Common use of Numeric Clause in Contracts

Numeric. X_$$ Pharmaceuticals Amount Paid 6 95 100 Numeric ------------------------------------------------------------------------------------------------------------- PA Physical Assistant Visit 2 101 102 Numeric ------------------------------------------------------------------------------------------------------------- PA_$$ Physical Assistant Costs Amount Paid 6 103 106 Numeric ------------------------------------------------------------------------------------------------------------- MD Physician Services Visit 2 109 110 Numeric ------------------------------------------------------------------------------------------------------------- Physician Services Costs Amount Paid 6 111 116 Numeric ------------------------------------------------------------------------------------------------------------- Encounter 3 117 119 Numeric ------------------------------------------------------------------------------------------------------------- OUTPT_$$ Amount Paid 6 120 125 Numeric ------------------------------------------------------------------------------------------------------------- Visit 2 126 127 Numeric ------------------------------------------------------------------------------------------------------------- PODIAT$$ Amount Paid 6 128 133 Numeric ------------------------------------------------------------------------------------------------------------- Rural Health Services Visit 2 134 135 Numeric ------------------------------------------------------------------------------------------------------------- Rural Health Services Costs Amount Paid 6 136 141 Numeric ------------------------------------------------------------------------------------------------------------- SNFREHAS Skilled nursing facility services - rehabilitation ** Amount Paid 6 142 147 Numeric ------------------------------------------------------------------------------------------------------------- EYE_$$ Visual Services including eyeglasses Amount Paid 6 148 153 Numeric ------------------------------------------------------------------------------------------------------------- Other Acute Service not listed (unit) Unit/Visit 6 154 159 Numeric ------------------------------------------------------------------------------------------------------------- DESCR 1 Description of other Acute service 35 160 194 Text ------------------------------------------------------------------------------------------------------------- OTH_$ Other Acute Service not listed (amount) Amount Paid 6 195 200 Numeric ------------------------------------------------------------------------------------------------------------- Description of other Acute service 35 201 235 Text ------------------------------------------------------------------------------------------------------------- **Medicare Crossovers EXHIBIT C (Page 1 of 1) (Plan Name) REPORT OF GRIEVANCES (Reporting Quarter) Were any new grievances filed during this reporting quarter? YES [ ] NO [ ] ------------------------------------------------------------------------------------------------------------------------------- ENROLLEE'S ENROLLEE'S ENROLLEE'S ENROLLEE'S GRIEVANCE GRIEVANCE EXPEDITED DISPOSITION DISPOSITION RESOLVED? LAST NAME FIRST NAME MEDICAID SOCIAL TYPE * DATE REQUEST? TYPE ** DATE (Y OR N) ID # SECURITY # (Y OR N) -------------------------------------------------------------------------------------------------------------------------------

Numeric. X_$$ Pharmaceuticals Amount Paid 6 Medicare crossovers are amounts that are billed to Medicaid for those Medicaid clients who are also eligible for Medicare. AHCA CONTRACT NO. FA309, AMENDMENT NO. 003, PAGE 8 OF 12 AHCA Form 2100-0002(Rev. OCT 02) AMERIGROUP FLORIDA, INC. MEDICAID HMO CONTRACT FEBRUARY 2003 ---------------------------------------------------------------------------------------------------------------------------- FIELD START FIELD NAME DESCRIPTION UNIT OF MEASUREMENT LENGTH COL. END COL. TEXT/NUMERIC ---------------------------------------------------------------------------------------------------------------------------- ESCORT Escort Services 15 Minute Unit 4 95 98 Numeric ---------------------------------------------------------------------------------------------------------------------------- FAMT_I Family Training Services (Individual) 15 Minute Unit 2 99 100 Numeric ------------------------------------------------------------------------------------------------------------- PA Physical Assistant Visit ---------------------------------------------------------------------------------------------------------------------------- FAMT_G Family Training Services (Group) 15 Minute Unit 2 101 102 Numeric ------------------------------------------------------------------------------------------------------------- PA_$$ Physical Assistant Costs Amount Paid 6 ---------------------------------------------------------------------------------------------------------------------------- FINARRS Financial Assessment/Risk Reduction Services 15 Minute Unit 4 103 106 Numeric ------------------------------------------------------------------------------------------------------------- MD Physician ---------------------------------------------------------------------------------------------------------------------------- FINM_RRS Financial Maintenance/Risk Reduction Services 15 Minute Unit 4 107 110 Numeric ---------------------------------------------------------------------------------------------------------------------------- HDMEAL Home Delivered Meals Meal 2 111 112 Numeric ---------------------------------------------------------------------------------------------------------------------------- HOMESRVS Homemaker Services 15 Minute Unit 4 113 116 Numeric ---------------------------------------------------------------------------------------------------------------------------- MH_CM Mental Health Case Management 15 Minute Unit 4 117 120 Numeric ---------------------------------------------------------------------------------------------------------------------------- SNF Nursing Facility Services- Long-term Days 2 121 122 Numeric ---------------------------------------------------------------------------------------------------------------------------- NUTR_RRS Nutritional Assessment/Risk Reduction Services 15 Minute Unit 4 123 126 Numeric ---------------------------------------------------------------------------------------------------------------------------- OT Occupational Therapy 15 Minute Unit 4 127 130 Numeric ---------------------------------------------------------------------------------------------------------------------------- PCS Personal Care Services 15 Minute Unit 4 131 134 Numeric ---------------------------------------------------------------------------------------------------------------------------- PERS_I Personal Emergency Response System Installation Job 2 135 136 Numeric ---------------------------------------------------------------------------------------------------------------------------- PERS_M Personal Emergency Response System- Maintenance Day 2 137 138 Numeric ---------------------------------------------------------------------------------------------------------------------------- PEST_I Pest Control - Initial Visit Job 2 139 140 Numeric ---------------------------------------------------------------------------------------------------------------------------- PEST_M Pest Control - Maintenance Month 1 141 141 Numeric ---------------------------------------------------------------------------------------------------------------------------- PT Physical Therapy 15 Minute Unit 4 142 145 Numeric ---------------------------------------------------------------------------------------------------------------------------- RISKREDU Physical Risk Assessment and Reduction 15 Minute Unit 4 146 149 Numeric ---------------------------------------------------------------------------------------------------------------------------- PRIVNURS Private Duty Nursing Services 15 Minute Unit 4 150 153 Numeric ---------------------------------------------------------------------------------------------------------------------------- PT_R Registered Physical Therapist Visit 2 109 110 154 155 Numeric ------------------------------------------------------------------------------------------------------------- Physician ---------------------------------------------------------------------------------------------------------------------------- RSPTH Respiratory Therapy 15 Minute Unit 4 156 159 Numeric ---------------------------------------------------------------------------------------------------------------------------- RESP_HM Respite Care- In Home 15 Minute Unit 4 160 163 Numeric ---------------------------------------------------------------------------------------------------------------------------- RESP_FAC Respite Care- Facility-Based Days 2 164 165 Numeric ---------------------------------------------------------------------------------------------------------------------------- NURSE Skilled Nursing Visit 4 166 169 Numeric ---------------------------------------------------------------------------------------------------------------------------- SPTH Speech Therapy 15 Minute Unit 4 170 173 Numeric ---------------------------------------------------------------------------------------------------------------------------- TRANSPOR Transportation Services Costs Amount Paid 6 111 116 (not included in Escort or Adult Day Health services) Trips 3 174 176 Numeric ------------------------------------------------------------------------------------------------------------- Encounter 3 117 119 Numeric ------------------------------------------------------------------------------------------------------------- OUTPT_$$ Amount Paid 6 120 125 Numeric ------------------------------------------------------------------------------------------------------------- Visit 2 126 127 Numeric ------------------------------------------------------------------------------------------------------------- PODIAT$$ Amount Paid 6 128 133 Numeric ------------------------------------------------------------------------------------------------------------- Rural Health Services Visit 2 134 135 Numeric ------------------------------------------------------------------------------------------------------------- Rural Health Services Costs Amount Paid 6 136 141 Numeric ------------------------------------------------------------------------------------------------------------- SNFREHAS Skilled nursing facility services - rehabilitation ** Amount Paid 6 142 147 Numeric ------------------------------------------------------------------------------------------------------------- EYE_$$ Visual Services including eyeglasses Amount Paid 6 148 153 Numeric ------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------- OTH_UNIT Other Acute LTC Service not listed (unit) Unit/Unit/ Visit 6 154 159 177 182 Numeric ------------------------------------------------------------------------------------------------------------- DESCR 1 ---------------------------------------------------------------------------------------------------------------------------- DESCR_1 Description of other Acute LTC service 35 160 194 183 217 Text ------------------------------------------------------------------------------------------------------------- OTH_$ ---------------------------------------------------------------------------------------------------------------------------- OTH_$$ Other Acute Service LTC service not listed (amount) Amount Paid 6 195 200 218 223 Numeric ------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------- DESCR_2 Description of other Acute LTC service 35 201 235 224 258 Text ------------------------------------------------------------------------------------------------------------- **Medicare Crossovers EXHIBIT C ---------------------------------------------------------------------------------------------------------------------------- AHCA CONTRACT NO. FA309, AMENDMENT NO. 003, PAGE 9 OF 12 AHCA Form 2100-0002 (Page 1 of 1Rev. OCT 02) (Plan Name) REPORT OF GRIEVANCES (Reporting Quarter) Were any new grievances filed during this reporting quarter? YES [ ] NO [ ] ------------------------------------------------------------------------------------------------------------------------------- ENROLLEE'S ENROLLEE'S ENROLLEE'S ENROLLEE'S GRIEVANCE GRIEVANCE EXPEDITED DISPOSITION DISPOSITION RESOLVED? LAST NAME FIRST NAME AMERIGROUP FLORIDA, INC. MEDICAID SOCIAL TYPE * DATE REQUEST? TYPE ** DATE (Y OR N) ID # SECURITY # (Y OR N) -------------------------------------------------------------------------------------------------------------------------------HMO CONTRACT FEBRUARY 2003 FILE 2: ACUTE CARE SERVICES

Numeric. X_$$ RX_$$ Pharmaceuticals Amount Paid 6 95 100 Numeric ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ PA Physical Assistant Visit 2 101 102 Numeric ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ PA_$$ Physical Assistant Costs Amount Paid 6 103 106 108 Numeric ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ MD Physician Services Visit 2 109 110 Numeric ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ MD_$$ Physician Services Costs Amount Paid 6 111 116 Numeric ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ OUTPT Outpatient Hospital Services Encounter 3 117 119 Numeric ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ OUTPT_$$ Outpatient Hospital Services Costs Amount Paid 6 120 125 Numeric ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ PODIATRY Podiatry Visit 2 126 127 Numeric ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ PODIAT$$ Podiatry Costs Amount Paid 6 128 133 Numeric ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ RURAL Rural Health Services Visit 2 134 135 Numeric ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ RURAL$$ Rural Health Services Costs Amount Paid 6 136 141 Numeric ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ SNFREHAS Skilled nursing facility services - rehabilitation ** Amount Paid 6 142 147 Numeric ------------------------------------------------------------------------------------------------------------- services - rehabilitation** ------------------------------------------------------------------------------------------------------------------------------------ EYE_$$ Visual Services including eyeglasses Amount Paid 6 148 153 Numeric ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ OTH UNIT Other Acute Service not listed (unit) Unit/Visit 6 154 159 Numeric ------------------------------------------------------------------------------------------------------------- DESCR 1 ------------------------------------------------------------------------------------------------------------------------------------ DESCR_1 Description of other Acute service 35 160 194 Text ------------------------------------------------------------------------------------------------------------- OTH_$ ------------------------------------------------------------------------------------------------------------------------------------ OTH_$$ Other Acute Service service not listed (amount) Amount Paid 6 195 200 Numeric ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ DESCR_2 Description of other Acute service 35 201 235 Text ------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ **Medicare Crossovers EXHIBIT C AHCA CONTRACT NO. FA309, AMENDMENT NO. 003, PAGE 10 OF 12 AHCA Form 2100-0002 (Page 1 of 1Rev. OCT 02) (Plan Name) REPORT OF GRIEVANCES (Reporting Quarter) Were any new grievances filed during this reporting quarter? YES [ ] NO [ ] ------------------------------------------------------------------------------------------------------------------------------- ENROLLEE'S ENROLLEE'S ENROLLEE'S ENROLLEE'S GRIEVANCE GRIEVANCE EXPEDITED DISPOSITION DISPOSITION RESOLVED? LAST NAME FIRST NAME AMERIGROUP FLORIDA, INC. MEDICAID SOCIAL TYPE * DATE REQUEST? TYPE ** DATE (Y OR N) ID # SECURITY # (Y OR N) -------------------------------------------------------------------------------------------------------------------------------HMO CONTRACT FEBRUARY 2003

Numeric. X_$$ Pharmaceuticals Amount Paid 6 ESCORT Escort Services 15 Minute Unit 4 95 98 Numeric -------------------------------------------------------------------------------------------------------------- FAMT_I Family Training Services (Individual) 15 Minute Unit 2 99 100 Numeric ------------------------------------------------------------------------------------------------------------- PA Physical Assistant Visit -------------------------------------------------------------------------------------------------------------- FAMT_G Family Training Services (Group) 15 Minute Unit 2 101 102 Numeric ------------------------------------------------------------------------------------------------------------- PA_$$ Physical Assistant Costs Amount Paid 6 103 -------------------------------------------------------------------------------------------------------------- FINARRS Financial Assessment /Risk Reduction Services 15 Minute Unit 4 [ILLEGIBLE] 106 -------------------------------------------------------------------------------------------------------------- ---------- * Medicare crossovers are amounts that are billed to Medicaid for those Medicaid clients who are also eligible for Medicare. EXHIBIT B (Page 2 of 3) -------------------------------------------------------------------------------------------------------------- UNIT OF FIELD FIELD NAME DESCRIPTION MEASUREMENT LENGTH START COL. END COL. TEXT/NUMERIC -------------------------------------------------------------------------------------------------------------- FINM RRS Financial Maintenance/Risk Reduction Services 15 Minute Unit 4 107 110 Numeric ------------------------------------------------------------------------------------------------------------- MD Physician -------------------------------------------------------------------------------------------------------------- HDMEAL Home Delivered Meal Meal 2 111 112 Numeric -------------------------------------------------------------------------------------------------------------- HOMESRVS Homemaker Services 15 Minute Unit 4 113 116 Numeric -------------------------------------------------------------------------------------------------------------- 15 Minute Unit 4 117 120 Numeric -------------------------------------------------------------------------------------------------------------- Days 2 121 122 Numeric -------------------------------------------------------------------------------------------------------------- 15 Minute Unit 4 123 126 Numeric -------------------------------------------------------------------------------------------------------------- 15 Minute Unit 4 127 130 Numeric -------------------------------------------------------------------------------------------------------------- 15 Minute Unit 4 131 134 Numeric -------------------------------------------------------------------------------------------------------------- PERS_I Personal Emergency Response System Installation Job 2 135 136 Numeric -------------------------------------------------------------------------------------------------------------- PERS_M Personal Emergency Response System - Maintenance Day 2 137 138 Numeric -------------------------------------------------------------------------------------------------------------- PEST_I Pest Control - Initial Visit Job 2 139 140 Numeric -------------------------------------------------------------------------------------------------------------- Month 1 141 141 Numeric -------------------------------------------------------------------------------------------------------------- 15 Minute Unit 4 142 145 Numeric -------------------------------------------------------------------------------------------------------------- 15 Minute Unit 4 146 149 Numeric -------------------------------------------------------------------------------------------------------------- 15 Minute Unit 4 150 153 Numeric -------------------------------------------------------------------------------------------------------------- Visit 2 109 110 154 155 Numeric ------------------------------------------------------------------------------------------------------------- Physician -------------------------------------------------------------------------------------------------------------- 15 Minute Unit 4 156 159 Numeric -------------------------------------------------------------------------------------------------------------- 15 Minute Unit 4 160 163 Numeric -------------------------------------------------------------------------------------------------------------- Days 2 164 165 Numeric -------------------------------------------------------------------------------------------------------------- Visit 4 166 169 Numeric -------------------------------------------------------------------------------------------------------------- SPTH 15 Minute Unit 4 170 173 Numeric -------------------------------------------------------------------------------------------------------------- TRANSPOR Transportation Services Costs Amount Paid 6 111 116 (not included in Escort or Adult Day Health services) Trips 3 174 176 Numeric ------------------------------------------------------------------------------------------------------------- Encounter 3 117 119 Numeric ------------------------------------------------------------------------------------------------------------- OUTPT_$$ Amount Paid 6 120 125 Numeric ------------------------------------------------------------------------------------------------------------- Visit 2 126 127 Numeric ------------------------------------------------------------------------------------------------------------- PODIAT$$ Amount Paid 6 128 133 Numeric ------------------------------------------------------------------------------------------------------------- Rural Health Services Visit 2 134 135 Numeric ------------------------------------------------------------------------------------------------------------- Rural Health Services Costs Amount Paid 6 136 141 Numeric ------------------------------------------------------------------------------------------------------------- SNFREHAS Skilled nursing facility services - rehabilitation ** Amount Paid 6 142 147 Numeric ------------------------------------------------------------------------------------------------------------- EYE_$$ Visual Services including eyeglasses Amount Paid 6 148 153 Numeric ------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------- OTH_UNIT Other Acute LTC Service not listed (unit) Unit/Visit 6 154 159 177 182 Numeric ------------------------------------------------------------------------------------------------------------- DESCR 1 Description of other Acute service -------------------------------------------------------------------------------------------------------------- 35 160 194 183 217 Text ------------------------------------------------------------------------------------------------------------- OTH_$ Other Acute Service not listed (amount) -------------------------------------------------------------------------------------------------------------- Amount Paid 6 195 200 Numeric ------------------------------------------------------------------------------------------------------------- Description of other Acute service -------------------------------------------------------------------------------------------------------------- 35 201 235 Text ------------------------------------------------------------------------------------------------------------- **Medicare Crossovers -------------------------------------------------------------------------------------------------------------- EXHIBIT C (Page 1 of 1) (Plan Name) REPORT OF GRIEVANCES (Reporting Quarter) Were any new grievances filed during this reporting quarter? YES [ ] NO [ ] ------------------------------------------------------------------------------------------------------------------------------- ENROLLEE'S ENROLLEE'S ENROLLEE'S ENROLLEE'S GRIEVANCE GRIEVANCE EXPEDITED DISPOSITION DISPOSITION RESOLVED? LAST NAME FIRST NAME MEDICAID SOCIAL TYPE * DATE REQUEST? TYPE ** DATE (Y OR N) ID # SECURITY # (Y OR N) -------------------------------------------------------------------------------------------------------------------------------B FILE 2: ACUTE CARE SERVICES