| | Pro Forma Income Statement |
| | | | Year 1 | Year 2 | Year 3 | Year 4 | Year 5 |
| | Visits | | 4,882 | 5,126 | 5,382 | 5,652 | 5,934 |
| | Revenue Per Visit | | $450 | $450 | $450 | $450 | $450 |
| | Gross Revenue |
| | Patient Reveue |
| | Gross Patient Revenue |
| | Deductions from Patient Revenue |
| | Contractual |
| | Total Deductions from Revenue |
| | Net Patient Revenue | | $0 | $0 | $0 | $0 | $0 |
| | Operating Expenses |
| | Salaries and Wages |
| | Employee Benefits |
| | Utilities |
| | Repair/Maintenance |
| | Housekeeping |
| | Telephone Service |
| | Depreciation |
| | Malpractice |
| | Miscellaneous/Other |
| | Variable Medical Supply Costs |
| | Other Non-Personnel Costs |
| | Total Operating Expenses |
| | Excess of Rev over Exp. From Operations | | $0 | $0 | $0 | $0 | $0 |
| | Cummulative Income | | $0 | $0 | $0 | $0 | $0 |
| | Net Cash from Excess Rev (excl Depreciation) | | $0 | $0 | $0 | $0 | $0 |
| | Cummulative Income Net Cash | | $0 | $0 | $0 | $0 | $0 |
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