MIAMI N4

CHILDREN'S HOSPITAL.

Date: March 10,2010

Patient Name; Maxim Kuznetsov

Diagnosis' Hemispheric Atrophy

Procedure: Surgery!: Subdural Implantation 8 days monitoring

Surgery 2: Resection

Length of Stay: 10-14 days

ICU stay 4 days

VEEC/FMRI: 3days

Thank you for your interest in Miami Children's Hospital Attached please find an estimate fo hospital¹? Portion of the al ove--Mentioned procedure, the hospital require? a fuli deposit be m the procedure in :he amount of $ 83,350.00. , Below you will find the breakdown of ail charges

( the

ade prior to

Hospital Charges

Neurology Fees Neurosurgery Fees PICU fees Anesthesia Fees ■ Radiology Fees

Total Charges

$ 53,250.00

$ 10,000.00

$ 12,000.00

$ 2,600 00
$ 5.000.00
$_... 500,00

$ 83,350.00

Ifa wire transfer is utilized; we ask that you please complete the transaction at 'east one week the procedure date information related to wire transfers is as follows

in advance ot

Wachovia Bank - Account number: 26-96-206-96-37-22

Wires

AВА #063000021 (USA)

if 1utll mist be accompany

by the swift code PNBPUS33

АСH and Electronic Funds

■ABA #067006432

Please do not ' hesitate to contact the Global Health Service Departments if you have questions of need additional information, it will be a pleasure to

Sincerely yours

______________________________

Annia Martinez

Global Health Services Representative

3100 S.W. 62nd Avenue--© • Miami, flo do 33155-3008 /3051 666 6511