| Budget C |
| REVENUES |
| Description | Detail | Yearly Budgeted Amount |
| Clinic Revenue Lab | 325 clients per month, 3,900 total visits | 163,800.00 |
| Revenue Medications | 195 of billable labs per month, 2340 labs per year | 58,500.00 |
| Revenue Procedures | 162 meds per month, 1,950 per year | 39,000.00 |
| Revenue Less | # of billable procedures done per year | 26,000.00 |
| Contractuals | Percentage negotiated with payer | 114,920.00 |
| TOTAL CLINIC REVENUE | | 402,220.00 |
| EXPENSES |
| Description | Detail | Yearly Budgeted Amount |
| PAYROLL |
| Provider salary | Total salary | 60,000.00 |
| Receptionist salary | | 13,395.00 |
| LPN salary | | 28,182.00 |
| Total Salary & Wages: | | 101,577.00 |
| Provider FICA | Salary x 0.0765 | 4,590.00 |
| Receptionist FICA | Salary x 0.0765 | 1,024.68 |
| LPN FICA | Salary x 0.0765 | 2,155.92 |
| Total FICA | | 7,770.60 |
| Unemployment |
| Health Insurance | | 10,222.08 |
| Life Insurance | | 2,216.00 |
| Long Term Disability | | 666.00 |
| 401K Employer Contribution |
| Total Additional Benefits: | | 13,104.08 |
| TOTAL PAYROLL: | | 122,451.68 |
| OPERATING EXPENSES |
| Supplies Food | | 100 |
| Misc. Supplies | | 1,000.00 |
| Medications | | 5,000.00 |
| Medical Supplies | | 4,500.00 |
| Office Supplies | | 500.00 |
| Printing | | 500.00 |
| Postage | UPS, Fed Ex, Postage | 500.00 |
| Professional Fees |
| Consulting | Accountants fees | 1,000.00 |
| Audit Fee | | 1,500.00 |
| Legal Fees | | 1,500.00 |
| Licensing Fees | Clinic | 300.00 |
| Bank Fees | | 250.00 |
| Advertising | | 5,000.00 |
| Insurance |
| Worker's Compensation | | 1,575.00 |
| Gen/Pro/Med Mal | liability, professional liability, employment, practice liability, property insturance, etc. | 15,000.00 |
| Umbrella Ins. | | 830.00 |
| D&O Ins. | | 1,000.00 |
| Professional Development Meetings | Continuing education for provider and staff | 1,000.00 |
| Cont. Memberships etc. | Exp. Rural Health Association | 300.00 |
| Travel & Entertainment | Monies for getting to conference | 1,000.00 |
| Facility |
| Telephone | Regular Service | 1,800.00 |
| | Internet Access | 300.00 |
| Utilities | Water, Electric, Garbage | 5,000.00 |
| Small Equipment & Tools | | 300.00 |
| Equipment Rental | | 1,200.00 |
| Capital Equipment | | 10,000.00 |
| Rent or mortgage | | 7,200.00 |
| Maintenance | cleaning service, building & grounds upkeep | 1,600.00 |
| TOTAL OPERATING EXPENSES | | 69,755.00 |
| TOTAL EXPENSES | | 192,206.68 |
| | | Yearly Budgeted Amount |
| NET INCOME (Loss) | [Revenue - Expenses] | 210,013.32 |