(2) Children’s Hospital Boston swnuimsensnnisn ‘he Cardiovaselar Progam 200 Longwood Avenue Boston, Maseachusets 02115, hone 61785-7885 0c 617-790-0214 (Cardin Surge fax 817-738-8742 (Cacology) stay 10, 2G org Me ame Lute RE: Harshita Ruthva Sent Via Email lutraiibox9malcom DOB: June 17, 2006 Dear Mr. Luthra ‘Tank you for your Interest in cur medical senices for your daughther, Harsha Luthrs, ised on the vrtten infarmatian te date reviewed by Or Pecro det Nida and Oy. Jane Newourger, Marshita wil requre a clagnostic caclac catheterization and surgcal Intervention far to repair her congenital heart defect. The procedure Dr. del Nigo would plan to do te repair her pulmonary atresia, VSO and MAPCAS Is @ unfocaseation and repair of Putronary atresia and VSD wth 2 coil, ‘The total cost for a hospital stay of wp to and inchiding 25 days is US $88,540.00 Also, after 15 days the addnonal cost per cay is US $3,300.00. “Tis cost includes the folowing fees for services at Chikren's Hospllal Boston: wp to and including a 15 day osptalzaton, (i) Gognaste cardise catheterzaton (1) preoperative vist with physsdans (cardolagist, candise anesthesiologst and cardiac surgean only), (1) Cardiovascular surgery and (1) postoperative follow-up visit before Harshitas return to India, This total does nat incude ether medial services wittin Chidren's Hogptal Boston, which a2 not releted/within the "Carchovasculr Program” (the Degactments of Cardiciogy, Cardawasoulor Surgery and ‘Cardiac Anesthesi). Please find the breakdown of the total cast below: ‘Case Rate (Surgery $73,080.00 Diagnostic Carciac Cathetetation $10,880.00 intensity Pre-op Exams: $ 1,980.00, ‘Sutsde Physicians Fees: £25000 ‘ola: $88,510.00 Please understand that the $88,510.00 total isa preally scouted rate, Ma further ccounts re applied to this total. In the highly ually event {hat the Gognosis andr procecure are ciferent from orginally planned, this ciscounted rte wll no longer apply (this Information f given to al aries). For daty ving expenses suchas feo, transportation and inidentals rt Incuding lodging), please pan on a miner of $30.00-540.00 per aduit per 43. You willed te stay in Ue Boston area for approximately 4-6 necks far Harshitas recupereion and postoperative appoiinents, Af you require a visa letter, th: total deposit of US $88,540.00 must be received in full pr toa leter being ween. 1 you do not require a ‘visa letter, the total deposit of US $88,520.00 is requred in ful 10 days prior tothe fist appointments and surgce! dete, This payment pre= roquisite Is a hospital requirement which will facilitate the admission process and secure the appolntment dates, The depost shoud be ee ranefered to the bark Este below, comes Be 1 Obes Drive Riverside, RU QJOLS USA ‘Account Nomar Cardhac Surgical Patient Func ‘Account Now L10788-791-4 ‘ABA No,: (11-500-120/Svit Code for International Transfers: CTZIUSS3 Reference: Clzens Bark of Massachusetts Patient Name: Aarshita deta {In order to fiitate the process of admission, a copy af the wire transfer receipt should be faxed (617-730-0214) to-my attention at east 10 days Porto Harsita’s first cine appointment or the dates will be canceled to accommodate ater patents. As soon as we haw netfeston from the, bank thatthe wire transfer has been recetrad confirmation wile sen to you. ‘fe understand this sa stressful tre for your Family, especaly given the great distance you vl eed to travel, We wil Mey te ty ta make the process as smooth as possible. IF you have any questions, please do not teste to contact me. Sincerey, D ACER VEC fh Beth Vol & International Patient Caecnator Department of Cardiac Surgery 617-355-5637 cx tan Motes meratona one The first place for children