Member Services A Primary and Urgent Care Concierge Service

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1 Our Medical Membership provides you and your family with medical care within the scope of MDSTAT's Urgent/Primary Care facility. Once active, members can bring their membership card to any MDSTAT clinic and receive medical care. Our Medical Membership is designed for: A. Uninsured individuals & families B. Individuals & families w/high deductibles C. Employers seeking care for employees Pricing Individuals Couples Families ( 3 or more ) $69/mo $99/mo $129/mo Once membership becomes active, members will pay only $10 for an office visit. Covered medical care could include consultation and treatment with a physician, on site labs and X-Ray. Most Common Visits: Illnesses & Treatments ( Office Visits $125 for non-members, $10 for members ) Abscess Incision and Drainage Allergic Reactions Allergies Bronchitis Burns from heat or chemical exposure Congestion Diaper Rash Ear Infection Earache Eye Infection Fever Flu Fractures * Fungus Infections GI Disorders Insect Bites Lacerations Migraines Nausea Physicals Rash Runny Nose Sinus Infection Skin Allergy Skin Infections Splints Sprains Stitches/Suturing Sore Throat Strains UTI Wound Infection And more! * Fractures: Closed only, will receive X-Ray, Splint and Orthopedist for reduction casting

2 Covered Chronic Disease Management ( Maintenance Program )* Hypertension Diabetes * High Cholesterol Asthma Osteoarthritis Hypothyroidism COPD Stress Depression Obesity And more! * Physician will determine frequency of patient visits * Diabetes: Non Insulin Dependent Only Covered Labs, Diagnostics, & Other Services On Site Labs Diagnostic Services Other Services Flu Test Mono Spot Test Strep Test Urinalysis by DIP Glucose test Pregnancy Urine Test KOH/Wet Mount Digital XRAY EKG Pulmonary Function Testing Pulse Oximeter Body Composition Analysis Nebulizer Treatment On Site Pharmacy Peak Flow Meter PFT Therapeutic Injection Covered Injections Benadryl 50mg Depo-Medrol Epinephrine SQ Kenolog 40mg Phenergan 50mg Rocephin 1g Rocephin 250mg Rocephin 500mg Solu-Medrol Toradol 60mg Xopenex/Albuterol

3 Prescription Medications $15 (Generic) Most prescriptions are conveniently filled at our clinics for only $15. For medications not listed, call Customer Service for availability and pricing. Brand Name Generic Name Brand Name Generic Name Acyclovir Acyclovir Lopressor Metoprolol Amaryl Glimepiride Norco Hydrocodone Ambien Zolpidem Tart Meclizine Antivert Amoxicillin Amoxicillin Mobic Mexloxicam Amoxicillin Susp Amoxicillin Motrin Ibuprofen Anusol-HC Anusol-HC Vicodin Hydrocodone Ativan Lorazepam Norvasc Amlodipine Amaryl Glimepiride Oflox Opthalmic Ocuflox Cipro Ciprofloxacin Oflox Otic Floxin Auralgan Antipyrine/Benz Penicillin VK Bactrim DS Sulfameth/Trimeth Tylenol w/codeine Acetmine Solution Keflex Susp Cephalexin Prednisone Deltasone Citalopram HBR Losartin Pyridium Phenazopyridine Cozaar Losartin Robitussin AC Guaituss Diflucan Fluconazole Soma Carisoprodol Doxycycline Vibramycin Tylenol w/codeine Acetime/COD Flagyl Metronidazole Ultram Tramadol HCL Flexeril Cyclobenzprine Valium Diazepam Flonase Flucticasone Zantac Ranitidine HCL Glucophage Metformin Zestril Lisinopril Hydrocortisone Hydrocortisone Zocor 20mg Simvasitin Hydrodiuril HTCZ Zocor Simvastin Keflex Cephalexin Zyrtec Cetrizine Kenalog Triamcinolone Lopressor Metoprolol *Prices are subject to change without any notification.

4 Prescription Medications $20 - $30 (Generic) Below are example prescription medications that are discounted to $20 to $30 for members. Prescription Cost Prescription Cost Agumentin $30 Hydrocodon/Ace ( Norco ) $20 Antipyrine/Benzocaine Otic $20 Levaquin $20 Azithromycin ( Zpack ) $20 Neomcyin/Hydrocortisone $25 Azithromycin Susp $30 Nitrofuratoin $20 Benzonatate $20 Permethrin Cream $20 Ceflin $25 Prednisone Syrub $25 Clindomycin $25 * Prices are subject to change without any notification. Discounted On-Site Services In effort to provide convenient and cost effect care, members will receive 20% off of the following on-site services: Fracture reduction end casting ( some procedures will require outside referral ) Physical Therapy Medical Weight Management Immunizations * Prices are subject to change without any notification.

5 Discounted Outside Labs ( $25 processing fee ) Members will have access to additional outside labs not covered under the membership, but offered at significant discounted prices. In additional to the discounted prices, members will be responsible for paying a $25 processing/draw feed. Lab Member Price Non-Member Price Hepatic Function Panel $13.00 $71.79 CMP $16.00 $67.85 Lipid Profile $20.00 $93.51 Renal Function Panel $14.00 $58.36 Acute Hepatitis Panel $70.00 $ CBC ( Includes Diff/PLT ) $11.00 $46.00 Prothrombin Time $6.50 $33.35 Amylase, Serum $10.00 $55.78 ANA IFA Screen with Reflex $18.00 $78.49 C-Reactive Protein $8.00 $86.54 Ferritin $20.00 $89.13 Hemoglobin A1C Immunoassay $14.50 $65.55 Iron and IBC W/O Reflex $19.75 $79.06 Iron, Total $10.00 $41.40 Magnesium/Serum $10.75 $48.01 Microalbumin/Random Urine $16.75 $74.18 Prolactin $28.00 $ Prostate Specific Antigen $26.75 $ Rheumatoid Factor $9.00 $51.75 Sedimentation Rate $4.00 $41.98 Testosterone, Toal $38.00 $ TSH ( 3 rd Generation ) $25.00 $ TSH Reflex to free T4 $25.00 $ T3 Total ( Trilodothyronine ) $20.00 $ Uric Acid, Serum $7.50 $47.49 Vitamin D, 25-Hydroxy $43.00 $ Cholesterol $6.50 PT/INR $6.69 $6.69 HIV 1/HIV 2 $19.00 Vitamin B12 $23.00 Culture, Urine, Routine $15.00 $69.58 GC/Chimydia $ $ Creatine Kinase $10.75 $50.60

6 Discounted Outside Imaging Services ( $25-$50 processing fee ) Members will have access to additional outside imaging services not covered under the membership, but offered at significant discounted prices. In additional to the discounted prices, members will be responsible for paying a $25-$50 processing fee Imaging Member Price Non Member Price (Average) MRI $400 - $500 $700 - $5,000 CT $400 - $500 $550 Ultra Sound $115 - $300 $150 - $600 Mammogram $200 - $225 $250-$300 Bone Density Scan $100 $150 *Prices are subject to change without any notification.

7 Services Not Covered There are some services that are outside the scope of primary/urgent medical care and are not covered. In addition to the services that are specifically excluded below, any service that is not explicitly stated as a covered service is considered an excluded service. Exclusions Ambulance transportation ( ground or air ) Any hospitalization Emergency room visits Specialist referrals Outside imaging ( discounted pricing available ) Fracture casting ( discounted pricing available ) Drug or alcohol rehabilitation Any other tests or care not specified in the agreement Long term pain management and administration of narcotics and controlled substances are not covered. Patients will be referred to a specialist at the provider s discretion Your Care in the Hands of Doctors With MDSTAT s Medical Membership, your care is placed directly into the hands of doctors whose number one priority is your health and wellbeing. This old fashion approach creates a direct patient to doctor relationship with no obstacles in between. Questions? If you have any questions about what is covered or the cost of services, please call us at MY-MDSTAT or us at memberships@mdstatuc.com