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John

Type of Service

Office Visits

Physicals

Preventive Screening

Immunizations

Chiropractic Visits

Lab and Radiology Tests

Emergency Room Visits

Outpatient Surgeries

Inpatient Admissions

Prescriptions

Total

Medical History from:

# of events

5

1

0

0

0

2

1

0

0

8

17

Paid by Insurance

$ 0.00

$ 0.00

$ 0.00

$ 0.00

$ 0.00

$ 200.00

$ 500.32

$ 0.00

$ 0.00

$ 150.21

$ 850.53

Paid by You

$ 350.00

$ 90.00

$ 0.00

$ 0.00

$ 0.00

$ 1,050.00

$ 0.00

$ 0.00

$ 0.00

$ 600.00

$ 2,000.00

Height

Weight

Heart Rate

Blood Pres.

Cholesterol

Immunizations

Blood Type

6 ‘ 0”

210 lbs

65/min

120/70

110

On Track

A+

Potential Savings

$140.00 view details

$265.00 view details

$225.00 view details

$730.00 view details

Change Date

Medical Conditions & Allergies Update

Allergy

Dairy Products

Mold

Condition Save $

Hypertension $

Diabetes $$$

Found out on:

01/21/1978

01/21/1978

Gap in Care

No details

Yes details

Update Medications Update

Name Save $

Diovan $

Prilosec

Last filled on:

01/21/2007

02/21/2007

View Your Doctors View Your Emergency Contact Info

January 20071 June 20071to

Total Cost

$ 350.00

$ 90.00

$ 0.00

$ 0.00

$ 0.00

$ 1,250.00

$ 500.32

$ 0.00

$ 0.00

$ 750.21

$ 2940.53

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Personal Health Record - John

Vitals: Weight – View History

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Print Weight History

194

196

198

200

202

204

206

208

210

212

1 1 1 1

Date 06/04/07 08/04/07 010/04/07 012/04/07 [date] [date]

Weight 210 205 200 205

Update

Weight History

06/04/07 08/04/07 10/04/07 12/04/07

210 lbs

205 lbs

200 lbs

205 lbs

Weight(lbs)

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Medical Conditions & Allergies: Diabetes

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Service Frequency StatusDate of Last

EventResult/ Score

Status

Eye Exam more info At least once per year Overdue 02/04/2005 20/20

HbA1c Test more info At least once per year Missing - - ?

Lipid Test more info At least once per year Missing - - ?

Mircoalbumin Test more info

At least once per year Complete 06/04/2007 12

The information below is based on claim data and self entered information. You can update information by selecting the “Update Info” button.

View the Diabetes Guide

Learn how to cost effectively

Manage Diabetes

Update Info

Understanding diabetes is the first step to managing it. Get information on diabetes causes, risk factors, warning signs, and prevention tips.

Click Here

Staying on op of your diabetes is the best way to avoid major costs due down the road, however here are ways to control costs today.

Click Here

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Medical Conditions & Allergies: Diabetes

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Service Frequency Status Date of Last Event Result/Score

Eye Exam more info At least once per year Overdue 02/04/2005

HbA1c Test more info At least once per year Missing

Lipid Test more info At least once per year

Mircoalbumin Test more info

The information below is based on claim data and self entered information. You can update information by selecting the “Update Info” button.

View the Diabetes Guide

Learn how to cost effectively

Manage Diabetes

Update Info

Understanding diabetes is the first step to managing it. Get information on diabetes causes, risk factors, warning signs, and prevention tips.

Click Here

Staying on op of your diabetes is the best way to avoid major costs due down the road, however here are ways to control costs today.

Click Here

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Medical Conditions & Allergies: Diabetes Guide

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Medical Conditions & Allergies: Diabetes - Cost Effective Management

Overview: Your records indicate a recent diagnosis of Type II Diabetes. This Financial Planner for Chronic Disease is intended to help you understand some of the important financial decisions that relate to this clinical disease. We hope to empower you with the knowledge to take care of this chronic condition by understanding the cost, quality, and outcomes issues that will affect your financial burden as it relates to Type II Diabetes.

The Financial Planner presents three alternative management scenarios with the financial impact of each choice. The Financial Planner enables you to stay informed and in control of your personal health future.

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Option 1Don’t Manage It

Potential Out of Pocket Costs

$5,000.00

View Details

Option2:Manage It: High Cost

Potential Out of Pocket Costs

$3,585.00

View Details

Option3Manage It: Low Cost

$1,585.00

View Details

Potential Out of Pocket Costs

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Personal Health Record - John

Medical Conditions & Allergies: Diabetes - Cost Effective Management: Option 1

Plan Information:

Office Visit Co-pays: $0 Prescription Drug $0 In Network Deductible: $5,000 Co-Insurance: 100% In Network Out of Pocket Max: $5,000

Potential Cost Information due to complications:

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Service Total Cost Insurance Pays You Pay View Details

Office Visit $ 800 $ 0 $ 800 view details

Prescriptions $ 2,000 $ 0 $ 2,000 view details

Foot Surgery: $ 15,000 $ 12,800 $ 2,200 view details

Total $ 17,800 $ 12,800 $ 5,000 view details

Note: Complications in following years could cost you an additional $5,000 each year.

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Medical Conditions & Allergies: Diabetes - Cost Effective Management: Option 2

Plan Information:

Office Visit Co-pays: $0 Prescription Drug $0 In Network Deductible: $5,000 Co-Insurance: 100% In Network Out of Pocket Max: $5,000

Potential Cost Information: Managing Diabetes in a high cost way

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Service Total Cost Insurance Pays

You Pay View Details

Brand Name Glucose Monitor

$ 200 $ 0 $ 800 view details

Brand Name Test Strips/year supply

$ 1,000 $ 0

Eye Exam $ 100 $ 0

Quarterly HbAc1 test $ 400 $ 0 $ 2,000 view details

Quarterly Lipid test $ 400 $ 0 $ 2,200 view details

Mircoalbumin Test $ 400

Total $ 2,500 $ 0 $ 2,500 view details

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Medical Conditions & Allergies: Diabetes - Cost Effective Management: Option 3

Plan Information:

Office Visit Co-pays: $0 Prescription Drug $0 In Network Deductible: $5,000 Co-Insurance: 100% In Network Out of Pocket Max: $5,000

Potential Cost Information: Managing Diabetes in a cost effective way

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Service Total Cost Insurance Pays You Pay View Details

Brand Name Glucose Monitor

$ 100 $ 0 $ 100 view details

Brand Name Test Strips/year supply

$ 500 $ 0 $ 500

Eye Exam $ 100 $ 0 $ 100

Home HbAc1 test $ 40 $ 0 $ 40 view details

Home Lipid test $ 40 $ 0 $ 40 view details

Home Test $ 40 $ 40

Total $ 820 $ 0 $ 820 view details

Click here to buy Home Test Kits

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Medical History: Office Visits – Jan 1, 1007 to June 1, 2007

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ServiceCPT Code

Date of Service

Total Costs

Paid By Insurance

Paid by You

Saving Opportunity

View Details

Office Visit 99213 01/03/07 $70.00 $ 0.00 $70.00 $$ view details

Office Visit 99212 02/03/07 $50.00 $ 0.00 $50.00 view details

Office Visit 99214 03/03/07 $90.00 $ 0.00 $90.00 view details

Office Visit 99213 04/03/07 $70.00 $ 0.00 $70.00 view details

Office Visit 99213 05/03/07 $70.00 $ 0.00 $70.00 $$ view details

Total $350.00 $ 0.00 $ 350.00 $140.00