab partner has been in business for 30 years, and ranks as one of the top seven laboratories in the country, providing physicians nationwide programs to promote better patient care while helping expand services within a physician's practice. They are CLIA certified, CAP certified for clinical testing and forensic drug testing and SAMHSA certified. Recognized for their scope of testing, accuracy of results, scientific expertise and innovation, customized testing options, and their customer service and support. We promote two core programs to our clients: Pharmacogenetic testing, (DNA) and toxicology testing services in addition to compounding pharmacy programs. *1 The income examples set forth in this presentation are hypothetical, and are intended to explain this concept only, based on a 5- day workweek. These hypothetical examples are not representative of the income, if any, you will earn. These figures should not be considered as guarantees or projections of your actual earnings or profits. We introduced our DNA testing with a patented billable kit with an FDA approved NDC code. The kit costs the health care provider $100, and is successfully marketed across the country allowing doctors after receiving pre-authorization to legitimately bill for reimbursement ranging often times between $400-$700 or more. We have had an overwhelming response from our doctors, as they are now able to offer a unique service that benefits their patients immensely while enhancing their own practice revenues. On a practical day-to-day and very conservative basis, if a doctor were to test three patients a day using the Medicated Wet Kit, using the California Official Medical Fee Schedule paying $472.55 increased daily revenue would be $1,417.65 with a net profit of $1,117.65 which is $22,353.00 in new monthly revenue from pharmacogenetic specimen collection. In addition to the Advanced DNA Medicated Collection Kit we added recently a billable NDC kit utilized for Active Toxicology Testing. Similar to the DNA kit, the toxicology collection kit has an NDC code, and is already being successfully reimbursed. We have a contract to market this kit, and you are one of the first to hear about it. To facilitate use of these NDC kits we have partnered with a pharmacy benefit manager called VantageRx™. They have a proprietary software application allowing you to input patient information, check off the test kit being utilized, and instantly see what you will be reimbursed along with the co-pay or coinsurance the patient is responsible for and their deductible. At that point you can choose to bill for the Wet Kit upon its use from your dispensary or obtain the specimen in another manner. Here’s the bottom line: we have a system in place that allows you to service your patients at a higher level while at the same time providing you with an additional second stream of income, which up until now you've not been able to be reimbursed for. We have a contract to market this kit, and you are one of the first to hear about it. Our Advanced DNA Medicated Collection Kit contains 2% viscous lidocaine HCl and glycerine. It is FDA approved and identified by NDC 76420-620-01, and billable through the pharmacy benefit of most health insurance policies, and Worker’s Compensation. Each kit contains: 1 (20 mL) Lidocaine HCl oral topical solution 2% (Viscous) 1 Pack Oral Glycerin Swabs (3 swabs/pack) 3 Buccal Swab Sticks 1 Pair Sterile Latex Gloves – Size 7 1 Face Mask 1 CSR Wrap The Wet Kit is manufactured by Enovachem™, and provides a mild topical anesthetic for the mucous membranes of the mouth and pharynx in persons with a sensitive oral cavity or an overly responsive gag reflex where obtaining a convention buccal specimen by swabbing is difficult The liver metabolizes lidocaine rapidly, and the kidneys excrete metabolites and unchanged drug. 90% of lidocaine administered is excreted in the form of various metabolites, and less than 10% is excreted unchanged. According to Redbook Online Product Details, the Average Wholesale Price, (AWP) for the DNA Wet Kit is $804. Below are actual EOBs and audits for using and dispensing this unique DNA collection kit: According to the California Official Medical Fee Schedule, the NDC Medicated DNA Collection Kit reimburses at $472.55. The net profit to the provider when using the DNA Medicated Wet Kit in a California Worker’s Compensation claim would be about $372.55 Adjudicated Worker’s Compensation claims from other states are from MCMC, The Hartford, Zurich, and ACE American Insurance, which pay $676.07. Because of the value in pharmacogenetic testing, recent studies have indicated how specific testing for variations in the CYP2D6 and the CYP2C19 genotypes may result in improved pain management, decreasing episodes of drug toxicity, and fewer adverse drug interactions. This assay tests for common variants that can result in increased or decreased metabolism of opioid analgesics and other common drugs. Persons who would most benefit from these two genotype variations would be those individuals being considered or receiving pain drugs metabolized by these two enzymes. For example CYP2D6 is specific for codeine, hydrocodone, oxycodone, tramadol and duloxetine while CYP2C19 is specific for methadone, meperidine and ibuprofen. Pharmacogenetic testing is appropriate for cardiovascular health especially those with bleeding or blood clot problems, thrombosis, multiple medications, medication resistance, or sequential ineffective individual drug trials. In addition this level of testing is appropriate for mental and behavioral health and allows the physician to decide the best course of treatment and deliver personalized medicine in order to achieve the best results possible. For example persons with an abnormally high or low metabolite to a substrate, and the complexities of treatment required for mental and behavioral disorders and the variety of available psychotropic drugs such as anti-anxiety, antidepressants, antipsychotics, mood stabilizers, SSRIs, and stimulants. Pharmacokinetic testing was first championed for oncology and cancer treatment but avails itself to many other specialties as noted above including orthopedic surgery especially for identifying optimal precision prescription writing for anticoagulants, pain and other anti-inflammatories, along with antibiotics. It's estimated that 33% of Caucasians are poor metabolizers for CYP2C9 while 2-5% of Caucasians, 4% of Africans and 13-23% of Asians or poor metabolizes for CYP2C19. These are just two of the nine genotypes currently being tested, and physicians can adjust the medication accordingly to achieve better compliance, better patient satisfaction, better patient outcomes and improved risk management minimizing liability from adverse drug reactions. Another unique concept is utilization of our Active-Medicated Specimen Collection Kit, also known as a urine specimen collection kit. This is identified with NDC codes 45861-107-01, and 68071-097-01. Each kit contains: 1x furosemide 20mg tablet 3x benzalkonium choloride toweletts 1x sterile urine collection cup w/ temperature strip 1x specimen bag Using a similar example as the DNA Wet Kit described above, using the Active Medicated Urine Collection Kit for toxicology screen 3- times a day based on an average reimbursement of $200 increased daily revenue would be $600 with a net profit of $375 which is $7,500 in new monthly revenue from toxicology specimen collection. These two new revenue streams by collecting DNA and urine toxicology specimens on only 3- patients a day would have a potential combined new monthly revenue of $29,853. This is work you are already doing, not being compensated for, and not collecting anything for your time, talent, or facility expenses. There’s even more to come when you add in our specialty custom compounded transdermal creams. You can easily have these dispensed, and this adds yet a third revenue stream you’ve probably not had available to you ever before. By further customizing patient care, personalized medicine is truly at your hands. Whether you treat inflammation and pain, muscle spasm, migraine headaches, muscle cramps in athletes, or plantar fasciitis there are formulas currently being compounded. Additional formulas include problems commonly associated with dermatology, post surgical scarring, dental care, weight loss, and podiatry. New revenue streams by incorporating pharmacogenetic testing; toxicology screening and custom compounded transdermal creams are what we call the “Trifecta.” An opportunity for increased patient compliance, increased patient satisfaction, improved clinical outcomes, and improved risk management by reducing your liability from adverse drug reactions, the 4th leading cause of death in the United States today. At the same time you can significantly increase your bottom line doing right by doing good. Finally you have an opportunity to get paid for what you’re already doing. It’s time to share the good news. After all the Mayo Clinic recognizes the value of pharmacogenetic testing, and the need for periodic toxicology screening follows very closely.