Summit Doppler Systems Inc Golden Colorado A Leading

Summit Doppler Systems, Inc. Golden, Colorado A Leading Manufacturer of Ultrasound Doppler Products

Course Overview This presentation will cover: n Featured products n Market overview n Awareness & diagnosis of P. A. D. n Product overview n Applicable specialties n Financial incentives n Benefits of Summit Doppler n Summary n Other diagnostic products

Featured Products Reimbursable ABI Systems Vista AVSTM Life. Dop. TM 300 ABI for the Diagnosis of Peripheral Arterial Disease (P. A. D. )

Featured Products The NEW Vantage ABITM A Clinical Innovation for the ABI Exam ONE TOUCH – 3 MINUTE ABI The Vantage ABI is an innovative system with a cuff-based technology for performing the ankle-brachial index (ABI) exam to assist in the diagnosis of peripheral arterial disease (P. A. D. )

Market Overview Peripheral Arterial Disease (P. A. D. ) n Affects 8– 12 million people in U. S. 1 n Under-diagnosed and under-treated n Narrowing of arteries (atherosclerosis) n Symptoms can be misinterpreted as normal aging or arthritis pain n Undetected P. A. D. associated with n 2 to 3 fold increase in mortality n 2 to 6 fold increase in heart attack and stroke as well as severe decline in quality of life n Leading cause of leg amputation (150 K annually)2 n More common than heart disease, cancer and stroke 1. American Diabetes Association 2. Jeff MR, Biamino G. Conquering Critical Limb Ischemia. Endovascular Today. February 2004; 3 (2).

Market Overview Fortunately… n Current increase in public and professional awareness of P. A. D. n Early detection can prevent further cardiovascular events: heart attack, stroke & death n Reimbursement rates increased to an average of $114/exam*. n Doppler ultrasound for diagnosis of P. A. D. n Now easier to use n Less expensive to acquire n Reimbursable • This average is based on Medicare Fee Schedules, CMS Part B Contractors, 2011. Arterial exams must be medically necessary in order to seek reimbursement. Other requirements, such as vascular accreditation may apply. Healthcare providers are advised to contact their third-party payers for specific coverage, coding and payment information. Summit Doppler Systems, Inc. makes no promise orguarantee of reimbursement by Medicare or any other third-party payer.

Market Overview n Annual testing is recommended for patients at risk by national health organizations n Ankle brachial index (ABI) exam is performed for the diagnosis of P. A. D. n Patients at high risk n 70+ years of age n Smokers 50+ years of age n Diabetics < 50 who smoke with 1 or more additional risk factors n Abnormal pulses during exam n Claudication in the leg n Critical limb ischemia (CLI)

Awareness & Diagnosis of P. A. D. n The American Heart Association, American Diabetes Association and the National Institutes of Health (NIH) are currently working to promote awareness nationally. n In 2006, the National Heart, Lung & Blood Institute (under the NIH) developed “Stay In Circulation”, a 3 year campaign, in cooperation with the P. A. D. Coalition, an alliance of national organizations and professional societies united to raise awareness. n Research has led to new medications that can help manage P. A. D. thus, pharmaceutical companies have launched public awareness campaigns to increase the education of P. A. D. n Increase in public and professional awareness opened up a market opportunity for Summit Doppler’s ABI systems for physicians to diagnose the disease.

Awareness & Diagnosis of P. A. D. n Patient lays in a supine or SEATED position (using the Vista AVS) n Clinician obtains the systolic pressures at the lower and upper extremities n Cuffs occlude arteries & a bi-directional Doppler probe or arterial photoplethysmography (PPG) probe detects the blood flow n Pressure at the ankle < pressure at the arm = some stage of P. A. D. n Printer creates waveform printouts on adhesivebacked paper n Waveforms acquired with a Doppler probe or with pulse volume recording (PVR) using blood pressure cuffs meet reimbursement criteria

Product Overview Summit Doppler’s Reimbursable ABI Systems Life. Dop 300 ABI System Convenient keypad for fast ABI calculation and dual ankle waveform printout. Affordable, ultra-portable system for performing the ABI exam – Doppler, bi-directional probe and printer Vista AVS Full-featured system - 3 modalities: PVR, bi-directional Doppler probe & arterial PPG – Seated ABI, automated segmental exams, PPG pressures –PC download capability (EMR compatible)

Product Overview Features of the Life. Dop 300 ABI n Convenient keypad for entering pressure data for ABI calculation n Sensitive, bi-directional probe & hand-held Doppler stores two ankle wave-forms prior to printing n Portable, rechargeable printer n Fast, waveform printout on adhesivebacked label paper n Automatic scaling and calibration n Small & easily transportable n Superior sound quality n Display shows pressure data, blood flow direction & ABI results after the exam is completed.

Product Overview Features of the Vista AVS n 3 modalities: PVR, bi-directional Doppler probe & Arterial PPG (photoplethysmography) probe n Perform the Seated ABI on mobility impaired patients n Automated segmental studies to customize exam n Automatic cuff inflation/deflation & index calculation n PPG probe for obtaining toe and limb pressures n Graphic waveform display with step-by-step exam instructions n Accommodates standard and custom exams n Built-in printer for waveforms on adhesivebacked label paper n Full-page reporting, exam storage and PC download capability

Product Overview The Seated ABI n For the first time ever, the ABI exam can be performed while the patient is sitting! Performing a Seated ABI using the Vista AVS. n The Seated ABI, a clinically proven method* makes it possible to easily assess patients with mobility impairments. n Physically disabled or wheel chair bound n Degenerative disease of the spine n Severe back pain n Advanced cardiopulmonary disease n Orthopnea n This feature is U. S. patent pending. * Gornik HL, Garcia B, Wolski K, Jones DC, Macdonald KA, Fronek A. Validation of a Method for Determination of the Ankle-Brachial Index in the Seated Position Journal of Vascular Surgery 2008; 48: 1204 -10.

Product Overview Features of the Vantage ABI n Convenient touch-screen to navigate the system. Displays patient data, exam information, instructions and menu options. n A USB memory stick is used for exporting data to a personal computer. n Uses digital Fourier oscillometric (DFO) waveform analysis, which Summit Doppler co-invented with researchers from the Cleveland Clinic where the technology was clinically validated. n New technology is a significant improvement in ankle and pressure determination and P. A. D. assessment over traditional forms of oscillometric ankle pressure measurement. After the cuffs are wrapped and the patient rests, touch one button and the Vantage ABI completes the exam in just 3 minutes!

Product Overview Vantage ABI uses Pulse Volume Recording (PVR) to obtain the ankle waveforms to assist in P. A. D. diagnosis SAMPLE OF NORMAL PVR Sharp systolic upstroke Dicrotic notch SAMPLE OF ABNORMAL PVR

Applicable Specialties n Cardiologists n Vascular labs n General practitioners n Podiatrists n Osteopaths n Endocrinologists n Internists n Interventional radiologists

Financial Incentive What’s in it financially for the customer? n Quick return on investment n Summit Doppler ABI Systems pay for themselves in as little as 3 weeks n ABI exam is reimbursable under CPT® Code 93922 an average of $114/exam. * n With the Vista AVS, 2 additional (reimbursable) exams can be performed: n Segmentals (CPT code 93923) average $177/exam* is n Stress Testing (CPT code 93924) average $221/exam*. is • These averages are based on Medicare Fee Schedules, CMS Part B Contractors, 2010. Reimbursement criteria and amounts vary by state. Arterial exams must be medically necessary in order to seek reimbursement. Other requirements, such as vascular accreditation may apply. Healthcare providers are advised to contact their third-party payers for specific coverage, coding and payment information. Summit Doppler Systems , Inc. makes no promise or guarantee of reimbursement by Medicare or any other third-party payer. Current Procedural Terminology (CPT®) is copyright 2011 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. CPT is a registered trademark of the American Medical Association. References to CPT codes herein are not intended to convey any endorsement or sponsorship by, or affiliation with, the AMA.

Benefits of Summit Doppler n Decades of experience in ultrasound Doppler technology n Committed to producing superior diagnostic products n Manufacturer reps available to support you locally n Manufactured in the U. S. A. (Golden, Colorado) n One year full warranty on all products n Service guarantee: 1 to 3 day turn-around time n Excellent customer service & technical support

Summary n Summit Doppler ABI Systems: the portable Life. Dop 300 ABI and the full-featured Vista AVS. n Solutions for performing the ABI for the diagnosis of P. A. D. n P. A. D. is a very common disease that’s widely under-diagnosed and under-treated. n Both systems generate fast, waveform printouts required for Medicare and insurance reimbursement. n Using a Doppler to perform the ABI exam is the gold-standard for diagnosing P. A. D. n Quick ROI—pays for itself in as little as three weeks!

Other Diagnostic Products Life. Dopplers for Obstetrical & Vascular Applications n L 350 Series – Table-Top Dopplers n Large display for indication of heart-rate and battery status, superior quality audio output from high-fidelity speaker, two probe holders, rechargeable batteries. n L 250 Series –Hand-Held Dopplers with Display n Full-featured Dopplers - large display for indication of heart-rate and battery status. Rechargeable batteries and audio recording options are available on specific models. n L 150 Series – Hand-Held Dopplers w/o Display n Non-display Dopplers - superior sound quality. Rechargeable batteries and audio recording options are available on specific models.

Other Diagnostic Products Life. Dopplers have Interchangeable Probe Capability Obstetrical probes n 3 MHz (model # SD 3) for early fetal heart detection thru delivery n 2 MHz (model # SD 2) for deep penetration for late term pregnancy and larger patients n Waterproof (model # SDW) for water assisted labor and delivery Vascular probes n 8 MHz (model # SD 8) for sensitivity and superficial vessel location n 5 MHz (model # SD 5) for deeper vessels n 4 MHz (model # SD 4) optimized for exams n 8 MHZ Sterilizable (model # STN) for use in sterile fields.

Antepartum Fetal Monitor (APM) Summit Doppler offers the FETALGARD Lite. TM by Analogic. n High quality fetal monitor performs nonstress testing (NST) & maternal blood pressure monitoring n Complete flexibility allows for configuring a system that best fits your needs and budget. Systems can be purchased in a package or configured independently. n Unique multifunctional features make it ideal for the clinic, office or home. - Mobile, lightweight monitor Single or twins transducers Programmable alarms Up to 12 hours of patient data storage High speed printer (z-fold paper) Durable, lightweight roll-stand Optional maternal BP monitoring

Thank You for Viewing Our Presentation. Please feel free to contact us for more information about our high-quality diagnostic products. Summit Doppler Systems, Inc. 4680 Table Mountain Dr. #150, Golden, CO 80403 #800 -554 -5090/Fax #303 -940 -7165 www. summitdoppler. com © 2011 Summit Doppler Systems, Inc.