Common use of SERVICES AND PROCEDURES Clause in Contracts

SERVICES AND PROCEDURES. TYPICAL SERVICES  Same day/next day appointments (for acute illness)  24/7 physician access via telephone for urgent after-hours issues  Annual Routine Physical Examination (Including certain annual lab tests). 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) 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)  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 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

SERVICES AND PROCEDURES. TYPICAL SERVICES  Same day/next day appointments (for acute illness)  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) 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)  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 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 raterate 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

SERVICES AND PROCEDURES. TYPICAL SERVICES  Same day/next day Prompt appointments (for acute illness)  24/7 physician Physician access via telephone for urgent after-hours issues  Annual Routine Physical Examination (Including certain annual lab tests). 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) 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)  Influenza vaccine & vaccination when available  Administration of non•influenza vaccines (vaccine Vaccines at wholesale 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 MINOR SURGICAL PROCEDURES INCLUDED  Laceration Repair  Burn Debridement  Skin/Lesion Biopsy  Mole Removal/Excision  Treatment of Skin Warts  Cyst Excision  Splinting (4when appropriate) months and only with a directed referral from Infinity Health  Licensed Professional Counselor Evaluation * at a discounted rate Ingrown toenail removal (when appropriate)  Registered Dietician/Nutritionist Evaluation * at a discounted rate Drainage of abscesses  Physical Therapy Evaluation * at a discounted rateJoint injections (e.g. shoulder, knee)  Trigger point injections DIAGNOSTIC TESTING  Blood Glucose Testing  Peak flow testing  Electrocardiograms (EKG)  Urine Analysis

SERVICES AND PROCEDURES. TYPICAL SERVICES  Same day/next day ⚫ Prompt appointments (for acute illness)  24/7 physician ⚫ Physician access via telephone for urgent after-hours issues  ⚫ Annual Routine Physical Examination (Including certain annual lab tests). 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) 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)  Influenza vaccine & vaccination when available  Administration of non•influenza vaccines (vaccine ⚫ Vaccines at wholesale 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 MINOR SURGICAL PROCEDURES INCLUDED ⚫ Laceration Repair ⚫ Burn Debridement ⚫ Skin/Lesion Biopsy ⚫ Mole Removal/Excision ⚫ Treatment of Skin Warts ⚫ Cyst Excision ⚫ Splinting (4when appropriate) months ⚫ 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 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 rateTreatments (e.g. Botox, Fillers, Kybella, etc)