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81. Exhibit 4.1 Cost by Diagnosis
    hcup-us.ahrq.gov/reports/factsandfigures/2008/figures/2008_4_1b.jsp
    January 01, 2008 - disorders, and other back problems 663 $9.5 $14,400 Pneumonia 1,156 $10.5 $9,000 Congestive … heart failure 1,020 $10.7 $10,500 Complication of device, implant or graft 685 $11.5

82. Statistical Brief #107
    hcup-us.ahrq.gov/reports/statbriefs/sb107.jsp
    March 01, 2011 - heart failure $34,596 3.0% 1,020 5 5 9 Pneumonia $31,654 2.7% 1,156 8 6 … heart failure, heart attack, pneumonia, and respiratory failure ranked among the top 20 most expensive … heart failure $2,881 1.8% 73 10 Acute cerebrovascular disease (stroke) $2,833 1.8% … heart failure $5,516 1.5% 137 15 Respiratory failure, insufficiency, arrest (adult) … heart failure $942 2.0% 31 17 Crushing injury or internal injury $919 1.9% 18

83. Most Frequent Conditions in U.S. Hospitals, 2011 (pdf file)
    hcup-us.ahrq.gov/reports/statbriefs/sb162.pdf
    March 01, 2013 - ■ Congestive heart failure was the most common reason for hospitalization for adults aged 85 years … Two circulatory conditions—congestive heart failure (CHF) and cardiac dysrhythmias—together accounted … heart failure (CHF), septicemia, pneumonia, and cardiac dysrhythmias. … heart failure, nonhypertensive 581 468 191 131 –31 Septicemia (except in labor) 195 466 64 131 104 … Congestive heart failure (CHF) and septicemia were the most common principal diagnoses, each accounting

84. Exhibit 4.2 Cost Factors Accounting for Growth by Diagnosis
    hcup-us.ahrq.gov/reports/factsandfigures/2009/figures/2009_4_2.jsp
    January 01, 2009 - tract disease 2.8 2.4 -0.6 1.0 Liveborn (newborn infant) 2.8 2.0 -0.2 1.0 Congestive … heart failure 3.6 3.3 -0.8 1.0 Chronic obstructive pulmonary disease and bronchiectasis

85. Facts and Figures Exhibit 2.3
    hcup-us.ahrq.gov/reports/factsandfigures/2008/exhibit2_3.jsp
    January 01, 2008 - 255 3.1 2.7 28 65-84 years, total discharges 10,121 10,761‡ 100.0 100.0 6 Congestive … heart failure 581 510 5.7 4.7 -12 Osteoarthritis 281 486 2.8 4.5 73 … 415 3.3 3.9 25 85+ years, total discharges 2,362 3,196 100.0 100.0 35 Congestive … heart failure 202 246 8.6 7.7 22 Pneumonia 197 199‡ 8.3 6.2 1 Septicemia … Congestive heart failure (CHF) was the most common condition for adults 65-84 and 85 and older.

86. Comoanaly2008
    hcup-us.ahrq.gov/toolssoftware/comorbidity/comoanaly2008.txt
    September 30, 2008 - order to work */ /* around this SAS constraint, the comorbidities for */ /* Congestive … Heart Failure and Complicated */ /* Hypertension have to be defined in this pgm … ***************/ /* Create detailed hypertension flags that */ /* cover combinations of Congestive … Heart */ /* Failure, Hypertension Complicated, and */ /* Renal Failure. … heart failure' VALVE = 'Valvular disease' PULMCIRC = 'Pulmonary circulation

87. Comoanaly2006-011207
    hcup-us.ahrq.gov/toolssoftware/comorbidity/comoanaly2006-011207.txt
    September 30, 2006 - order to work */ /* around this SAS constraint, the comorbidities for */ /* Congestive … Heart Failure and Complicated */ /* Hypertension have to be defined in this pgm … ***************/ /* Create detailed hypertension flags that */ /* cover combinations of Congestive … Heart */ /* Failure, Hypertension Complicated, and */ /* Renal Failure. … heart failure' VALVE = 'Valvular disease' PULMCIRC = 'Pulmonary circulation

88. Comoanaly2009
    hcup-us.ahrq.gov/toolssoftware/comorbidity/comoanaly2009.txt
    September 30, 2009 - order to work */ /* around this SAS constraint, the comorbidities for */ /* Congestive … Heart Failure and Complicated */ /* Hypertension have to be defined in this pgm … ***************/ /* Create detailed hypertension flags that */ /* cover combinations of Congestive … Heart */ /* Failure, Hypertension Complicated, and */ /* Renal Failure. … heart failure' VALVE = 'Valvular disease' PULMCIRC = 'Pulmonary circulation

89. Comoanaly2007-012907
    hcup-us.ahrq.gov/toolssoftware/comorbidity/comoanaly2007-012907.txt
    September 30, 2007 - order to work */ /* around this SAS constraint, the comorbidities for */ /* Congestive … Heart Failure and Complicated */ /* Hypertension have to be defined in this pgm … ***************/ /* Create detailed hypertension flags that */ /* cover combinations of Congestive … Heart */ /* Failure, Hypertension Complicated, and */ /* Renal Failure. … heart failure' VALVE = 'Valvular disease' PULMCIRC = 'Pulmonary circulation

90. Statistical Brief #2
    hcup-us.ahrq.gov/reports/statbriefs/sb2.jsp
    February 01, 2006 - This was followed by four conditions related to the heart�congestive heart failure, chest pain, hardening … failure, chronic obstructive lung disease, and asthma were such admissions. … Most notably, 72 percent of cases with congestive heart failure, chronic obstructive lung disease, and … heart failure 807,000 5.0 3 Chest pain 702,400 4.3 4 Hardening of the arteries … heart failure 72.1 Mood disorders (depression and bipolar disorders 49.2 Chronic obstructive

91. National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2011 (pdf file)
    hcup-us.ahrq.gov/reports/statbriefs/sb160.pdf
    July 01, 2013 - heart failure, nonhypertensive 10,535 2.7 970 9 Coronary atherosclerosis 10,400 2.7 605 10 Respiratory … heart failure  Coronary atherosclerosis  Complication of device, implant or graft  Respiratory … heart failure, nonhypertensive 955 1.6 73 14 Complications of surgical procedures or medical … heart failure, nonhypertensive 1,429 1.3 111 16 Mood disorders 1,341 1.2 289 17 Appendicitis … heart failure, nonhypertensive 296 1.7 29 16 Appendicitis and other appendiceal conditions 293

92. Statistical Brief #93: Hospital Stays for Patients with Diabetes, 2008 (pdf file)
    hcup-us.ahrq.gov/reports/statbriefs/sb93.pdf
    August 09, 2010 - heart failure, coronary atherosclerosis (hardening of the arteries), acute myocardial infarction … Circulatory disorders represented five of the top 10 reasons for hospital admission: congestive heart … heart failure, 38 percent of stays for hardening of the arteries, and 34 percent of stays for heart … heart failure (nonhypertensive) 424,147 (5.5%) 41.6% 3 Coronary atherosclerosis (hardening of the … For example, for hospitalizations with a principal diagnosis of congestive heart failure, 41.6 percent

93. Facts and Figures Exhibit 2.2
    hcup-us.ahrq.gov/reports/factsandfigures/2007/exhibit2_2.jsp
    January 01, 2007 - 3.1 2.9 31 65-84 years, total discharges 10,121 10,277‡ 100.0 100.0 2 Congestive … heart failure 581 515 5.7 5.0 -11 Coronary atherosclerosis (coronary artery disease) … 379 3.3 3.7 14 85+ years, total discharges 2,362 2,953 100.0 100.0 25 Congestive … heart failure 202 234 8.6 7.9 16 Pneumonia 197 193‡ 8.3 6.5 -2 Septicemia … Congestive heart failure (CHF) was the most common condition for adults 65-84 and 85 and older.

94. Section4 (pdf file)
    hcup-us.ahrq.gov/reports/factsandfigures/2008/pdfs/section4.pdf
    January 01, 2008 - heart failure 6.9 9.9 10.7‡ 3.0 3.2 2.9 4.1 Pneumonia 9.2 11.2 … heart failure, acute cerebrovascular disease, and cardiac dysrhythmias … heart failure ($10,500) Complication of device, implant or graft ($16,800) Liveborn infant ($2,700 … heart failure (4.1%) Septicemia (11.9%) Coronary atherosclerosis (-0.4%) Spondylosis, intervertebral … heart failure, acute cerebrovascular disease, fracture of neck of femur (hip), acute myocardial infarction

95. Mnpoavideotranscript (pdf file)
    hcup-us.ahrq.gov/datainnovations/clinicaldata/MNPOAvideotranscript.pdf
    September 24, 2010 -  heart failure and chest pain during recovery after  outpatient surgery.      …  heart failure and rule out acute  myocardial ischemia.   …  heart failure.  … The patient is discharged with  diagnoses of congestive heart failure and atrial fibrillation.    …  heart failure.  

96. Comoanaly2010
    hcup-us.ahrq.gov/toolssoftware/comorbidity/comoanaly2010.txt
    September 30, 2010 - order to work */ /* around this SAS constraint, the comorbidities for */ /* Congestive … Heart Failure and Complicated */ /* Hypertension have to be defined in this pgm … ***************/ /* Create detailed hypertension flags that */ /* cover combinations of Congestive … Heart */ /* Failure, Hypertension Complicated, and */ /* Renal Failure. … heart failure' VALVE = 'Valvular disease' PULMCIRC = 'Pulmonary circulation

97. Comoanaly2011
    hcup-us.ahrq.gov/toolssoftware/comorbidity/comoanaly2011.txt
    September 30, 2011 - order to work */ /* around this SAS constraint, the comorbidities for */ /* Congestive … Heart Failure and Complicated */ /* Hypertension have to be defined in this pgm … ***************/ /* Create detailed hypertension flags that */ /* cover combinations of Congestive … Heart */ /* Failure, Hypertension Complicated, and */ /* Renal Failure. … heart failure' VALVE = 'Valvular disease' PULMCIRC = 'Pulmonary circulation

98. Statistical Brief #160
    hcup-us.ahrq.gov/reports/statbriefs/sb160.jsp
    August 01, 2013 - heart failure, nonhypertensive 10,535 2.7 970 9 Coronary atherosclerosis 10,400 2.7 … heart failure Coronary atherosclerosis Complication of device, implant or graft Respiratory failure … heart failure, nonhypertensive 7,641 4.2 739 4 Complication of device, implant or graft … heart failure, nonhypertensive 1,429 1.3 111 16 Mood disorders 1,341 1.2 289 … heart failure, nonhypertensive 296 1.7 29 16 Appendicitis and other appendiceal conditions

99. Exhibit 4.2 Cost Factors Accounting for Growth by Diagnosis
    hcup-us.ahrq.gov/reports/factsandfigures/2008/figures/2008_4_2.jsp
    January 01, 2008 - cerebrovascular disease 2.8% 3.5% -1.8% 1.0% Cardiac dysrhythmias 6.6% 3.5% 2.0% 1.1% Congestive … heart failure 4.1% 3.8% -0.8% 1.0% Septicemia 11.9% 5.7% 5.2% 1.1% Coronary

100. Comoanaly2012-2015
     hcup-us.ahrq.gov/toolssoftware/comorbidity/comoanaly2012-2015.txt
     January 01, 2015 - order to work */ /* around this SAS constraint, the comorbidities for */ /* Congestive … Heart Failure and Complicated */ /* Hypertension have to be defined in this pgm … ***************/ /* Create detailed hypertension flags that */ /* cover combinations of Congestive … Heart */ /* Failure, Hypertension Complicated, and */ /* Renal Failure. … heart failure' VALVE = 'Valvular disease' PULMCIRC = 'Pulmonary circulation