Common use of SERVICES AND PROCEDURES Clause in Contracts

SERVICES AND PROCEDURES. TYPICAL SERVICES ⚫ Prompt appointments (for acute illness) ⚫ Physician access via telephone for urgent after-hours issues ⚫ Annual Routine Physical Examination (Including certain annual lab tests) ⚫ Periodic Patient Education ⚫ Physical Examinations (School, Athletic, Scout, Mission) ⚫ Limited Minor Surgeries (wound care, minor laceration repair, skin biopsies, wart destruction, skin cancer treatment See (MINOR SURGICAL PROCEDURES INCLUDED below) ⚫ Home or workplace visits (on a case by case, special circumstances basis determined by physician) ⚫ Women’s Health ⭘ Menopausal and hormone care ⭘ PAP smear collection (pathologist interpretation not covered) ⚫ Chronic Disease Management (Diabetes, Asthma, Hypertension, Depression, Obesity) ⚫ Vaccines at wholesale cost ⚫ Technology access (Electronic Record Portal, Lab access, Text, Virtual Visit capability, email contact and communication) ⚫ Direct doctor- to doctor communication with sub-specialists and care coordination ⚫ Certain laboratory tests at a discounted rate ⚫ Preventative medicine counseling MINOR SURGICAL PROCEDURES INCLUDED ⚫ Laceration Repair ⚫ Burn Debridement ⚫ Skin/Lesion Biopsy ⚫ Mole Removal/Excision ⚫ Treatment of Skin Warts ⚫ Cyst Excision ⚫ Splinting (when appropriate) ⚫ Ingrown toenail removal (when appropriate) ⚫ Drainage of abscesses ⚫ Joint injections (e.g. shoulder, knee) ⚫ Trigger point injections DIAGNOSTIC TESTING ⚫ Blood Glucose Testing ⚫ Peak flow testing ⚫ Electrocardiograms (EKG) ⚫ Urine Analysis EXCLUDED SERVICES Any procedures requiring general anesthesia; chronic pain management; rehabilitation services; major surgeries or similar advanced procedures, services, or supplies; hospital care; radiologic procedures including computed tomography, positron emission, magnetic resonance imaging; prenatal/obstetric care; cardiac testing; Department of Transportation physical examinations; cost of non-influenza vaccines; urine drug screen; all other services not specifically listed in Appendix B SERVICES OFFERED REQUIRING AN ADDITIONAL FEE • Cosmetic Injections and Treatments (e.g. Botox, Fillers, Kybella, etc)

SERVICES AND PROCEDURES. TYPICAL SERVICES ⚫  Prompt appointments (for acute illness) ⚫  Physician access via telephone for urgent after-hours issues ⚫  Annual Routine Physical Examination (Including certain annual lab tests) ⚫  Periodic Patient Education ⚫  Physical Examinations (School, Athletic, Scout, Mission) ⚫  Limited Minor Surgeries (wound care, minor laceration repair, skin biopsies, wart destruction, skin cancer treatment See (MINOR SURGICAL PROCEDURES INCLUDED below) ⚫  Home or workplace visits (on a case by case, special circumstances basis determined by physician) ⚫  Women’s Health ⭘  Menopausal and hormone care ⭘  PAP smear collection (pathologist interpretation not covered) ⚫  Chronic Disease Management (Diabetes, Asthma, Hypertension, Depression, Obesity) ⚫  Vaccines at wholesale cost ⚫  Technology access (Electronic Record Portal, Lab access, Text, Virtual Visit capability, email contact and communication) ⚫  Direct doctor- to doctor communication with sub-specialists and care coordination ⚫  Certain laboratory tests at a discounted rate ⚫  Preventative medicine counseling MINOR SURGICAL PROCEDURES INCLUDED ⚫  Laceration Repair ⚫  Burn Debridement ⚫  Skin/Lesion Biopsy ⚫  Mole Removal/Excision ⚫  Treatment of Skin Warts ⚫  Cyst Excision ⚫  Splinting (when appropriate) ⚫  Ingrown toenail removal (when appropriate) ⚫  Drainage of abscesses ⚫  Joint injections (e.g. shoulder, knee) ⚫  Trigger point injections DIAGNOSTIC TESTING ⚫  Blood Glucose Testing ⚫  Peak flow testing ⚫  Electrocardiograms (EKG) ⚫  Urine Analysis EXCLUDED SERVICES Any procedures requiring general anesthesia; chronic pain management; rehabilitation services; major surgeries or similar advanced procedures, services, or supplies; hospital care; radiologic procedures including computed tomography, positron emission, magnetic resonance imaging; prenatal/obstetric care; cardiac testing; Department of Transportation physical examinations; cost of non-influenza vaccines; urine drug screen; all other services not specifically listed in Appendix B SERVICES OFFERED REQUIRING AN ADDITIONAL FEE • Cosmetic Injections and Treatments (e.g. Botox, Fillers, Kybella, etc)Analysis

SERVICES AND PROCEDURES. TYPICAL SERVICES ⚫ Prompt  Same day/next day appointments (for acute illness) ⚫ Physician  24/7 physician access via telephone for urgent after-hours issues ⚫  Annual Routine Physical Examination (Including certain annual lab tests) ⚫ Periodic Patient Education ⚫ ). This Comprehensive Annual Routine Physical is not the same as the “Medicare Annual Wellness Physical.”  Physical Examinations (School, Athletic, Scout, Mission) ⚫  Limited Minor Surgeries (wound care, minor laceration repair, skin biopsies, wart destruction, skin cancer treatment treatment) See (MINOR SURGICAL PROCEDURES INCLUDED below) ⚫ .  Home or workplace visits (on a case by case, special circumstances basis determined by physician) ⚫  Women’s Health ⭘  Menopausal and hormone care ⭘  PAP smear collection (pathologist interpretation not covered, can be billed to conventional insurance) ⚫  Chronic Disease Management (Diabetes, Asthma, Hypertension, Depression, Obesity) ⚫ Vaccines at wholesale  Influenza vaccine & vaccination when available  Administration of non•influenza vaccines (vaccine cost ⚫ not included)  Technology access (Electronic Record Portal, Lab access, Text, Virtual Visit capability, email contact and communication) ⚫  Direct doctor- to doctor communication with sub-specialists sub•specialists and care coordination ⚫  Certain laboratory tests at a discounted rate ⚫  Preventative medicine counseling MINOR SURGICAL PROCEDURES INCLUDED ⚫ Laceration Repair ⚫ Burn Debridement ⚫ SkinAfter having been a member for four (4) months and only with a directed referral from Infinity Health  Licensed Professional Counselor Evaluation * at a discounted rate  Registered Dietician/Lesion Biopsy ⚫ Mole Removal/Excision ⚫ Treatment of Skin Warts ⚫ Cyst Excision ⚫ Splinting (when appropriate) ⚫ Ingrown toenail removal (when appropriate) ⚫ Drainage of abscesses ⚫ Joint injections (e.g. shoulder, knee) ⚫ Trigger point injections DIAGNOSTIC TESTING ⚫ Blood Glucose Testing ⚫ Peak flow testing ⚫ Electrocardiograms (EKG) ⚫ Urine Analysis EXCLUDED SERVICES Any procedures requiring general anesthesia; chronic pain management; rehabilitation services; major surgeries or similar advanced procedures, services, or supplies; hospital care; radiologic procedures including computed tomography, positron emission, magnetic resonance imaging; prenatal/obstetric care; cardiac testing; Department of Transportation physical examinations; cost of non-influenza vaccines; urine drug screen; all other services not specifically listed in Appendix B SERVICES OFFERED REQUIRING AN ADDITIONAL FEE • Cosmetic Injections and Treatments (e.g. Botox, Fillers, Kybella, etc)Nutritionist Evaluation * at a discounted rate  Physical Therapy Evaluation * at a discounted rate

SERVICES AND PROCEDURES. TYPICAL SERVICES ⚫ Prompt  Same day/next day appointments (for acute illness) ⚫ Physician  24/7 physician access via telephone for urgent after-hours issues ⚫  Annual Routine Physical Examination (Including certain annual lab tests) ⚫ including follow-up communication concerning the Examination. This Comprehensive Annual Routine Physical is not the same as the “Medicare Annual Wellness Physical.”  Periodic Patient Education ⚫  Physical Examinations (School, Athletic, Scout, Mission) ⚫  Limited Minor Surgeries (wound care, minor laceration repair, skin biopsies, wart destruction, skin cancer treatment See (MINOR SURGICAL PROCEDURES INCLUDED below) ⚫  Home or workplace visits (on a case by case, special circumstances basis determined by physician) ⚫  Women’s Health ⭘  Menopausal and hormone care ⭘  PAP smear collection (pathologist interpretation not covered) ⚫  Chronic Disease Management (Diabetes, Asthma, Hypertension, Depression, Obesity) ⚫ Vaccines at wholesale  Influenza vaccine & vaccination when available  Administration of non•influenza vaccines (vaccine cost ⚫ not included)  Technology access (Electronic Record Portal, Lab access, Text, Virtual Visit capability, email contact and communication) ⚫  Direct doctor- to doctor communication with sub-specialists sub•specialists and care coordination ⚫  Certain laboratory tests at a discounted rate ⚫  Preventative medicine counseling After having been a member for four (4) months and only with a directed referral from Infinity Health  Licensed Professional Counselor Evaluation * at a discounted rate  Registered Dietician/Nutritionist Evaluation * at a discounted rate  Physical Therapy Evaluation * at a discounted rate MINOR SURGICAL PROCEDURES INCLUDED ⚫  Laceration Repair ⚫  Burn Debridement ⚫  Skin/Lesion Biopsy ⚫  Mole Removal/Excision ⚫  Treatment of Skin Warts ⚫  Cyst Excision ⚫  Splinting (when appropriate) ⚫  Ingrown toenail removal (when appropriate) ⚫  Drainage of abscesses ⚫  Joint injections (e.g. shoulder, knee) ⚫  Trigger point injections DIAGNOSTIC TESTING ⚫ Blood Glucose Testing ⚫ Peak flow testing ⚫ Electrocardiograms (EKG) ⚫ Urine Analysis EXCLUDED SERVICES Any procedures requiring general anesthesia; chronic pain management; rehabilitation services; major surgeries or similar advanced procedures, services, or supplies; hospital care; radiologic procedures including computed tomography, positron emission, magnetic resonance imaging; prenatal/obstetric care; cardiac testing; Department of Transportation physical examinations; cost of non-influenza vaccines; urine drug screen; all other services not specifically listed in Appendix B SERVICES OFFERED REQUIRING AN ADDITIONAL FEE • Cosmetic Injections and Treatments (e.g. Botox, Fillers, Kybella, etc)injections