305-262-1610

TABLE OF CONTENTS / TABLA DE CONTENIDO Membership Agreement / Acuerdo de Membrecia..........................................................7 Welcome Letter / Carta de Bienvenida...............................................................................8 Terms and Conditions / Términos y Condiciones.............................................................9 How to Use Your Card? / ¿Cómo usar su tarjeta?..........................................................10 Primary and Specialist Physicians / Medicos Primarios y Especialistas ....................11 Primary Physicians Locations / Direcciones de los Medicos Primarios......................12 Gynecology & Obstetrics / Ginecologia y Obstetricia....................................................19 Pediatrics / Pediatria..........................................................................................................21 Primary and Specialist Providers Fees / Precios de los servicios medicos primarios y especialistas...................................................................................................24 Medical Centers / Centros Medicos..................................................................................25 Specialist Physicians Locations / Direcciones de los Medicos Especialistas............29 Neurological Studies Fees / Precios de los estudios neurologicos..............................37 Urgent Care Centers / Centros de Cuidados de Urgencia.............................................42 Dental Services / Servicios Dentales................................................................................45 General Dentistry Fees / Precios de los servicios de Odontologia General.................47 Dental Specialties Fees / Precios de los Servicios Dentales por Especialidad...........52 Optical Services / Servicios Opticos................................................................................53 Optical Sevices Fees / Precios de los Servicios Opticos...............................................56 Clinical Laboratories / Laboratorios Clinicos..................................................................57 Laboratories Locations / Direcciones de los Laboratorios............................................58 Laboratory Services Fees / Precios de los Servicios de Laboratorio...........................60 Diagnostic and Radiology Centers / Centros de Diagnostico y Radiologia.................68 Diagnostic Centers Locations / Direcciones de los Centros de Diagnostico..............68 Diagnostic Services Fees / Precios de los Servicios de Diagnostico..........................71 Ancillary Services / Servicios Auxiliares........................................................................76 Durable Medical Supplies / Equipos Medicos Duraderos..............................................76 Orthopedic Supplies/ Suplementos Ortopedicos...........................................................77 Hearing Aids/ Suplementos Auditivos.............................................................................78 Transportation/ Transportacion........................................................................................79 Home Health and Physical Therapy / Servicios a domicilio y Terapia Fisica....................80 Alternative Medicine / Medicina Alternativa....................................................................82 Diabetes Supply Services / Suplementos para la Diabetes...........................................83 Pharmacy Services / Servicios Farmaceuticos...............................................................84 Pharmacy Locations / Direcciones de las Farmacias.....................................................85 Pharmacy Services Fees / Precios de los Servicios de Farmacia.................................88 Cosmetology Services Fees / Precios de los Servicios de Cosmetologia...................93

Disclaimer of Liability In consideration of the monthly payment fees to be paid to Med Plan by you or on your behalf, Med Plan agrees to arrange for the delivery of health care services in accordance with and subject to the terms of the Agreement entered into between you or on your behalf, and Med Plan. Med Plan, in so arranging for the delivery of health care services and supplies, does not directly provide these services nor supply them. Rather, Independent Contractors provide these services and supplies. The health care providers listed in this directory are not employees or agents of MedPlan. MedPlan shall not be liable for any negligent act or omission committed by any of the providers listed in this directory, or any of their employees or agents who may, from time to time provide medical services to you. MedPlan expressly disclaims any agency relationship, actual or implied, with any health care provider. MedPlan does not exercise any control or direction over the medical judgement or clinical decisions of any health care provider listed in this directory and does not interfere with the physician patient relationship between you and any health care provider. It is important for you to know when you enroll in MedPlan that the continued participation of any one doctor, hospital or other provider cannot be guaranteed. This directory is current as of date of publication. Some plan providers may have been added or removed from this list after this directory was printed. To get the most up-to-date information about MedPlan providers in your area, you can visit www.floridamedplan.com or call our Customer Service Department at 305-262-1610, Monday through Friday, 9:00 am to 6:00 pm. The fact that a provider is listed does not guarantee that they are still in the network or accepting new patients. The “Plan Providers” listed in this directory have agreed to provide you with your health care coverage at fixed discounted from their usual and customary pricing rate. Members are limited to only those providers that are affiliated to the MedPlan Network of Providers. Participating physicians and other providers listed in this directory or on our website www.floridamedplan.com are not agents, employees or partners of MedPlan or any of its subsidiaries. MedPlan is not a medical services provider, a medical insurance plan nor an HMO. MedPlan does not control nor endorse the judgement or clinical treatment recommendations made by the physicians or other providers listed in our directory, or in our website www.floridamedplan.com nor those that you chose to select. All MedPlan providers are independent contractors. You may go to any of our plan providers listed in this directory; however some services may require a prescription or medical treatment plan provided by a licensed medical physician. If you have been going to one plan provider, you are not required to continue going to that same provider.

Providers are independent. Providers are listed in this directory by the type of provider: Primary Care Physicians (PCP), Family Medicine, Specialists, Urgent Care Centers, Diagnostic Centers, Laboratory, Pharmacy, Optical, Dental, and Durable Medical Equipment providers. Within each provider type, providers are lsited by COUNTY. You can also visit www.floridamedplan.com or call Customer Care Department at 305-262-1610. Our providers are paid on a contracted discount fee-for-service basis by you at the time the service is rendered. If you use Non-Plan providers, understand that Non-Plan providers are not part of MedPlan network. In that case, you will have to pay the provider their usual and customary fees which are significantly higher than the contracted rate MedPlan has with its in-network providers. care or services you get from non-plan providers will NOT be covered. MedPlan services are limited to the counties that MedPlan has providers and services contracted in. Any services provided outside MedPlan service areas will not be at the contract price. You have the right to get timely access to plan providers and to all discounts covered by the plan. Timely access means that you can get appointments and services within a reasonable period of time. You have the right to get full information from your providers when you go for medical care. You have the right to participate fully in decisions about your healthcare. You have the right to refuse care. MedPlan does not limit its members from visiting any provider contracted by MedPlan. You can visit any provider or service without any limitation or need for referral. MedPlan does however recommend that the member choose a primary care physician from our directory to be the gate keeper or central coordinator for all referrals to specialist and services. 4

This insures that the member’s service ordered or more importantly that the member is not prescribed medication that can be contraindicated to another medication ordered by an unknown provider. Also please note due to the nature of health care delivery systems it is sometimes necessary to have a written prescription or medical treatment plan in order to have services rendered by certain MedPlan providers. These services are Pharmacy, Durable Medical Equipment, Laboratory Services, Physical Therapy and Diagnostic Radiology services. Please visit your Primary Care Provider or Specialist to get the proper treatment orders before visiting any MedPlan support service providers listed above. Services such as Dental and Optical can be accessed directly by the member at anytime without providing notification to your PCP. Please note that any medical emergency should be directed to the nearest Urgent Care Center or local Hospital Emergency Room. The following directory is constantly changing and is therefore subject to change without notice. For current and update providers information please visit our website: www.floridamedplan.com

Excepción de responsabilidad civil. MedPlan, en consideración al pago de su membrecía, está de acuerdo en ofrecerle el acceso a la red de proveedores establecida que prestan sus servicios a nuestros miembros. MedPlan coordinará su primera cita con el proveedor que usted elija dentro del directorio. MedPlan no asigna a ningún proveedor. Es responsabilidad del miembro elegir el médico que le prestará los servicios. MedPlan no ofrece los servicios médicos directamente, sino a través de proveedores independientes que proveen estos servicios y sus suplementos. Los proveedores que aparecen en este directorio no son empleados o agentes de MedPlan. Los empleados o agentes de MedPlan no deben ser responsables legalmente por alguna negligencia o acto de omisión cometida en cualquier momento por algún proveedor que aparezca en este directorio. MedPlan específicamente no se responsabiliza en ningún momento y no tiene ninguna relación de agencia con ningún proveedor médico. MedPlan no ejerce ningun control o dirección respecto a un criterio médico o decisión clínica de algún proveedor del directorio ni interfiere en la relación entre el paciente y su médico. Es importante que al convertirse en miembro de Med Plan, la persona sepa que no se le garantiza la continua participación de un doctor, hospital, u otro proveedor. Este directorio está vigente desde el día en que fue publicado. Es muy posible que a partir de ese dia se hayan agregado o eliminado de la lista algunos proveedores. Para obtener una información actualizada de los proveedores en su area, visítenos en www.floridamedplan.com o llame a nuestro Departamento de Servicio al Cliente, al 305262-1610, de Lunes a Viernes de 9:00 am a 6:00 pm. El hecho de que un proveedor se encuentre en la lista no garantiza que todavía se encuentre en la red o que participe consultando nuevos pacientes. Los proveedores listados en este directorio han acordado en proveerles a los miembros de Med Plan sus servicios de cuidado a su salud con una tarifa fija que representa un Ahorro sobre la tarifa regular. Usted puede ir a cualquiera de nuestros proveedores en este directorio y no necesita ser referido por el médico primario que le atiende para visitar a un especialista dentro de la red, pero algunos de estos servicios, como son los exámenes de laboratorio, radiología o diagnóstico sí requieren de una referencia por parte del doctor que le ordena el examen o procedimiento. Si usted ha ido a uno de nuestros proveedores y no se siente satisfecho con sus servicios, usted no está en la obligación de seguir visitándolo. Los miembros están limitados a los proveedores que están afiliados a la red de MedPlan. Los proveedores participantes en este directorio o en www.floridamedplan.com no son agentes, empleados o socios de MedPlan, ni ninguno de sus subsidios. MedPlan no es un proveedor de servicios médicos, ni tampoco un plan de seguros médicos ni un HMO. MedPlan no apoya los diagnósticos ni los tratamientos médicos dados por los proveedores participantes en la red de MedPlan listados en este directorio, ni en www.floridamedplan.com, ni los proveedores escogidos por nuestros miembros.

Los proveedores son independientes. Los proveedores en este directorio han sido clasificados según tipo de proveedor: Doctores primarios(PCP), Medicina familiar, Especialistas, Centros de cuidados de urgencia, Centros de terapia física, Centros de diagnóstico, Laboratorios, Cuidado médico en el hogar, Farmacias y Equipos médicos. Cada especialidad ha sido clasificada en sus respectivos condados. Visítenos en www.floridamedplan.com o llámenos al Departamento de atención al cliente al 305-262-1610. Nuestros proveedores tienen que ser pagados por usted a la hora de recibir sus servicios. MedPlan tiene varios tipos de acuerdos contractuales con los proveedores que son comunes en los planes médicos. Si usted usa un proveedor que no forma parte de la red de MedPlan, usted no recibirá la tarifa negociada y tendrá que pagar la tarifa completa que exija ese proveedor. Los descuentos de MedPlan no se aplican si usted viaja fuera de las areas de servicios. 5

Usted tiene derecho al acceso de la red de nuestros proveedores y a todos los descuentos disponibles en el plan. Esto significa que usted puede obtener citas y servicios en un tiempo razonable. Usted tiene derecho a recibir de su proveedor toda la información referente a su cuidado o tratamiento médico, a participar completamente en las decisiones sobre su salud, y al derecho de rehusar su tratamiento médico. MedPlan no limita a sus miembros a visitar a cualquier proveedor que pertenezca a su red. Usted puede visitar a cualquier proveedor o servicio sin ningún tipo de limitación o necesidad de derivación. MedPlan recomienda, sin embargo, que el miembro elija un médico de atención primaria de nuestro directorio para ser el coordinador central para todas las derivaciones al especialista y servicios. Esto asegura que los servicios de los miembros se coordinen y el miembro reciba la atención médica adecuada con el pleno conocimiento de su PCP. Esto evitará la duplicación de los servicios solicitados, o más importante aún, que al miembro no se le prescriba un medicamento que puede estar contraindicado con otro medicamento ordenado por un proveedor desconocido. Tambien tenga en cuenta que debido a la naturaleza de los sistemas de prestación de asistencia sanitaria, a veces es necesario tener una prestación escrita o plan de tratamiento médico a fin de que los servicios prestados por determinados proveedores de MedPlan estén prescritos correctamente. Estos servicios son Farmacia, Equipo médico duradero, Laboratorio, Radiología diagnóstica, Terapia física, etc. Visite a su proveedor de atención primaria o especialista para obtener las órdenes de un tratamiento adecuado antes de visitar cualquier proveedor de los antes mencionados. El siguiente directorio está sujeto a modificaciones constantes y puede cambiar sin previo aviso. Para más información actualizada visítenos en www.floridamedplan.com

6

MEMBERSHIP AGREEMENT MED PLAN LLC Attn: Compliance Department 7200 NW 7th ST, Suite 100 Miami, Fl. 33126 For assistance and plan information call: 305-262-1610. or plan information, to change your method of payment, to add family members or for any other assistance please call the customer service number located on the back of your membership card. All documents contained herein (i.e. Terms and Conditions and Member Benefits) are hereby attached to and made a part of the Membership Agreement. Disclosures: 1. This plan is not a health insurance policy. 2. This plan provides discounts at certain health care providers for medical services. 3. This plan does not make payments directly to the providers of medical services. 4. The plan member is obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the discount plan organization. Terms and Agrements: To terminate or cancel the member agreement please call the number above or send a written cancellation notice to the Discount Medical Plan Organization at the address provided above. This agreement will not be cancelled for nonpayment. If the discount medical plan organization cancels a membership for any reason other than nonpayment of fees by the member, the discount medical plan organization shall make a pro rata reimbursement of all periodic charges to the member. If you cancel for any reason within 30 days after the effective date, you will receive a full refund of paid membership fee, excluding the one-time application fee. Legal Notice: Med Plan is not an insurance company. Med Plan offers discounts on some health providers for their medical services. Med Plan does not make direct payments to the providers of medical services. The members of Med Plan are required to pay for all the health care services, but will have a discount on the health providers contracted.

ACUERDO DE MEMBRECIA Para asistencia e información sobre el plan por favor llame al 877-334-1634. Para información del plan, para cambiar la forma de pago, para agregar miembros de la familia o cualquier otro tipo de asistencia llame al Departamento de Atencion al cliente situado en la parte superior de su tarjeta de membrecia: 305-262-1610. Todos los documentos incluidos (beneficios de los miembros, términos y condiciones de estos) se mostrará en estas páginas y forma parte del Acuerdo de Membrecía. Para cancelar su membrecía, por favor llame al número indicado anteriormente y envíe una notificacion con su puño y letra explicando los motivos de su cancelación al Departamento de Servicio al Cliente de MedPlan. Por favor envíe las tarjetas de membrecía de cada miembro junto con la carta de cancelación, esta carta debemos recibirla antes de los 30 días despues que se afilió a la Compañía. Este acuerdo puede ser cancelado por no pagar su mensualidad. Si el Departamento de Servicios al Cliente de MedPlan cancela su membrecía por cualquier razón que no sea el pago de su mensualidad MedPlan le hará el reembolso con la suma de los días no utilizados. Proceso de cancelación:Si usted cancela su membrecía por cualquier razón dentro de los 30 días siguientes a la fecha de efectividad, usted recibirá un rembolso completo de su pago, excepto la cuota de inscripción de $30.00. Aviso Legal Med Plan no es un seguro médico. Med Plan proporciona descuentos con los proveedores de la salud que han sido contratados. Med Plan no efectúa pagos directamente a los proveedores de los servicios médicos. Los miembros de Med Plan están obligados a pagar por todos los servicios Médicos, pero recibirán un descuento de los provedores de salud que han sido contratados. 7

WELCOME We are pleased to welcome you to Med Plans Premier Plus benefits program. You can enjoy savings on your health care needs by using your new membership card, which is enclosed in your new member packet.

We help in caring for your health and your family. For your convenience we have enclosed with your membership kit a complete directory of all Med Plans contracted participating providers. Our Member Services Department is also available during business hours to assist you in locating additional providers in your area. Just call our toll-free number located on the back of you membership card, or you may go to the internet at www.floridamedplan.com at any time day or night. If your favorite provider is not already on our program, you may nominate them to Members Services for additional follow-up. Please keep in mind that your membership is NOT insurance, so it is simple and easy to use. You can begin using Med Plans complete list of services immediately as many times as needed without need of prior approvals. When you present your card with your ID to a participating provider you will have immediately access to the exclusive pricing Med Plan members receive at time of service. We also understand that your family’s health is your number one priority, so all legal dependents you have enrolled as part of your plan will receive their own card that they need to take with them to access the same pricing and services. If for any reason you are not satisfied with this program or are having problems in accessing services, pleased call the number on the back of your card for prompt response to any issue. We encourage our new members to please take a moment to familiarize yourself with the instructions in this booklet so that you can better understand how Med Plan works and what is required to access the different services. Please remember the more informed you are, the better your experience with Med Plan will be and the more often you will take advantage of the tremendous serves and exclusive pricing that Med Plan offers you. Remember your Health is the most precious gift you have. Let Med Plan help protect it.

BIENVENIDOS Nos complace darle la bienvenida a un programa de beneficios de primer nivel. Puede disfrutar de ahorros en sus necesidades de salud mediante el uso de su nueva tarjeta de membrecía, que se incluye en su paquete de nuevo miembro.

Le ayudamos en el cuidado de su salud y la de su familia Para su comodidad, le proporcionamos una guía de proveedores contratados por Med Plan que incluyen, direcciones y números de teléfono. Nuestro Departamento de Servicios también está disponible durante horas de oficina para ayudarle a encontrar proveedores en su área y ayudarlos a conseguir una cita o usted puede visitar nuestro sitio Web: www.floridamedplan.com a cualquier hora del día o llamar al (305) 262-1610 en horas laborables. Si su Doctor favorito no pertenece a nuestra Red, usted puede llamar a Med Plan al Departamento de Relación con proveedores y nosotros lo vamos a contactar, haciendo todo lo posible por lograr que se una a nuestra Red y continúe brindándole los servicios que usted se merece a través de nuestro Plan Médico. Med Plan en ningún caso le garantiza el resultado de esta Gestión. Por favor, tenga en cuenta que su membrecía NO ES UN SEGURO MEDICO, por lo que es simple y fácil de usar. Usted puede usar la tarjeta inmediatamente y tantas veces como sea necesario. Al presentar su tarjeta a usted se le aplicará inmediatamente la tarifa de descuento en el momento de la compra o servicio. En Med Plan, sabemos que la salud de su familia es su prioridad. Todos los dependientes legales podrán utilizar su tarjeta de membrecía, o solicitar tarjetas adicionales en caso de pérdida para usted o algún miembro de la familia con su propio nombre sin costo alguno, simplemente llamando al Departamento de Servicios al cliente. Si por alguna razón usted no está satisfecho con este plan, llame al número en la parte posterior de su tarjeta para su reclamo.

¡PORQUE SU SATISFACCION ESTA GARANTIZADA!

8

TERMS AND CONDITIONS 1 - Primary member is defined as the person who is responsible for the monthly payments for membership fees and is of legal age. The primary member, spouse, and all legal dependents listed on the enrollment application can access the services and exclusive pricing at Med Plan Contracted service providers. 2 - Participating provider may be added or removed from the respective network in which they are associated with. These changes are made in best interest of our members. Updated Provider information will be made available online at www. floridamedplan.com 3 - Companies contracted to provide benefits and services in this program are not a licensed insurer, health maintenance organization (HMO), or any other underwriters of healthcare services. No portion of any provider fees will be reimbursed or otherwise paid. 4 - The exclusive Med Plan pricing contained herein may not be used in conjunction with any other medical plan or discount program. All listed or quoted prices are current prices from participating providers and subject to change without notice. From time to time, certain providers may offer products and /or services to the general public at prices lower than the prices available through this program. In such event, members will be charged the lowest price. 5 - Providers are subject to change without notice and programs may vary in some states. This is a discount membership program only, not insurance, and may be discounted or modified at anytime. 6 - Savings are based upon the provider’s normal fees. Actual savings will vary depending upon location and specific services or products purchased. 7 - This discount medical plan does not warrant professional services, nor is it responsible for the quality of care provided by participating providers. 8 - (30) Day Money Back Guarantee: If you cancel for any reason within 30 days, you will receive a full refund. Nonrefundable one time fees will be disclosed at time of application. 9 - All applicable limitations, exclusions and exceptions of the discount medical plan benefits are listed with each benefit description.

TERMINOS Y CONDICIONES 1 - El titular es definido como miembro principal, siendo el responsable de los pagos mensuales y debe ser mayor de edad. Dicho titular, el cónyuge y todos los dependientes legales adicionales contaran automáticamente con los mismos beneficios que se ofrecen en el plan. 2 - En cualquier momento, un proveedor participante puede ser eliminado de la red de Med Plan. Estos cambios se realizan para beneficio de nuestros miembros. Usted encontrará esta información acualizada en el sitio web www.floridamedplan. com 3 - Las compañías proveedoras de servicios asociadas a nuestro plan no son aseguradoras, organizaciones de la salud (HMO) o evaluadores de servicios de salud. Cualqueir honorario que usted les pague a estas compañías no le será reembolsado. 4 - Los descuentos que figuran en este documento no pueden ser utilizados en combinación con cualquier otro plan de descuento médico o programa de descuentos. Todos los precios cotizados son los precios actuales de los proveedores participantes y están sujetos a cambios sin previo aviso. De vez en vez, algun proveedor puede ofrecer productos y / o servicios al público en general a precios inferiores a los precios disponibles en este programa. En tal caso, se cobrará el precio más bajo. 5 - Los proveedores están sujetos a cambios sin previo aviso, los programas pueden variar en algunos términos. Este es un programa de membrecía de descuentos, no un seguro medico, y puede ser cancelado o modificado en cualquier momento. 6 - Los ahorros se basan en las tasas normales del proveedor. Los ahorros reales variarán dependiendo de la localización de los servicios específicos o productos comprados. 7 - Este plan médico de descuentos no ofrece garantía por la calidad de los servicios profesionales brindados por los proveedores participantes. 8 - Garantía de Reembolso por 30 Días: Si cancela por cualquier razón en un plazo de 30 días, usted recibirá un reembolso completo de su mensualidad. Tasa no reembolsable se revelará en el momento de aplicación. 9 - Las limitaciones, exclusiones o excepciones que apliquen dentro este plan médico de descuentos se enumeran en la descripción de cada servicio.

9

HOW TO USE YOUR MEMBERSHIP CARD 1. Keep your membership card with you at all times so it will be easily accessible to present at provider locations. Please note that you must present your membership card so that the status of you membership can be verified before services are provided and to qualify for Med Plan exclusive price at contracted provider locations. 2. When visiting your Physician and or Specialist you must present your Med Plan membership card with a picture ID so that your eligibility can be verified at time of your visit to receive the exclusive pricing offered to Med Plan members 3. Med Plan has sent all persons covered in your plan their own membership cards. Each card has its own ID number and must be shown to the provider so that the status of you membership can be verified before services are provided. If the dependent is a minor then it is the responsibility of the “minors” parent or legal guardian to accompany the minor to all provider visits and services. 4. To locate participating providers in your area, please refer to the Provider Directory provided in your “Membership Kit”. This directory contains information on all Med Plan contracted providers including pricing for all covered services. Since providers and services are being added monthly, Med Plan has created a website for our members to view all of their membership information which includes updates and new services. To access this information online please call Med Plans “Member Service Department” and ask for them to email you your username and password. For additional provider locations, call the appropriate number on the back of your card or visit: www.floridamedplan.com 5. Please remember that Payment for all services must be made directly to the provider at time of service. 6. If you have any questions on how to use your membership, call our Member Services departments at the toll-free number listed on your card for prompt, friendly service. 7. We are located at 7200 NW 7th street Suite 100, Miami FL 33126 (305) 262-1610. Our Offices are open Monday through Friday 9:00 a.m. to 5:00 p.m.

COMO USAR SU TARJETA DE MIEMBRO Cuando usted visite a un proveedor (Ejemplo: Médico general o Especialista) usted deberá presentar su tarjeta de miembro con una identificación con fotografía (ID) para que su elegibilidad pueda ser verificada en el momento de solicitar sus servicios y pueda beneficiarse de las tarifas preferenciales exclusivas que aplican únicamente a los miembros de MedPlan. Cuando usted visite a proveedor participante usted pagará una tarifa fija preferencial que ha sido establecida para los miembros de MedPlan. Las Tarifas establecidas aparecen en este libro que ha sido incluido dentro del paquete de membrecía que usted recibió. Por favor refiérase a la sección que corresponda dentro de este directorio. Todos los servicios prestados en el consultorio de un médico de atención primaria o especialista usted lo pagará directamente en el momento de recibir los servicios. Solo los médicos y demás proveedores de la red que brindan sus servicios a nuestros miembros, honraran las tasas establecidas. Los proveedores de la red tienen en su poder las mismas tarifas que usted tiene, esto le asegura que lo que usted pagará no puedan ser alterados. MedPlan no le asigna ningún proveedor, usted es libre de elegir dentro del directorio. La información detallada para localizar a un proveedor, dirección, número telefónico, tarifa etc. se encuentra dentro del directorio médico que usted recibió. Usted puede obtener esta información en cualquier momento visitando nuestra página web: www.floridamedplan.com Para coordinar su primera cita con un proveedor de la red usted puede elegir cualquiera de las siguientes opciones: a) Llame directamente al proveedor que usted haya elegido. b) Llame a nuestro departamento de atención al cliente al (877) 334-1634 y solicite que se le coordine la cita con el doctor que usted haya elegido. En ese caso tenga a mano el nombre del doctor para que la asistencia sea efectiva y rápida en función de sus necesidades. Nos encontramos en 7200 NW 7th street Suite 100, Miami FL 33126 (305) 262-1610. Nuestras oficinas estan abieras de Lunes a Viernes de 9:00 a.m. to 5:00 p.m. 10

PRIMARY PHYSICIANS AND SPECIALISTS

All services rendered at your primary care physicians office or Specialist will be paid directly to the provider at fix rates that are completely disclosed inside this book. These prices are exclusive to Med Plan members and represent an average savings of 70% percent off the Providers Usual and customary fees. All prices cover service provided at your Physicians office which can include, routine X-rays, EKG’s, Ultrasounds and many other services. Services vary from provider to providers depending on equipment each Physician or Specialist practice elects to provide. It’s unlimited the access to Primary Care and Specialist Visits. No prior approval is needed. Physician and Specialists address and phone numbers are located inside your Membership kit or on our website www. floridamedplan.com. To schedule an appointment please call the provider you have chosen from the directory. If you need assistance or cannot find a provider near you please call our Customer Service Department for assistance at 305-262-1610. Only approved and contracted Med Plan Physicians and Specialists will honor the exclusive prices as defined in the Pricing Guide included in your membership kit. Any Diagnostic studies, Laboratory test, Prescription Medication or services ordered by a Med Plan contracted Physician or Specialist must be performed or completed by a Med Plan approved and contracted provider. This will insure that the service and its price are within the scope of the agreements Med Plan has in place with its approved service providers If you need assistance in coordinating these services please feel free to contact our Customer Service Department at 305262-1610. Note: If your favorite physician is not already a participating provider, Call our Provider Relation Department to nominate him or her. Have the physicians name, address, and telephone number available when you call.

MEDICOS PRIMARIOS Y ESPECIALISTAS Todas las tasas aplican a los servicios prestados en la oficina de los médicos que pueden incluir, rutina de Rayos X, electrocardiogramas, ecografías y muchos otros servicios. Los servicios pueden estar disponibles o no, dependiendo el equipo médico o especialista que usted pueda elegir. Tenga en cuenta que no todos reúnen las mismas condiciones de equipamiento dentro de su consulta médica. Usted cuenta con visitas médicas ilimitadas y además tendrá la libertad de visitar a cualquier médico especialista sin la necesidad de ser referido por su médico primario. Cualquier estudio de Diagnóstico, Examen de Laboratorio, Medicamentos recetados u otro servicio deberá ser indicado por un proveedor que haya sido aprobado o contratado por MedPlan. Esto asegura que el servicio que usted va a recibir y la tasa que va a pagar esta dentro de los acuerdos que MedPlan ha establecido con los proveedores de la red. Si usted necesita ayuda para coordinar estos servicios por favor contacte a nuestro departamento de servicio al cliente (877) 3341634. Nota: Si su doctor favorito aun no es participante de nuestra red y desea que se integre para que pueda continuar con sus servicios y adaptar nuestras tarifas preferenciales, por favor contacte a nuestro departamento de Relación con Proveedores y ofrezca información precisa del doctor (Nombre, Dirección y Teléfono de su oficina) nosotros nos sentiremos complacidos en contactarlo a mayor brevedad posible y lo invitaremos a que se una a nuestra Red.

11

PRIMARY PHYSICIANS / MEDICOS PRIMARIOS Primary Care Physicians / Médicos Primarios

Miami - Dade

Andres Cazau, M.D. (General Practice) (Med Plan Clinic) 7200 N.W. 7th St #202 Miami, Fl. 33126 Phone: (305) 267-7784 Price 1st Visit: $40.00 Price Follow Up. $20.00 Esperanza A. Nuñez, M.D. (General Practice) (Glez and Gonzalez Medical Center) 3804 NW 167th Street Opalocka, Fl. 33054 Phone: (305) 624-2700 Price 1st Visit: $40.00 Price Follow Up. $20.00

John Padron, M.D. (General Practice) (Opa Medical Center) 1865 NE 163th Street North Miami, Fl. 33162 Phone: (305) 948-9958 Price 1st Visit: $40.00 Price Follow Up. $20.00

Juan C. Romero, M.D. (General Practice) (C&I Medical Center) 13903 NW 67th Ave #440 Miami Lakes, Fl. 33014 Phone: (305) 824-0880 Price 1st Visit: $40.00 Price Follow Up. $20.00

Mara De Garcia, M.D. (General Practice) (C&I Medical Center) 13903 NW 67th Ave #440 Miami Lakes, Fl. 33014 Phone: (305) 824-0880 Price 1st Visit: $40.00 Price Follow Up. $20.00

Armando Segui, M.D. (General Practice) (Ambert Medical Center) 15495 Eagle Nest Ln, Suite 100 Miami Lakes, Fl. 33016 Phone: (305) 556-0021 Price 1st Visit: $40.00 Price Follow Up. $20.00

Felix A. Rodriguez, M.D. (General Practice) (American Family Health Center) 2150 W. 68th St, Suite 102 Hialeah, Fl. 33018 Phone: (305) 231-8996 Price 1st Visit: $40.00 Price Follow Up. $20.00

Miguel A. Chamah, M.D. (General Practice) 1800 West 68th St, Suite 127 Hialeah, Fl. 33014 Phone: (305) 820-0903 Price 1st Visit: $40.00 Price Follow Up. $20.00

Humberto Hernandez, M.D. (General Practice) 1435 West 49th Place, Ste 604 Hialeah, Fl. 33012 Phone: (305) 231-3151 Price 1st Visit: $40.00 Price Follow Up. $20.00

Gilda de la Calle, M.D. (General Practice) 1435 West 49th Place Suite 400-B Hialeah, Fl. 33012 Phone: (305) 823-5730 (305) 823-5738 Price 1st Visit: $40.00 Price Follow Up. $20.00

Odalys Frontela, M.D. F.A.C.P (General Practice) 801 West 48th St, Suite A Hialeah, Fl. 33012 Phone: (305) 698-7172 Price 1st Visit: $40.00 Price Follow Up. $20.00

Johspercer Anchinihm, M.D. (Family Practice) (Felicidad Medical Center) 4410 West. 16th Ave. # 55 Hialeah, Fl. 33013 Phone (305) 824-8559 Price 1st Visit: $40.00 Price Follow Up. $20.00

Lucky Flores, M.D. (General Practice) (Elite Health & Rehabilitation) 6450 West. 21 Ct, Suite 200 Hialeah, Fl. 33016 Phone: (305) 698-0806 Price 1st Visit: $40.00 Price Follow Up. $20.00

Conchita Jackson, M.D. (General Practice) (Vida Health Centers) 881 E 2nd Ave Hialeah, Fl. 33010 Phone: (305) 882-1100 Price 1st Visit: $40.00 Price Follow Up. $20.00

Maray Rocher, M.D. (General Practice) 87 E 49 ST Hialeah, Fl. 33013 Phone: (786) 536-5001 Price 1st Visit: $40.00 Price Follow Up. $20.00

Juan C. Sarol, M.D. (General Practice) 87 E 49 ST Hialeah, Fl. 33013 Phone: (786) 536-5001 Price 1st Visit: $40.00 Price Follow Up. $20.00 12

Primary Care Physicians / Médicos Primarios

13

Miami - Dade

Juan J. Salinas, M.D. (General Practice) 4212 W 16 Ave Hialeah, Fl. 33012 Phone: (305) 821-5525 Price 1st Visit: $40.00 Price Follow Up. $20.00

Viviana Pérez, M.D. (General Practice) 4410 West. 16 ave Suite 26 Hialeah, Fl. 33012 Phone: (305) 822-8883 Price 1st Visit: $40.00 Price Follow Up. $20.00

Amado Viera, M.D. (General Practice) 777 East 25th St. Suite 118 Hialeah, Fl. 33013 Phone: (305) 835-0438 Price 1st Visit: $40.00 Price Follow Up. $20.00

Ausberto Hidalgo, M.D. (Family Practice) 5590 W 20 Ave # 101 Hialeah, Fl. 33016 Phone: (305) 827-3303 Price 1st Visit: $40.00 Price Follow Up. $20.00

Edgar N Escobar, M.D. (General Practice) (Florida Care Health Center) 11300 NW 87th Court, Suite 141 Hialeah Gardens, Fl. 33018 Phone: (305) 364-8600 Price 1st Visit: $40.00 Price Follow Up. $20.00

Mayre Urdaneta, M.D. (General Practice) 8060 NW 155th Street Ste 201 Miami Lakes, Fl. 33016 Phone: (305) 826-0606 Price 1st Visit: $40.00 Price Follow Up. $20.00

Yamile Porro, M.D. (General Practice) (Private Medical Center) 10 NW 42th Avenue, Suite 300 Miami, Fl. 33126 Phone: (305) 774-0742 Price 1st Visit: $40.00 Price Follow Up. $20.00

Jose Pena, M.D. (General Practice) (Private Medical Center) 10 NW 42th Avenue, Suite 300 Miami, Fl. 33126 Phone: (305) 774-0742 Price 1st Visit: $40.00 Price Follow Up. $20.00

Conchita Jackson, M.D. (General Practice) (Private Medical Center) 10 NW 42th Avenue, Suite 300 Miami, Fl. 33126 Phone: (305) 774-0742 Price 1st Visit: $40.00 Price Follow Up. $20.00

Gretell Trullenque, M.D. (General Practice) (Acevedo Medical Group) 2525 NW 54th St. Miami, Fl. 33142 Phone: (305) 633-9090 Price 1st Visit: $40.00 Price Follow Up. $20.00

Lucky Flores, M.D. (General Practice) 5881 NW 151 St, Suite 127 Miami Lakes, Fl. 33014 Phone: (305) 827-0208 Price 1st Visit: $40.00 Price Follow Up. $20.00

Abraham A. Benchabatt, M.D. (General Practice) MD Health Care and Rehabilitation 7975 NW 154 St, Suite 200 Miami Lakes, Fl. 33016 Phone: (305) 822-2824 Price 1st Visit: $40.00 Price Follow Up. $20.00

Hector Rodriguez, M.D. (General Practice) (Acevedo Medical Group) 2525 NW 54th St. Miami, Fl. 33142 Phone: (305) 633-9090 Price 1st Visit: $40.00 Price Follow Up. $20.00

Jorge Martinez, M.D. (General Practice) (St. John Medical Center) 161 NW 29th St Miami, Fl. 33127 Phone: (305) 576-0231 Price 1st Visit: $40.00 Price Follow Up. $20.00

Juan Delgado, M.D. (Family Practice) (St. John Medical Center) 161 NW 29th St Miami, Fl. 33127 Phone: (305) 576-0231 Price 1st Visit: $40.00 Price Follow Up. $20.00

Alicia R. Mirabal, M.D. (General Practice) (Clinica Venamer) 10200 NW 25th St, Suite 114 Doral, Fl. 33172 Phone: (305) 594-6505 Price 1st Visit: $40.00 Price Follow Up. $20.00

Jose R. Martin, M.D. (General Practice) (Clinica Venamer) 10200 NW 25th St. Suite 114 Doral, Fl. 33172 Phone: (305) 594-6505 Price 1st Visit: $40.00 Price Follow Up. $20.00

Primary Care Physicians / Médicos Primarios

Miami - Dade

Milady Fernandez, M.D. (General Practice) (Clinica Venamer) 10200 NW 25th St, Suite 114 Doral, Fl. 33172 Phone: (305) 594-6505 Price 1st Visit: $40.00 Price Follow Up. $20.00

José Gil, M.D. (General Practice) (Davila Medical Center) 782 NW 42th Ave # 348 Miami, Fl. 33126 Phone: (305) 441-2760 Price 1st Visit: $40.00 Price Follow Up. $20.00

Jesús J. Cid, M.D. (General Practice) (Medical Counsulting Center) 759 NW 22 ave Miami, Fl. 33125 Phone: (305) 649-0492 Price 1st Visit: $40.00 Price Follow Up. $20.00

Jesús J. Cid, M.D. (General Practice) 711 NW 23 ave # 301 Miami, Fl. 33125 Phone: (305) 643-4797 Price 1st Visit: $40.00 Price Follow Up. $20.00

Baudilio Cuzco Prieto, M.D. (General Practice) (Complete Medical Care) 630 NW 33th Ave Miami, Fl. 33125 Phone: (305) 649-6378 Price 1st Visit: $40.00 Price Follow Up. $20.00

Mario Palomino, M.D. (General Practice) (Private Medical Center) 10 NW 42th Ave, Suite 300 Miami, Fl. 33126 Phone: (305) 774-0742 Price 1st Visit: $40.00 Price Follow Up. $20.00

Gamaliel Mattos, M.D. (General Practice) 4001 N.W. 97 ave #101 Doral, Fl. 33178 Phone: (305) 418-2233 Price 1st Visit: $40.00 Price Follow Up. $20.00

Johanne Zephir, M.D. (General Practice) (7th Ave. Medical Plaza) 10071 NW 7 ave Miami, Fl. 33150 Phone: (305) 403-7777 Price 1st Visit: $40.00 Price Follow Up. $20.00

Jon Hemstreet, M.D. (General Practice) (7th Ave. Medical Plaza) 10071 NW 7 ave Miami, Fl. 33150 Phone: (305) 403-7777 Fax: (305) 403-7700 Price 1st Visit: $40.00 Price Follow Up. $20.00

William Suarez, M.D. (General Practice) (Penalver Clinic Medical Group) 971 NW 2 ST Miami, Fl. 33128 Phone: (305) 545-7737 Price 1st Visit: $40.00 Price Follow Up. $20.00

Guillermo Somodevilla, M.D. (General Practice) (Penalver Clinic Medical Group) 971 NW 2 ST Miami, Fl. 33128 Phone: (305) 545-7737 Price 1st Visit: $40.00 Price Follow Up. $20.00

Mauricio Vargas, M.D. (General Practice) (Private Medical Center) 10 NW 42th Avenue, Suite 300 Miami, Fl. 33126 Phone: (305) 774-0742 Price 1st Visit: $40.00 Price Follow Up. $20.00

Leonardo Marquez, M.D. (General Practice) J.O. Medical Center, Inc. 42 NW 27th Avenue, Suite 303 Miami, Fl. 33125 Phone: (305) 642-7704 Price 1st Visit: $40.00 Price Follow Up. $20.00

Luis E. De Armas, M.D. (General Practice) 11373 W Flagler St. # 212 Miami, Fl. 33174 Phone: (305) 228-1919 Fax (305) 220-7730 Price 1st Visit: $40.00 Price Follow Up. $20.00

Lucky Flores, M.D. (General Practice) (Micnady Medical Office) 8820 SW 24 St Miami, Fl. 33165 Phone: (786) -391-0264 Price 1st Visit: $40.00 Price Follow Up. $20.00 14

Primary Care Physicians / Médicos Primarios

15

Miami - Dade

Mario R. Villoch, M.D. (General Practice) (AV Medical Center) 2075 SW 27 ave Suite 101 Miami, Fl. 33145 Phone: (305) 856-6081 Price 1st Visit: $40.00 Price Follow Up. $20.00

Pedro R. Caro, M.D. (General Practice) Varadero Medical Center 5850 West Flagler ST Miami, Fl. 33144 Phone: (305) 263-9590 Fax: (305) 263-9657 Price 1st Visit: $40.00 Price Follow Up. $20.00

Roberto A. Fernandez, M.D. (General Practice) Latin Foundation for Health 8260 West Flagler St. Suite 2-M Miami, Fl. 33147 Phone: (305) 228-1919 Fax (305) 228-1940 Price 1st Visit: $40.00 Price Follow Up. $20.00

Julian Guerrero, M.D. (General Practice) 8370 W. Flagler St, Suite 120 Miami, Fl. 33144 Phone: (305) 222-8365 Price 1st Visit: $40.00 Price Follow Up. $20.00

John A. Padron, M.D. (General Practice) 8370 W. Flagler St, Suite 120 Miami, Fl. 33144 Phone: (305) 222-8365 Price 1st Visit: $40.00 Price Follow Up. $20.00

Maria L. Margolles, M.D. (General Practice) (Varadero Medical Center) 5850 W. Flagler St Miami, Fl. 33144 Phone: (305) 263-9590 Price 1st Visit: $40.00 Price Follow Up. $20.00

Jorge L. Santander, M.D. (General Practice) (Leda Medical Center, Inc) 6621 SW 8th ST Miami, Fl. 33144 Phone (305) 262-4801/03 2nd Phone: (305) 262-4840 Price 1st Visit: $40.00 Price Follow Up. $20.00

Maria E. de Garcia, M.D. (General Practice) (R and R Medical Center) 2272 SW 7 St Miami, Fl. 33135 Phone: (305) 541-2191 Price 1st Visit: $40.00 Price Follow Up. $20.00

Maria Lourdes Zeno, M.D. (General Practice) Best Medical Care, Inc 920 SW 82th ave Miami, Fl. 33144 Phone: (305) 262-3999 Price 1st Visit: $40.00 Price Follow Up. $20.00

Aurelio A. Ortiz, M.D. (General Practice) 1313 SW 1th Street. Miami, Fl. 33135 Phone: (305) 541-8448 Price 1st Visit: $40.00 Price Follow Up. $20.00

Valdemir Santos, M.D. (General Practice) (ACN Physician Group) 7490 SW 23 ST #201 Miami, Fl. 33155 Phone: (786) 953-8221 Price 1st Visit: $40.00 Price Follow Up. $20.00

Shirley P. Jimenez, P.A. (General Practice) (Leda Medical Center, Inc) 6621 SW 8th ST Miami, Fl. 33144 Phone (305) 262-4801/03 2nd Phone: (305) 262-4840 Price 1st Visit: $40.00 Price Follow Up. $20.00

Hugo Romeu, M.D. (General Practice) (ABC Medical Group) 1393 SW 1th ST Suite 320 Miami, Fl. 33135 Phone: (305) 644-0977 Price 1st Visit: $40.00 Price Follow Up. $20.00

Gilda de la Calle, M.D. (General Practice) 421 SW 107th Avenue Miami, Fl. 33174 Phone: (786) 360-4219 Fax: (786) 360-4217 Price 1st Visit: $40.00 Price Follow Up. $20.00

Oscar Mendez Turino, M.D. (General Practice) Private Medical Center 1393 SW 1st street # 415 Miami Fl. 33135 Phone: (786) 953-6735 Price 1st Visit: $40.00 Price Follow Up. $20.00

Primary Care Physicians / Médicos Primarios

Miami - Dade

Isabel K. Yague, M.D. (General Practice) 1393 SW 1st street # 415 Miami Fl. 33135 Phone: (786) 953-6735 Price 1st Visit: $40.00 Price Follow Up. $20.00

Abdón S. Borges, M.D. (General Practice) 8300 SW 8th St. Suite 105 Miami, Fl. 33144 Phone: (305) 446-8236 Fax: (305) 448-7830 Price 1st Visit: $40.00 Price Follow Up. $20.00

Ramon Hechavarria, M.D. (General Practice) Private Medical Center 1393 SW 1st street # 415 Miami Fl. 33135 Phone: (786) 953-6735 Price 1st Visit: $40.00 Price Follow Up. $20.00

Alberto Gonzalez-Gomez, M.D. (General Practice) 7968 SW 8th ST Miami, Fl. 33144 Phone: (786) 332-2093 Price 1st Visit: $40.00 Price Follow Up. $20.00

Adolfo R. Martínez, M.D. (General Practice) 8480 SW 8th Street. Miami, Fl. 33144 Phone: (305) 264-1131 Fax:(305) 264-1134 Price 1st Visit: $40.00 Price Follow Up. $20.00

Rogelio O. Bardiñas, M.D. (General Practice) 747 Ponce de Leon Blv # 700 Coral Gables, Fl. 33134 Phone: (305) 441-9700 Price 1st Visit: $40.00 Price Follow Up. $20.00

Josefina Hernández, M.D. (General Practice) 8480 SW 8th Street. Miami, Fl. 33144 Phone: (305) 264-1131 Fax:(305) 264-1134 Price 1st Visit: $40.00 Price Follow Up. $20.00

Hilda M Brito M.D. (General Practice) 12260 SW 8th Street, Suite 224 Miami, Fl. 33184 Phone: (305) 220-6917 Price 1st Visit: $40.00 Price Follow Up. $20.00

Myriam Lacayo, M.D. (General Practice) The Children Medical Center Group, Inc 8300 SW 8 St, Suite # 302 Miami, Fl. 33144 Phone: (305) 225-4434 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Ramon Pichardo, M.D. (General Practice) 1393 SW 1 St Suite 415 Miami, Fl. 33135 Phone: (786) 953-6735 Price 1st Visit: $40.00 Price Follow Up. $20.00

Julio C. Rosales, M.D. (General Practice) (Hammocks Medical Center) 15122 SW 72th Street Miami, Fl. 33193 Phone: (305) 383-3848 Price 1st Visit: $40.00 Price Follow Up. $20.00

Juan Blemil Fdez. M.D, P.A. (General Practice) 13303 SW 42th Street Miami, Fl. 33175 Phone: (305) 227-6497 Price 1st Visit: $40.00 Price Follow Up. $20.00

Jorge L. Santander, M.D. (General Practice) 4080 SW 84 ave Suite D Miami, Fl. 33155 Phone (305) 2232-1140 Price 1st Visit: $40.00 Price Follow Up. $20.00

Rodolfo Vega, M.D. (General Practice) (Vega Medical Center) 3720 SW 107 ave Miami, Fl. 33165 Phone: (305) 554-4270 Price 1st Visit: $40.00 Price Follow Up. $20.00

Carlos E. Aguilar, M.D. (General Practice) (Panamerican Sports Medicine Institute of miami) 3850 SW 87 ave Ste 201 Miami, Fl. 33165 Phone: (305) 227-3350 Price 1st Visit: $40.00 Price Follow Up. $20.00 16

Primary Care Physicians / Médicos Primarios Alicia Chilito, M.D. (General Practice) (Panamerican Sports Medicine Institute of miami) 3850 SW 87 ave Ste 201 Miami, Fl. 33165 Phone: (305) 227-3350 Price 1st Visit: $40.00 Price Follow Up. $20.00

Eduardo Almaguer, M.D. (General Practice) 330 S.W 27th Ave # 404 Miami, Fl. 33135 Phone: (305) 644-9798 Price 1st Visit: $40.00 Price Follow Up. $20.00

Florence Faucauld, M.D. (Family Practice) 11010 SW 88th Street, Ste 104 Miami, Fl. 33176 Phone: (305) 595-1122 Price 1st Visit: $40.00 Price Follow Up. $20.00

Jorge L. Santander, M.D. (General Practice) 4080 SW 84 ave Suite D Miami, Fl. 33155 Phone: (305) 223-1140 Price 1st Visit: $40.00 Price Follow Up. $20.00

Francisco Macias, M.D. (General Practice) (Miami Community Health Center) 2324 SW 8 St Miami, Fl. 33135 Phone: (305) 643-0535 Price 1st Visit: $40.00 Price Follow Up. $20.00

Ramon A. Pichardo, M.D. (General Practice) (Medical Health and Research Inc) 6854 W Flagler St Miami Fl. 33144 Phone: (786) -310-7697 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Jose Martin, M.D. (General Practice) (Clinica Venamer Coral Way) 1757 SW 22 St Miami, Fl. 33145 Phone: (786) 442-1040 Price 1st Visit: $40.00 Price Follow Up. $20.00

Luis Serentill, M.D. (General Practice) (Clinica Venamer Coral Way) 1757 SW 22 St Miami, Fl. 33145 Phone: (786) 442-1040 Price 1st Visit: $40.00 Price Follow Up. $20.00

Rolando Padro, M.D. (General Practice) 15439 SW 137th Avenue Miami, Fl. 33177 Phone: (305) 259-5570 Price 1st Visit: $40.00 Price Follow Up. $20.00

Aaron B. Tuckler, M.D. (General Practice) 26799 S. Dixie Hwy Naranja, Fl. 33032 Phone: (305) 258-6070 Price 1st Visit: $40.00 Price Follow Up. $20.00

Maria C. Cubillas, M.D. (General Practice) 27543 S. Dixie Hwy Homestead, Fl. 33032 Phone: (305) 246-0047 Price 1st Visit: $40.00 Price Follow Up. $20.00

John G. Gutleber, M.D. (General Practice) 139 N.E 15th Street Homestead, Fl. 33033 Phone: (305) 247-1213 Fax: (305) 247-5701 Price 1st Visit: $40.00 Price Follow Up. $20.00

Maria Delgado, M.D. (General Practice) (Homestead Medical Clinic, M.D) 125 N.E 8th Street Homestead, Fl. 33030 Phone: (786) 243-1909 Price 1st Visit: $40.00 Price Follow Up. $20.00

Eduardo Medrano, M.D. (General Practice) (All Family Care Inc.) 38 Northwest 8th Street Homestead, Fl. 33030 Phone: (305) 246-0460 Price 1st Visit: $40.00 Price Follow Up. $20.00

Josefa L. Binker, M.D. (Family Practice) 70 NW 8 St Homestead, Fl. 33030 Phone: (305) 242-5225 Price 1st Visit: $40.00 Price Follow Up. $20.00

Rafael A. Ubeda, M.D. (Family Practice) (Leal Medical Center LLC) 925 NE 30 Terr # 206 Homestead, Fl. 33033 Phone: (305) 246-1265 Price 1st Visit: $40.00 Price Follow Up. $20.00

Julio C. Rosales, M.D. (General Practice) Kendall Medical Plaza 11880 SW 40 St # 120 Miami, Fl. 33175 Phone: (305) 225-7330 Price 1st Visit: $40.00 Price Follow Up. $20.00

17

Miami - Dade

Primary Care Physicians / Médicos Primarios

Broward

Silvia Soto, M.D. (General Practice) (Miramar Medical Center) 11904 Miramar Parkway Miramar, Fl. 33025 Phone: (954) 639-7560 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Oli Mendez, M.D. (General Practice) (Miramar Medical Center) 11904 Miramar Parkway Miramar, Fl. 33025 Phone: (954) 639-7560 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Elsa Pichardo Matos, M.D. (General Practice) (Sunset Strip Medical Center) 4269 N.W 88 ave Sunrise, Fl. 33351 Phone: (954) 578-0200 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Stacy H. Katz, M.D. (General Practice) (Broward Medical Center of Davie) 255 SE 14 St Suite C-1 Ft. Lauderdale, Fl. 33316 Phone: (954) 321-9826 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Eugene Gregorie, M.D. (General Practice) 4141 NW 5th Street, Ste 100 Plantation, Fl. 33317 Phone: (954) 486-6866 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Yaneth Trujillo, M.D. (General Practice) 2300 North Commerce Park Way Suite 301 Weston, Fl. 33326 Phone: (954) 436-8036 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Johnjairo Catano, M.D. (General Practice) 7300 W. Menab Rd Suite 112 Tamarac, Fl. 33321 Phone: (954) 718-3752 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00 Controlled Substance Call for a Schedule

Karen Gaynair, M.D. (General Practice) 4900 West Oakland Park Blv #202 Lauderdale Lakes, Fl. 33313 Phone: (954) 730-7993 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Mark Leeds, D.O. PA. (General Practice) 3500 Hollywood Blvd Hollywood, Fl. 33021 Phone: (954) 239-6060 Mon-Fri 9am to 5pm Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00 Controlled Substance Call for a Schedule

Edward Buonopane, M.D. Carolyn Zaumeyer MSN, ARPN (General Practice) (Womens Awareness) 4540 N. Federal Hwy Fort Lauderdale, Fl. 33308 Phone: (954) 791-4475 Fax: (954) 791-5652 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Emmauel Eloi, M.D. (General Practice) (Sunshine Medical & Chiropractic Care Inc) 3500 N. State Rd Suite # 211 Lauderdale Lakes, Fl. 33319 Phone: (954) 306-2056 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Marcos Zaragona, M.D. (General Practice) Vanguard Medical Group 603 N. Flamingo Road Suite #150 Pembroke Pines, Fl. 33028 Phone: (954) 436-6660 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Kishov Sheth, M.D. Vanguard Medical Group (General Practice) 100 NW 82 ave Suite # 401 Plantation, Fl. 33324 Phone: (954) 370-9402 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Shyne Golin, M.D. Vanguard Medical Group (General Practice) 100 NW 82 ave Suite # 401 Plantation, Fl. 33324 Phone: (954) 370-9402 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Primary Care Physicians / Médicos Primarios

Palm Beach

Bob M. Gairaj, M.D. Paul Murry, M.D. (General Practice) (Boca Family Practice) 7280 West Palmetto Park Rd Suite # 104 Boca Raton, Fl. 33433 Phone: (561) 391-6552 Fax: (561) 391-6285 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Pedro Sanchez, DO. (General Practice) (Basic Gynecology) (Vital Care Medical Center) 2188 Jog Road Green Acres, Fl. 33415 Phone: (561) 439-0850 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00 Mon-Fri 9 am to 8 pm Sat 9 am to 1 pm

Alfred G. Salas, M.D. (General Practice) (Internal Medicine, Geriatrics) (Vital Care Medical Center) 2188 Jog Road Green Acres, Fl. 33415 Phone: (561) 439-0850 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00 Mon-Fri 9 am to 8 pm Sat 9 am to 1 pm

Rafael Ubeda, M.D. (General Practice) (Basic Gynecology) (Johnson Medical Services) 2531 N Dixie Hwy Lake Worth, Fl. 33460 Phone: (561) 582-0330 Fax: (561) 582-0339 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Jose E. Blandon, M.D. (General Practice) (Basic Gynecology) (Johnson Medical Services) 2531 N Dixie Hwy Lake Worth, Fl. 33460 Phone: (561) 582-0330 Fax: (561) 582-0339 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Alfonso Ramirez, M.D. (General Practice) (Basic Gynecology) (Johnson Medical Services) 2531 N Dixie Hwy Lake Worth, Fl. 33460 Phone: (561) 582-0330 Fax: (561) 582-0339 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Marco Fabregas, M.D. (General Practice) (Basic Gynecology) (Johnson Medical Services) 2531 N Dixie Hwy Lake Worth, Fl. 33460 Phone: (561) 582-0330 Fax: (561) 582-0339 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Primary Care Physicians / Médicos Primarios

Lee

Varghese E. Mathai, M.D. (General Practice) (Region Medical Center) 3900 Broadway Unit 1 Bldg A Fort Myers, Fl. 33976 Phone: (239) 288-5413 Fax: (239) 288-5418 Price 1st Visit: $ 40.00 Price Follow Up: $ 20.00

Gynecology & Obstetrics / Ginecología y Obstetricia Esperanza A. Nuñez M.D. (OB)-(GYN) (Glez. and Glez. Medical Center) 3804 NW 167th Street. Opa-Locka, Fl. 33054 Phone: (305) 624-2700 Price 1st Visit: $60.00 Price Follow Up. $40.00

Conchita Jackson, M.D.(GYN)) (Private Medical Center) 10 NW 42 Ave Suite 300 Miami, Fl. 33126 Phone: (305) 774-0742 Price 1st Visit: $60.00 Price Follow Up. $40.00

Miami - Dade Ramon Hechavarria, M.D.(GYN) (Private Medical Center) 10 NW 42 Ave Suite 300 Miami, Fl. 33126 Phone: (305) 774-0742 Price 1st Visit: $60.00 Price Follow Up. $40.00 19

Gynecology & Obstetrics / Ginecología y Obstetricia

Miami - Dade

Matias Guerra M.D. (OB-GYN). (ST. John Medical Center) 161 NW 29th Street Miami, Fl. 33121 Phone: (305) 576-0231 Price 1st Visit: $60.00 Price Follow Up. $40.00

Tomas Seville, M.D. (OB-GYN). (Holistic Medical Center) 5040 NW 7th street Suite 300 Miami Fl. 33126 Phone: (305) 448-8557 / 397-7230 Price 1st Visit: $60.00 Price Follow Up. $40.00

Carlos Roig M.D. (Medical Consulting Center) 759 NW 22 ave Miami , Fl. 33125 Phone: (305) 649-0492 Price 1st Visit: $60.00 Price Follow Up. $40.00

Remberto Santos, M.D. (OB) - (GYN) (Penalver Clinic Medical Group) 971 NW 2 ST Miami, Fl. 33128 Phone: (305) 545-7737 Price 1st Visit: $60.00 Price Follow Up. $40.00

Laura Dean Albuja, ARPN (Ginecology) (Penalver Clinic Medical Group) 971 NW 2 ST Miami, Fl. 33128 Phone: (305) 545-7737 Price 1st Visit: $60.00 Price Follow Up. $40.00

Emilio Blanco, M.D. (OB) - (GYN) (Vida Health Centers) 881 East 2nd ave Hialeah Fl. 33010 Phone: (305) 882-1100 Price 1st Visit: $60.00 Price Follow Up. $40.00

Eduardo Lavado, M.D. (OB-GYN) 4160 W. 16 Avenue, Ste 406 Hialeah, Fl. 33012 Phone: (305) 822-4561 Price 1st Visit: $60.00 Price Follow Up. $40.00

Esperanza A. Nuñez M.D. (OB)-(GYN) 1840 W 49th ST Ste # 420 Hialeah, Fl. 33012 Phone: (305) 823-3000 Price 1st Visit: $60.00 Price Follow Up. $40.00

Julio A. Diaz-Jane, M.D. (Ginecology/Obstetrics) 4201 Palm Ave Suite 2A Hialeah, Fl. 33012 Phone: (305) 822-8123 Price 1st Visit: $60.00 Price Follow Up. $40.00

Fernando Lora, M.D. (Gynecololy) (Vital Medical Center) 8300 W Flagler, Suite 175 Miami, Fl. 33144 Phone: (305) 220-0300 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Rolando Padro, M.D. (OB) - (GYN) 15439 SW 137 Avenue Miami, Fl. 33177 Phone: (305) 259-5570 Price 1st Visit: $60.00 Price Follow Up. $40.00

Carlos Verdeza, M.D. (Gynecology) 13780 SW 26th St Suite 203 Miami, Fl. 33175 Phone: (305) 553-8033 Price 1st Visit: $60.00 Price Follow Up. $40.00

Josefa L. Binker, M.D. (Gynecology) 70 NW 8 St Homestead, Fl. 33030 Phone: (305) 242-5225 Price 1st Visit: $60.00 Price Follow Up. $40.00

Gynecology / Ginecología Edward Buonopane, M.D. (Gynecology) (Womens Awareness) 4540 N. Federal Hwy Fort Lauderdale, Fl. 33308 Phone: (954) 791-4475 Fax: (954) 791-5652 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

20

Broward Carolyn Zaumeyer MSN, ARPN (Gynecology) (Womens Awareness) 4540 N. Federal Hwy Fort Lauderdale, Fl. 33308 Phone: (954) 791-4475 Fax: (954) 791-5652 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Pediatrics / Pediatría

Miami - Dade

Yamile Porro, M.D. (Pediatrics 7 and Up) (Private Medical Center) 10 NW 42th Avenue, Suite 300 Miami, Fl. 33126 Phone: (305) 774-0742 Price 1st Visit: $40.00 Price Follow Up. $30.00

Olabisi Oyadiran, M.D. (Pediatrician / Pediatra) 99 NW 183 St, Suite 114 Miami Gardens, Fl. 33169 Phone: (305) 625-4100 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Miriam Estévez, M.D. (Pediatrician / Pediatra) St. John medical Center 161 NW 29th ST Miami, Fl. 33127 Phone: (305) 576-0231 (786) 230-6127 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Armando Segui, M.D. (Pediatrician / Pediatra) (Ambert Medical Center) 15495 Eagle Nest Ln, Suite 100 Miami Lakes, Fl. 33016 Phone: (305) 305-556-0021 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Jorge L. Alsina, M.D. (Pediatrician / Pediatra) 4980 W. 10 Ave. Suite, 204 Hialeah, Fl. 33012 Phone: (305) 556-4447 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Ausberto Hidalgo, M.D. (Pediatrician / Pediatra) 5590 W 20 Ave # 101 Hialeah, Fl. 33016 Phone: (305) 827-3303 Price 1st Visit: $40.00 Price Follow Up. $30.00

Armando Acevedo, M.D. (Pediatrician / Pediatra) (Acevedo Medical Group) 2525 NW 54th Street. Miami, Fl. 33142 Phone: (305) 633-9090 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Juan Del Sol, M.D. (Pediatrician / Pediatra) (ST. John Medical Center) 161 NW 29th Street Miami, Fl. 33127 Phone: (305) 576-0231 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Ivette Valle, M.D. (Pediatrician / Pediatra) (ST. John Medical Center) 161 NW 29th Street Miami, Fl. 33127 Phone: (305) 576-0231 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Eduardo Díaz, M.D. (Pediatrician / Pediatra) 5703 NW 7 ST Miami, Fl. 33126 Phone: (305) 267-3462 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Jorge Cabrera, M.D. (Pediatrician / Pediatra) (Penalver Clinic Medical Group) 971 NW 2 ST Miami, Fl. 33128 Phone: (305) 545-7737 Price 1st Visit: $40.00 Price Follow Up. $30.00

Hilda M. Brito, M.D. (Pediatrician / Pediatra) 12260 SW 8th Street, Suite 224 Miami, Fl. 33184 Phone: (305) 220-6917 Price 1st Visit: $40.00 Price Follow Up. $30.00

Gloria López, M.D. (Pediatrician / Pediatra) 747 Ponce de Leon Blv, Ste 607 Coral Gables, Fl. 31334 Phone: (305) 443-2324 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Rodolfo Sidron, M.D. (Pediatrician / Pediatra) 7285 W Flagler St Miami, Fl. 33144 Phone: (786) 388-9877 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Luis E. De Armas, M.D. Pediatric 11373 W Flagler St. # 212 Miami, Fl. 33174 Phone: (305) 228-1919 Fax (305) 220-7730 Price 1st Visit: $40.00 Price Follow Up. $30.00

Johanne Zephir, M.D. (Pediatrician/Pediatra) (7th Ave. Medical Plaza) (0 and Up) 10071 NW 7 ave Miami, Fl. 33150 Phone: (305) 403-7777 Price 1st Visit: $40.00 Price Follow Up. $30.00

Jon Hemstreet, M.D. (Pediatrician/Pediatra) (7th Ave. Medical Plaza) (0 and Up) 10071 NW 7 ave Miami, Fl. 33150 Phone: (305) 403-7777 Fax: (305) 403-7700 Price 1st Visit: $40.00 Price Follow Up. $30.00

Otneil Hernandez, DNP, ARNP. (Pediatrician/Pediatra) 4410 West. 16th Ave. # 55 Hialeah, Fl. 33013 Phone (305) 824-8559 Price 1st Visit: $40.00 Price Follow Up. $30.00

Pediatrics / Pediatría

Miami - Dade

Pedro C. Reimon, M.D. (Child Obesity Specialist) 13155 SW 42nd Street Ste 106 Miami Fl. 33175 Phone: (305) 220-1310 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Maria I. Delgado, M.D. (Pediatrician / Pediatra) 7815 SW 24th street, Suite 106 Miami, Fl. 33155 Phone: (305) 262-2467 Price 1st Visit: $40.00 Price Follow Up. $30.00

Rodolfo B. Ferretti M.D. (Pediatrician / Pediatra) 7765 SW 87 Avenue Suite 209 Miami, Fl. 33173 Phone: (305) 595-0429 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Juan Ruiz, M.D. (Pediatrician / Pediatría) 8900 SW 24 ST #204 Miami, Fl. 33165 Phone: (305) 554-6666 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Lazaro de la C. Nunez, M.D. (Pediatrician / Pediatría) (Medical Health and Research Inc) 6854 W Flagler St Miami Fl. 33144 Phone: (786) -310-7697 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Myriam Lacayo, M.D. (Pediatrician / Pediatría) The Children Medical Center Group, Inc 8300 SW 8 St, Suite # 302 Miami, Fl. 33144 Phone: (305) 225-4434 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Francisco Martinez, M.D. (Pediatrician / Pediatra) 15122 SW 72th ST Miami, Fl. 33193 Phone: (305) 383-3848 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Dorses Goosby, M.D. (Pediatrician / Pediatría) (Pediatric Ass. of Florida) 151 N.W 11th St. Ste E-202 Homestead, Fl. 33030 Phone: (305) 245-3220 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Alfredo Machado, M.D. (Pediatrician / Pediatría) (Pediatric Ass. of Florida) 151 N.W 11th St. Ste E-202 Homestead, Fl. 33030 Phone: (305) 245-3220 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Milady Fernandez, M.D. (Pediatrician / Pediatra) (All Family Care Inc.) 38 Northwest 8 Street Homestead, Fl. 33030 Phone: (305) 246-0460 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Marta Delgado, M.D. (Pediatrician / Pediatría) (Homestead Medical Clinic PA) 125 NE 8th St # 6 Homestead, Fl. 33030 Phone: (786) 243-1909 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Pediatrics / Pediatría

22

Broward

Yuelice Villamar, M.D. (Sacred Hearth Medical) (Pediatrician / Pediatra) 17901 N.W. 5 St. # 205 Pembroke Pines, Fl. 33029 Phone: (954) 392-0333 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Ausberto Hidalgo, M.D. (Pediatrician / Pediatra) (Pines Professional Campus) 302 NW 179 St # 103 Pembroke Pines, Fl. 33029 Phone: (954) 442-8888 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Neelan Seth, M.D. (Pediatrician / Pediatra) 2929 University Dr. Coral Spring, Fl. 33065 Phone: (954) 510-7900 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Emmauel Eloi, M.D. (Pediatrician / Pediatra) (0 through 18 years old) (Sunshine Medical & Chiropractic care Inc) 3500 N. State Rd Suite # 211 Lauderdale Lakes, Fl. 33319 Phone: (954) 766-4233 Fax: (954) 306-2056 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Dibanni Vazquez, M.D. (Pediatrician / Pediatra) (Pines Professional Campus) 302 NW 179 St # 103 Pembroke Pines, Fl. 33029 Phone: (954) 442-8888 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Pediatrics / Pediatría

Palm Beach

Bradley J. Bradford, M.D. (Pediatrician / Pediatra) (Pediatrics by the Sea) 285 SE 5th Ave Delray Beach, Fl. 33483 Phone: (561) 272-8991 Fax: (561) 272-8985 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Kenia Martinez, M.D. (Pediatrician / Pediatra) (Pediatrics by the Sea) 285 SE 5th Ave Delray Beach, Fl. 33483 Phone: (561) 272-8991 Fax: (561) 272-8985 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Pedro Sanchez, DO. (Pediatrician / Pediatra) (11 and Up) (Vital Care Medical Center) 2188 Jog Road Green Acres, Fl. 33415 Phone: (561) 439-0850 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00 Mon-Fri 9 am to 8 pm Sat 9 am to 1 pm

Jose E. Blandon, M.D. (Pediatrics 6 and Up) (Johnson Medical Services) 2531 N Dixie Hwy Lake Worth, Fl. 33460 Phone: (561) 582-0330 Fax: (561) 582-0339 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Rafael Ubeda, M.D. (Pediatrics 6 and Up) (Johnson Medical Services) 2531 N Dixie Hwy Lake Worth, Fl. 33460 Phone: (561) 582-0330 Fax: (561) 582-0339 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Alfonso Ramirez, M.D. (Pediatrics 6 and Up) (Johnson Medical Services) 2531 N Dixie Hwy Lake Worth, Fl. 33460 Phone: (561) 582-0330 Fax: (561) 582-0339 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Marco Fabregas, M.D. (Pediatrics 6 and Up) (Johnson Medical Services) 2531 N Dixie Hwy Lake Worth, Fl. 33460 Phone: (561) 582-0330 Fax: (561) 582-0339 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Pediatrics / Pediatría

Collier

Héctor Cordero, M.D. (Pediatrician / Pediatra) 1090 6th Ave N Naples, Fl. 34102 Phone: (239) 213-9200 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Pediatrics / Pediatría Varghese E. Mathai, M.D. (Pediatrician / Pediatra) (Region Medical Center) 3900 Broadway Unit 1 Bldg A Fort Myers, Fl. 33976 Phone: (239) 288-5413 Fax: (239) 288-5418 Price 1st Visit: $ 40.00 Price Follow Up: $ 30.00

Lee

MEDICAL CENTERS / CENTROS MEDICOS

MED PLAN CLINIC

7200 N.W 7Th Street, Suite 202 Miami, Fl. 33126

305-267-7784

A Clinic For Our

MED PLAN MEMBERS

UNA CLINICA PARA NUESTROS MIEMBROS

Med/Plan members will receive excellent health services aimed at detecting and preventing diseases by means of

PREVENTIVE MEDICINE Nuestros miembros cuentan con excelentes servicios de salud especialmente pensados para detectar y prevenir a tiempo enfermedades mediante la

MEDICINA PREVENTIVA

25

Medical Centers / Centros médicos

26

Miami - Dade

Private Medical Center. (Medical Center Family) 10 NW 42th Ave. Suite 300 Miami, Fl. 33126 Phone: (305) 774-0742 Services / Servicios: General Medicine, Ginecology Pediatric, Cardiology, Dermathology, Internal Medicine, Minor Surgery, Diagnostic Services, Holter Monitors, Immigration Exams $60, Work Physicals, Transportation (Call the Clinic for the fee), Pharmacy.

Felicidad Medical Center (Medical Center Family) 4410 West. 16th Ave. # 55 Hialeah, Fl. 33013 Phone (305) 824-8559 Services / Servicios: General Medicine, Internal Medicine, Loss Weight, Ultrasound Laboratory, Physical Therapy.

Vida Health Medical Center. (Medical Center Family) 881 East 2 ave Hialeah, Fl. 33010 Phone: (305) 882-1100 Services / Servicios: General Medicine, Surgery, Angiology, Gastroenterology, Gynecology and Psychiatry

Medical Counsulting Center. (Medical Center Family) 759 NW 22 ave Miami , Fl. 33125 Phone: (305) 649-0492 Services / Servicios: General Medicine, .Ginecology Physicial Therapy

Florida Care Health Center. (Medical Center Family) 11300 NW 87th Court, Ste 141 Hialeah Gardens, Fl. 33018 Phone: (305) 364-8600 Fax: (305) 364-8604 Services / Servicios: General Medicine

Complete Medical Care. (Medical Center Family) 630 NW 33 Avenue Miami, Fl. 33125 Phone: (305) 649-6378 Services / Servicios: General Medicine

Acevedo Medical Group. (Medical Center Family) 2525 NW 54th Street Miami, Fl. 33142 Phone: (305) 633-9090 Fax: (305) 633-9383 Services / Servicios: General Medicine

C&I Medical Center. (Medical Center Family) 13903 NW 67th Ave #440 Miami Lakes, Fl. 33014 Phone: (305) 824-0880 Services / Servicios: General Medicine

Gonzalez and Gonzalez. (Medical Center Family) 3804 NW 167th Street. Opa-Locka Fl. 33054 Phone: (305) 624-2700 Fax: (305) 624-3154 Services / Servicios: General Medicine, Psychiatrist Psiquiatry, Gynecology

Ambert Medical Center. (Medical Center Family) 15495 Eagle Nest Ln Suite 100 Miami Lakes, Fl. 33016 Phone: (305) 556-0021 Services / Servicios: General Medicine Pediactrics

St. John Clinic Medical Center. (Medical Center Family) 161 NW 29th Street. Miami, Fl. 33127 Phone: (305) 576-0231 Services / Servicios: General Medicine, Pediatric Podiatric, Cardiovascular Gynecology, Orthopedic

Medical Centers / Centros médicos

Miami - Dade

J.O. Medical Center. (Medical Center Family) 42 NW 27 ave Ste 303 Miami, Fl. 33125 Phone: (305) 642-7704 Services / Servicios: General Medicine

California Club Medical Center. (Medical Center Family) 790 Ives Dary Rd. North Miami Beach, Fl. 33179 Phone: (305) 405-0365 Services / Servicios: Internal Medicine

Opa Medical Center. (Medical Center Family) 1865 NE 163th Street. Miami, Fl. 33162 Phone: (305) 948-9958 Services / Servicios: General Medicine Gynecology and Minor Surgery

Holistic Medical Center (Family Medicine) 5040 NW 7th Street, Suite 300 Miami, Fl. 33126 Phone: (305) 448-8557 Services / Servicios: General Medicine, Gynecology Ophthalmology

Latin Foundation for Health. (Medical Center Family) 8260 West Flagler Street, Suite 2-M Miami, Fl. 33147 Phone: (305) 228-1919 Fax: (305) 228-1940 Services / Servicios: General Medicine, Alergyst

Universal Community Mental Care. (Medical Center Family) 928 SW 82 Ave. Miami, Fl. 33144 Phone: (305) 265-5744 Fax: (305) 265-5745 General Medicine, Internal Medicine Psyquiatry, Psychologist, Neurology, Pain Management, Podiatry

Hammocks Medical Center. (Medical Center Family) 15122 SW 72 Street. Miami Fl. 33193 Phone: (305) 383-3848 Services / Servicios: General Medicine Pediactrics

ACN Physician Group 7490 SW 23 St, Ste 201 Miami, Fl. 33155 Phone: (786) 953-8221 Services / Servicios: General Medicine

Delgado Pediatrics After Hours PA. (Medical Center Family) 7815 SW 24th Street, Suite 106 Miami, Fl. 33155 Phone: (305) 262-2467 Services / Servicios: Pediactric

Anchor Medical Center. (Medical Center Family) 12781 SW 40th St # H Miami, Fl. 33175 Phone: (305) 229-3990 Fax: (305) 229-3880 Services / Servicios: General Medicine

ABC Medical Group. (Medical Center Family) 1393 SW 1st Street, Suite 320 Miami Fl. 33135 Phone: (305) 644-0977 General Medicine, Psychiatry, Psychology, Physicial Therapy Ophthalmology, Dental, Podiatry, Optical

Miami Community Health Center (Medical Center Family) 2324 SW 8 ST Miami, Fl. 33135 Phone: (305) 643-0535 (305) 767-5635 Fax: (305) 642-9360 Services / Servicios: General Medicine, Basic Ginecology Psychologist, Psychiatry, Podiatry.

All Family Care Inc. (Medical Center Family) 38 NW 8th Street. Homestead, Fl. 33030 Phone: (305) 246-0460 Services / Servicios: General Medicine Pediactrics

Pediatrics Ass. of South Florida. 151 N.W 11th Street, Suite E-202 Homestead, Fl. 33030 Phone: (305) 245-3220 Fax: (305) 247-5849 Services / Servicios: Pediactrics

Homestead Medical Clinic PA. (Medical Center Family) 125 NE 8th Street, Suite 6 Homestead, Fl. 33030 Phone: (786) 243-1909 Services / Servicios: General Medicine Pediactrics

27

Medical Centers / Centros médicos Emeril Health Medical Center. 4330 Sheridan Street, Suite 102 Hollywood, Fl. 33021 Phone: (954) 987-4455 Fax: (954) 964-7342 Services / Servicios: Internal Medicine

Pines Care Medical Center, LLC. 301 NW 103 Ave, # 235 Pembroke Pines, Fl. 33026 Phone: (954) 251-1497 Fax: (954) 404-9537 Services / Servicios: General Medicine Internal Medicine

Miramar Medical Center. 11904 Miramar Parkway Miramar, Fl. 33025 Phone: (954) 639-7560 Fax: (954) 639-7563 Services / Servicios: Medicina Interna, General Medicine, Rayos X Cardiology, Endocrinology Ultrasound

Sunset Strip Medical Center. 4269 N.W.88 ave Sunrise Fl. 33351 Phone: (954) 578-0200 Services / Servicios: General Medicine, Gynecology

Broward Medical Center of Davie. 255 SE 14 St Suite C-1 Ft. Lauderdale, Fl. 33316 Phone: (954) 321-9826 Fax: (954) 321-9660 Services / Servicios: General Medicine

Urgent Care Center. (UrgentMed) 2337 S. University Drive Davie, Fl. 33324 Phone: 954-423-9234 Fax: (954) 423-9231 French, Italian & Creole Services / Servicios: General Medicine

Medical Centers / Centros médicos Naples Health Care Inc. Martha R. Fernandez, M.D. (General Medicine & Gynecology) 4947 Tamiami Trail North Suite 206 Naples Fl. 34103 Phone: (239) 304-9290 SERVICES / SERVICIOS: Multi Specialist Practice, General Medicine, Gynecology Podiatry, Physical Therapy

Naples Health Care Inc. Angel Garcia, D.P.M. (Podiatry) 4947 Tamiami Trail North Suite 206 Naples Fl. 34103 Phone: (239) 304-9290 SERVICES / SERVICIOS: Multi Specialist Practice, General Medicine, Gynecology Podiatry, Physical Therapy

Medical Centers / Centros médicos

28

Broward

Del Prado Medical Center. Martha R. Fernandez, M.D. (General Medicine) 2500 Del Prado Blvd South Cape Coral Fl. 33954 Phone: (239) 772-1194 / 1195 Services / Servicios: Multi Specialist Practice General Medicine, Gynecology, Podiatry Podiatría, Physical Therapy

Del Prado Medical Center. Nelson Gonzalez, M.D. (Podiatry) 2500 Del Prado Blvd South Cape Coral Fl. 33954 Phone: (239) 772-1194 / 1195 Services / Servicios: Multi Specialist Practice General Medicine, Gynecology, Podiatry Podiatría, Physical Therapy

Del Prado Medical Center. Calixto Garcia, M.D. (Psychologist) 2500 Del Prado Blvd South Cape Coral Fl. 33954 Phone: (239) 772-1194 / 1195 Services / Servicios: Multi Specialist Practice General Medicine, Psychologist Gynecology, Podiatry Podiatría, Physical Therapy

The Medical Center of Lehigh Acres. 1303 Homestead Rd. North, Suite 102 Lehigh Acres, Fl. 33936 Phone: (239) 303-2700 Services / Servicios: General Medicine, Internal Medicine Psychiatry, OB-GYN, Chiropractor Laser Therapy, Therapeutic massage Acupuncture and Radiology.

Collier Naples Health Care Inc. Calixto Garcia, M.D. (Psychologist) 4947 Tamiami Trail North Suite 206 Naples Fl. 34103 Phone: (239) 304-9290 SERVICES / SERVICIOS: Multi Specialist Practice, General Medicine, Gynecology Podiatry, Physical Therapy

Lee / Cape Coral Del Prado Medical Center. Luis Martinez, M.D. (Ginecology) 2500 Del Prado Blvd South Cape Coral Fl. 33954 Phone: (239) 772-1194 / 1195 Services / Servicios: Multi Specialist Practice General Medicine, Gynecology, Podiatry Podiatría, Physical Therapy

SPECIALIST PHYSICIANS / ESPECIALISTAS

Angiology / Angiólogo

Miami-Dade Abdón S. Borges, M.D. (Angiology / Angíologo) 8300 West Flagler St. Suite 105 Miami, Fl. 33144 Phone: (305) 446-8236 Price: 1st. Visit $ 80.00 Follow Up: $ 50.00

Alergist /Alergista

Miami-Dade Roberto A. Fernandez, M.D. (Latin Foundation for Health) 8260 West Flagler Street, Suite 2-M Miami, Fl. 33144 Phone: (305) 228-1919 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Vicente A. Chavarria, M.D (Alergist / Alergista) 1840 W. 49th Street, Suite 515 Hialeah, Fl. 33012 Phone: (305) 670-7006 Price: 1st. Visit $ 80.00 Follow Up: $ 50.00

Vicente A. Chavarria, M.D (Alergist / Alergista) 7400 N. Kendall Dr., Suite 204 Miami, Fl. 33156 Phone: (305) 670-7006 Price: 1st. Visit $ 80.00 Follow Up: $ 50.00

Anesthesiology / Anestesiólogo Lazaro R. Martinez, M.D. (Pain Management) (Universal Comunity Mental Care) 928 SW 82 Ave. Miami, Fl. 33144 Phone: (305) 265-5744 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Miami-Dade

Manuel A. Barbeito, M.D. (Pain Management) (South Florida Institute of Pain Management) 9370 Sunset Dr. Suite A-150 Miami, Fl. 33173 Phone: (305) 663-6681 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00 29

Cardiology / Cardiólogo

Miami-Dade

Mario R. Villoch, M.D. (Cardiologist / Cardiólogo) (AV Medical Center) 2075 SW 27 ave #101 Miami, Fl. 33145 Phone: (305) 856-6081 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Francisco Dieguez, M.D. (Cardiologist / Cardiólogo) 1435 West 49 Place, Suite 500 Hialeah, Fl. 33012 Phone: (305) 575-1776 Fax: (305) 575-1780 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Michelle Malow, M.D. (Cardiologist / Cardiólogo) (St. John Medical Center) 161 NW 29 Street. Miami, Fl. 33127 Phone: (305) 576-0231 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Mauricio Vargas, M.D. (Cardiologist / Cardiólogo) (7 years and Up) (Private Medical Center) 10 NW 42 Ave Suite 300 Miami, Fl. 33126 Phone: (305) 774-0742 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Guido A. Perez, MD (Cardiovascular Disease) 8756 SW 8 St, Miami, Fl. 33174 (Phone: (305) 554-1819 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Melvin Martinez-Castrillon, M.D. (Cardiologist / Cardiólogo) 3661 South Miami Ave # 902 Miami, Fl. 33133 Phone: (305) 856-7636 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Cardiology / Cardiología Mian Hasan, MD (Cardiology / Cardiología) 603 N Flamingo Road #150 Pembroke Pine, Fl. 33028 (Phone: (954) 436-6660 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

30

Broward Maximo Fernandez, MD (Cardiology / Cardiología) 603 N Flamingo Road #150 Pembroke Pine, Fl. 33028 Phone: (954) 436-6660 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Luis Tami, M.D. (Cardiology / Cardiologia) (Miramar Medical Center) 11904 Miramar Parkway Miramar, Fl. 33025 Phone: (954) 639-7560 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Chiropractor / Quiropráctico

Aixa Goodrich, D.C. (Chiropractor) 7990 SW 117 Ave Suite 205 Miami, Fl. 33183 Phone: (305) 271-7447 Fax: (305) 271-7448 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Maria Del Campillo, DC. (Chiropractor) 3625 NW 82nd Ave. Suite 320 Doral, Fl. 33166 Phone: (305) 593-1555 Fax: (305) 593-1556 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Yolaris Garcia, DC. (Chiropractor) 11730 Biscayne Blv. #104 North Miami, Fl. 33181 Phone: (305) 981-0899 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Anthony Jones, DC. (Chiropractor) MD Health Care and Rehabilitation 7975 NW 154 St # 200 Miami Lakes, Fl. 33016 Phone: (305) 822-2824 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Chiropractor / Quiropráctico

Miami - Dade

Dennis Kogut, DC. (Chiropractor) 9999 NE 2nd ave Ste # 303 Miami Shores, Fl. 33138 Phone: (305) 978-7680 Fax: (305) 757-6220 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Broward

Jan Scott Buchholz, D.C. (Chiropractor) (Hands On Healthcare) 2901 West Oakland Park Blvd, Suite A-23 Ft. Lauderdale, Fl. 33311 Phone: (954) 731-8097 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Chiropractor / Quiropráctico Charles Wolter, D.C. (Chiropractor) (Region Medical Center) 3900 Broadway Unit 1 Bldg A Fort Myers, Fl. 33976 Phone: (239) 288-5413 Fax: (239) 288-5418 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Lee

Cosmetic Surgery / Cirugía Cosmética

Miami - Dade

Constantine N. Kitsos, M.D. (Board certified plastic surgeon) (Seduction Cosmetic Center) 2500 NW 107 Ave #102 Doral, Fl. 33172 Phone: (305) 406-9055 (See price list, Page 94)

Camille Chavez, M.D. (Board certified plastic surgeon) (Seduction Cosmetic Center) 2500 NW 107 Ave #102 Doral, Fl. 33172 Phone: (305) 406-9055 (See price list, Page 94)

Horacio Leyva, M.D. (Board Certified Plastic Surgeon) (Seduction Cosmetic Center) 2500 NW 107 Ave #102 Doral, Fl. 33172 Phone: (305) 406-9055 (See price list, Page 94)

Patrick Abuzeni, M.D. (Board certified plastic surgeon) (Seduction Cosmetic Center) 2500 NW 107 Ave #102 Doral, Fl. 33172 Phone: (305) 406-9055 (See price list, Page 94)

Manuel Lopez Prieto, M.D. (Board certified plastic surgeon) (Seduction Cosmetic Center) 2500 NW 107 Ave #102 Doral, Fl. 33172 Phone: (305) 406-9055 (See price list, Page 94)

Carlos Verdeza, M.D. P.A. (Board certified plastic surgeon) 13780 SW 26th St Suite 203 Miami, Fl. 33175 Phone: (305) 553-8033 (See price list, Page 94)

Armando Pineda, M.D. (Board certified plastic surgeon) (Juventus Cosmetic) 920 SW 82 Ave #102 Miami, Fl. 33144 Phone: (305) 262-3999 (See price list, Page.94)

Luis A. Ramirez, M.D. (Board certified plastic surgeon) (Juventus Cosmetic) 920 SW 82 Ave #102 Miami, Fl. 33144 Phone: (305) 262-3999 (See price list, Page 94)

Siddharth Singh Bass, M.D. (Board certified plastic surgeon) (Juventus Cosmetic) 920 SW 82 Ave #102 Miami, Fl. 33144 Phone: (305) 262-3999 (See price list, Page 94)

Julio L. Arronte, M.D. (Board certified plastic surgeon) (Juventus Cosmetic) 920 SW 82 Ave #102 Miami, Fl. 33144 Phone: (305) 262-3999 (See price list, Page 94)

PARADISUS MEDICAL CENTER 4410 West 16 Ave Suite 55 Hialeah, Fl. 33012 Phone: 305 - 824 - 8559 / 8561 (See price list, Page 95)

As a provider of Med Plan, Seduction Cosmetic Center will like to offer all MedPlan clients as of August 10, 2011 the Lap Band System at a promotional price of $8,500.00. This offer is only valid till December 31,2012. Como proveedor de Med Plan, Seduction Cosmetic Center se complace en ofrecer a todos los miembros de Med Plan, a partir del 10 de Agosto de 2011, el sistema de banda gástrica por un precio promocional de $8,500.00. Esta oferta estará disponible solamente hasta el 31 de Diciembre de 2012.

Dermatology / Dermatología

Miami - Dade

Jose E. Mendez, D.O. (Dermatology) 1435 W 49 Place # 702 Hialeah, Fl. 33121 Phone: (305) 828-7504 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Jaime Garcia, M.D. (Dermatology) 935 West 49 St #107 Hialeah, Fl. 33012 Phone: (305) 827-2268 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Mauricio Vargas, M.D. (Dermatology) (7 years and Up) (Private Medical Center) 10 NW 42 Ave Suite 300 Miami, Fl. 33126 Phone: (305) 774-0742 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Maria Cartaya, M.D. (Dermatology) 7805 Coral Way, Suite 131 Miami, Fl. 33175 Phone: (305) 261-4474 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Hector Wiltz, M.D. (Dermatology) 11760 SW 40th Street Ste 451 Miami Fl. 33175 Phone: (305) 227-9233 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Hector Wiltz, M.D. (Eric W. Bussear M.P.H , PA-C) (Dermatology) 7400 N. Kendall Drive Suite 411 Miami Fl. 33156 Phone: (305) 670-0178 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Hector Wiltz, M.D. (Eric W. Bussear M.P.H, PA-C) (Dermatology) 151 NW 11 Street, Suite W-201 Homestead Fl. 33030 Phone: (305) 245-1332 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Josefa L. Binker, M.D. (Dermatology) 70 NW 8 St Homestead, Fl. 33030 Phone: (305) 242-5225 Price 1st Visit: $60.00 Price Follow Up. $40.00

Dermatology / Dermatología

Broward

Jose E. Mendez, D.O. (Dermatology) 12600 Pembroke Road # 312 Miramar, Fl. 33027 Phone: (954) 431-7681 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Endocrinology / Endocrinología Carlos Barrera, M.D. (Endocrinology) 7400 North Kendall Dr., Suite 617 Miami, Fl. 33156 Phone: (305) 670-0576 Price 1st Visit: $ 90.00 Price Follow Up: $ 75.00

Carlos Barrera, M.D. (Endocrinology) 151 NW 11th Street, Ste 102-B Homestead, Fl. 33030 Phone: (305) 670-0576 Price 1st Visit: $ 90.00 Price Follow Up: $ 75.00

Endocrinology / Endocrinología Emilio Castañeda (Miramar Medical Center) 11904 Miramar Parkway Miramar, Fl. 33025 Phone: (954) 639-7560 Price 1st Visit: $ 90.00 Price Follow Up: $ 75.00

Miami - Dade Alexander A. Miranda, M.D. (Endocrinology) Juventus Medical Center, Inc. 1165 W 49th St # 208 Hialeah, Fl. 33012 Phone: (305) 512-5480 Price 1st Visit: $ 90.00 Price Follow Up: $ 75.00

Broward

33

ENT / Otorrino Miriam Lacayo, M.D. (Otolaryngologist ENT / Otorrino) 7821 Coral Way Suite 104 Miami, Fl. 33155 Phone: (305) 261-1337 Fax: (305) 261-1997 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Miami - Dade Maria T. llopiz, M.D. (Otolaryngologist ENT / Otorrino) 330 SW 27 ave Suite 603 Miami Fl. 33155 Phone: (305) 649-5455 Price 1st Visit: $ 80.00 Price Follow Up: $ 50.00

Gastroenterology / Gastroenterólogo Orlando Torres, M.D. (Gastroenterology) 4791 W 4 ave Hialeah, Fl. 33012 Phone: (305) 825-0500 Fax: (305) 825-5557 Servicios: All Included Endoscopía $ 530.00 Colonoscopía $ 675.00 Sigmoidoscopía $ 400.00 Price 1st Visit: $60.00 Price Follow Up. $50.00

Juan Sarol, M.D. (Gastroenterology) (Vida Health Centers) 881 E 2nd ave Hialeah, Fl. 33010 Phone: (305) 882-1100 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Internal Medicine / Medicina Interna

34

Miami - Dade

Miami - Dade

Mayre Urdaneta, M.D. (Internal Medicine) 8060 NW 155th Street Ste 201 Miami Lakes, Fl. 33016 Phone: (305) 826-0606 Fax: (305) 826-0630 Price 1st Visit: $60.00 Price Follow Up. $40.00

Madeline Castro, M.D. (Internal Medicine) (Penalver Clinic Medical Group) 971 NW 2 ST Miami, Fl. 33128 Phone: (305) 545-7737 Price 1st Visit: $60.00 Price Follow Up. $40.00

Margarita del Val, M.D. (Internal Medicine) (MD Health Care and Rehabilitation) 7975 NW 154th St # 200 Miami Lakes, Fl. 33016 Phone: (305) 855-2824 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Mauricio Vargas, M.D. (Internal Medicine) (7 years and Up) (Private Medical Center) 10 NW 42 Ave Suite 300 Miami, Fl. 33126 Phone: (305) 774-0742 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Felix A. Rodriguez, M.D. (Internal Medicine) (American Family Health Center) 2150 W. 68th Street, Suite 102 Hialeah, Fl. 33018 Phone: (305) 231-8996 Fax: (305) 231-8433 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Noel E. Lezama, M.D. (Internal Medicine) (Universal Comunity Mental Care) 928 SW 82 Ave. Miami, Fl. 33144 Phone: (305) 265-5744 Fax: (305) 265-5745 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Humberto Hernandez, M.D. (General Medicine) 1435 West 49th Place, Ste 604 Hialeah, Fl. 33012 Phone: (305) 231-3151 Price 1st Visit: $60.00 Price Follow Up. $40.00

Renato Dominguez, M.D. (Internal Medicine) 85 Gran Canal Dr. Suite 209 Miami, Fl. 33144 Phone: (305) 263-8340 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Alejandro de la Cruz, M.D. (Internal Medicine) 4118 W 12 Ave Hialeah, Fl. 33012 Phone: (305) 824-8787 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Internal Medicine / Medicina Interna

Miami - Dade

Odalys Frontela, M.D. F.F.C.P (General Medicine) 801 West 48th Street, Suite A Hialeah, Fl. 33012 Phone: (305) 698-7172 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Otneil Hernandez, DNP, ARNP. (Internal Medicine) (Felicidad Medical Center) 4410 West. 16th Ave. # 55 Hialeah, Fl. 33013 Phone (305) 824-8559 Price 1st Visit: $60.00 Price Follow Up. $40.00

Gonzalo Gonzalez, M.D. (Internal Medicine) (Medical Health and Research Inc) 6854 W Flagler St Miami Fl. 33144 Phone: (786) -310-7697 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Joseph Thevenin, M.D. (Internal Medicine) 9635 SW 181 Terrace. Miami, Fl. 33157 Phone: (305) 238-8561 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

José Padrón, M.D. (Internal Medicine) 2601 SW 37 Ave, Suite 707 Miami, Fl. 33133 Phone: (305) 569-0010 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Mario R. Villoch, M.D. (Internal Medicine) (AV Medical Center) 2075 SW 27 ave #101 Miami, Fl. 33145 Phone: (305) 856-6081 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Ramses Vega, M.D. (Internal Medicine) 3720 SW 107 ave Miami, Fl. 33165 Phone: (305) 554-4270 Price: 1st. Visit $ 60.00 Follow Up: $ 40.00

Manuel Jimenez Rodriguez M.D. (Internal Medicine) The Wellness Clinic Center 15190 SW 136 ST, Suite 15 Miami, Fl. 33196 Phone: (305) 964-7689 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Roberto Sotolongo, M.D. (Internal Medicine) (Leal Medical Center LLC) 925 NE 30 Terr # 206 Homestead, Fl. 33033 Phone: (305) 246-1265 Price 1st Visit: $60.00 Price Follow Up. $40.00

Alfonso Garcia_Bello, M.D. (Internal Medicine) (Leal Medical Center LLC) 925 NE 30 Terr # 206 Homestead, Fl. 33033 Phone: (305) 246-1265 Price 1st Visit: $60.00 Price Follow Up. $40.00

Internal Medicine / Medicina Interna

Broward

Herbert Pardell, DO. (Emeril Health Medical Center) 4330 Sheridan Street, Suite 102 Hollywood, Fl. 33021 Phone: (954) 987-4455 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Carlos Vallin, M.D. (Miramar Medical Center) 11904 Miramar Parkway Miramar, Fl. 33025 Phone: (954) 639-7560 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Emilio Castañeda, M.D. (Miramar Medical Center) 11904 Miramar Parkway Miramar, Fl. 33025 Phone: (954) 639-7560 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Santiago Cardenas ,M.D. Pines Care Medical Center, LLC (General & Internal Medicine) 301 NW 103 Ave, # 235 Pembroke Pines, Fl. 33026 Phone: (954) 251-1497 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Karen Prida, M.D. (General & Internal Medicine) Pines Care Medical Center, LLC 301 NW 103 Ave, # 235 Pembroke Pines, Fl. 33026 Phone: (954) 251-1497 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Jayner Moya, M.D. (General & Internal Medicine) Pines Care Medical Center, LLC 301 NW 103 Ave, # 235 Pembroke Pines, Fl. 33026 Phone: (954) 251-1497 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00 35

Internal Medicine / Medicina Interna

Palm Beach

Alfred G. Salas, M.D. (Internal Medicine, Geriatrics) (Vital Care Medical Center) 2188 Jog Road Green Acres, Fl. 33415 Phone: (561) 439-0850 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00 Mon-Fri 9 am to 8 pm Sat 9 am to 1 pm

Nephrology / Nefrología Guibel Perera, M.D. (Nephrology / Nefrólogo) 10710 SW 38 St Miami, Fl. 33165 Phone: (305) 392-1000 Price 1st Visit: $ 80.00 Price Follow Up: $ 50.00

Miami - Dade Jorge L. Posada, M.D. (Nephrology / Nefrólogo) 747 Ponce de Leon Blvd # 605 Coral Gables, Fl. 33134 Phone: (305) 445-4535 Price 1st Visit: $ 80.00 Price Follow Up: $ 50.00

Neurology / Neurología

36

Luis Garcia-Mayol, M.D. (Nephrology / Nefrólogo) 747 Ponce de Leon Blvd # 605 Coral Gables, Fl. 33134 Phone: (305) 445-4535 Price 1st Visit: $ 80.00 Price Follow Up: $ 50.00

Miami - Dade

James Gorelick, M.D. (Neurology / Neurología) 351 NW Le Jeune Rd Suite 103 Miami Fl. 33126 Phone: (305) 642-4616 Fax: (305) 631-1419 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Carlos Perez, M.D. (Neurology / Neurología) (All Future Medical Center) 3237 NW 7 Th Street, Suite 101 Miami, Fl. 33125 Phone: (305) 805-6903 (305) 879-1753 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Martha Bustamante, M.D (Pediatric Neurology) 4160 W. 16 Ave. Suite 100 Hialeah, Fl. 33012 Phone: (305) 826-5655 Price 1st Visit: $ 80.00 ** Price Follow Up: $ 50.00 **

Gonzalo Quesada, M.D. (Neurology / Neurología) (Medical Health and Research Inc) 6854 W Flagler St Miami Fl. 33144 Phone: (786) -310-7697 Price 1st Visit: $ 90.00 Price Follow Up: $ 75.00

James Gorelick, M.D. (Neurology / Neurología) 20700 West Dixie Hwy Adventura Fl. 33180 Phone: (305) 642-4616 Fax: (305) 631-1419 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Diagnostic Center of Neurological Studies

Miami - Dade

Neurology Mobile System Associates, Inc 7374 SW 93 ave, Suite 201 Miami, Fl. 33173 Phone: 305-270-7771 Fax: 305-270-7775 PROCEDURE Soft-Tissue Ultrasound

DESCRIPTION

Cervical Soft Tissue Spinal Canal & Contents Extremities Leg / Arm Neurological NCS Upper Motor Studies NCS Upper Motor + F-Wave NCS Upper Sensory NCS Lower Motor NCS Lower Motor + F-Wave NCS Lower Senory EEG - Electroencephalogram BAER - Brainstem Auditory Evoked Response VER - Visual Evoked Response VEP - Visual Evoked Potential EMG - 1 Extremity EMG - 2 Extremities EMG - 3 Extremities EMG - 4 Extremities Orbucularis Ocull - Blink Cardiac Studies Echo 2D M-Mode Cardiac Doppler Coloflow Doppler EKG Holter Electrocardiogram Holter Monitor 24 hour (Global) Vascular Studies Carotid Arterial Doppler Carotid Arterial Duplex Arterial Doppler (Bilateral) Arterial Duplex (Bilateral) Arterial Duplex (Unilateral) Venous Doppler (Bilateral) Venous Doppler (Bilateral) Venous Duplex (Unilateral) Small Parts Testicular Breast Thyroid Biophysical Pelvic Complete Bladder Obstetric Complete Abdominal Abdominal Complete (2 or More) Studies Abdominal Limited (Only 1 organ) Retro Complete (2 or More) Retro Limited (Only one organ)

CPT CODES 76536 76800 76880 95900 95903 95904 95900 95903 95904 95819 92585 92280 95930 95860 95861 95863 95864 95933 93307 93320 93325 93000 93230 93875 93880 93923 93925 93926 93965 93970 93971 76870 76645 76536 76856 76857 76805 76700 76705 76770 76775

Member Fees

$100.00 $100.00 $100.00 $125.00 $125.00 $125.00 $125.00 $125.00 $125.00 $150.00 $125.00 $125.00 $125.00 $130.00 $180.00 $225.00 $275.00 $150.00 $150.00 $150.00 $100.00 $100.00 $90.00 $90.00 $100.00 $100.00 $100.00 $90.00 $90.00 $75.00 $75.00 $75.00 $70.00 $70.00 $70.00 $70.00 $70.00 $70.00 $70.00

37

Ophthalmology / Oftalmología

Miami - Dade

Manuel Airala, M.D. Marta Airala M.D. (Laser & Cataract Institute) 202 East 49 Street. Hialeah, Fl. 33013 Phone: (305) 558-7895 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Salomon Esquenazi, M.D. (Laser & Cataract Institute) 202 East 49 Street. Hialeah, Fl. 33013 Phone: (305) 558-7895 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Jorge J. Bacallao, M.D. (Laser & Cataract Institute) 202 East 49 Street. Hialeah, Fl. 33013 Phone: (305) 558-7895 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Tomas Ugarte M.D. (Ophthalmology) 900 West 49th Street, Ste 300 Hialeah, Fl. 33012 Phone: (305) 823-6525 Fax: (305) 823-6527 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Marta Airala, M.D. (Laser & Cataract Institute) 2441 SW 37 Avenue. Miami, Fl. 33145 Phone: (305) 442-0066 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Jonathan Leon-Rosen MD (Laser & Cataract Institute) 2441 SW 37 Avenue. Miami, Fl. 33145 Phone: (305) 442-0066 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Salomon Esquenazi, MD (Laser & Cataract Institute) 2441 SW 37 Avenue. Miami, Fl. 33145 Phone: (305) 442-0066 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Jorge J. Bacallao, M.D. (Laser & Cataract Institute) 2441 SW 37 Avenue. Miami, Fl. 33145 Phone: (305) 442-0066 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Osvaldo Caffa, M.D. Rodrigo Belalcazar, M.D. (Visionl Specialty Care) 9000 SW 87 Ct Suite 206 Miami, Fl. 33176 Phone: (305) 263-9050 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Osvaldo Caffa, M.D. Rodrigo Belalcazar, M.D. Jorge J. Bacallao, M.D. (Vision Specialty Care) 7949 NW 2 St Miami, Fl. 33126 Phone: (305) 263-9050 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Ophthalmology / Oftalmología

Palm Beach

Daniel Hernandez, PAC (Johnson Medical Services) 2531 N Dixie Hwy Lake Worth, Fl. 33460 Phone: (561) 582-0330 Fax: (561) 582-0339 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Orthopedics / Ortopedia Alejandro de la Cruz, M.D. (Orthopedic / Ortopédico) 4118 W 12 Ave Hialeah, Fl. 33012 Phone: (305) 824-8787 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00 38

Miami - Dade Carlos Roig, M.D. (Orthopedic Medicine & Surgery) (St. John Medical Center) 161 NW 29 Street, Miami, Fl. 33127 Phone: (305) 576-0231 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Gustavo Torres, M.D. (Orthopedic Medicine & Surgery) 900 West 49th Street, Suite 450 Hialeah, Fl. 33012 Phone: (305) 821-4020 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Orthopedics / Ortopedia Ignacio Calvo, M.D. (Orthopedic Medicine & Surgery) 777 East 25 Street, Suite 508 Hialeah, Fl. 33013 Phone: (305) 696-7772 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Miami - Dade Arnaldo V. Lopez, M.D. (Orthopedic Medicine & Surgery) 1545 S.W 1St Street, Suite 200 Miami, Fl. 33135 Phone: (305) 541-3230 Fax: (305) 541-1650 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Jose L Ponce de Leon, M.D. (Orthopedic / Ortopédico) 3501 SW 107 ave Miami, Fl. 33165 Phone: (305) 229-1227 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Ignacio Calvo, M.D. (Orthopedic Medicine & Surgery) 1800 SW 27 Ave, Ste 400 Miami, Fl. 33145 Phone: (305) 856-7411 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Podiatry / Podiatría

Miami - Dade

Hialeah Foot Center. (Podiatry / Podiatría) 4410 West 16 Ave #53 Hialeah, Fl. 33012 Phone: (305) 558-7437 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Nguyen Phu, D.P.M. (Podiatry / Podiatría) 3661 S. Miami Ave. Suite 309 Miami, Fl. 33133 Phone: (305) 854-6600 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Yanssel Delgado, D.P.M. (Podiatry / Podiatría) 5590 W 20 Ave Suite # 404 Hialeah, Fl. 33016 Phone: (305) 819-9240 / 9239 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Richard Mallia, D.P.M. (Podiatry / Podiatría) (St. John Medical Center) 161 NW 29 Street. Miami, Fl. 33127 Phone: (305) 576-0231 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Joaquin Fernandez, D.P.M. (Podiatry / Podiatría) 605 SW 57 Avenue. Miami, Fl. 33144 Phone: (305) 269-8223 Fax: (305) 262-0554 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Oscar Barreto, D.P.M. (D.P.M., F.A.C.F.A.S). (Podiatry / Podiatría) 7975 NW 154th Street, Ste 390 Miami Lakes, Fl. 33016 Phone: (305) 825-5633 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Francisco Perez, C.M.D. (Podiatry / Podiatría) (Elite Health & Rehabilitation) 6450 W. 21th Ct Suite 200 Hialeah, Fl. 33016 Phone: (305) 698-0806 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00 Flavia Inesta, D.P.M. (Podiatry / Podiatría) 1797 SW 3 ave Miami, Fl. 33129 Phone: (305) 856-4454 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Richard Millia, D.P.M. (Podiatry / Podiatría) 5590 W 20 Ave # 101 Hialeah, Fl. 33016 Phone: (305) 827-3303 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00 Howard Umansky, D.P.M. (Podiatry/ Podiatría) (Miami Community Health Center) 2324 SW 8 St Miami, Fl. 33135 Phone: (305) 643-0535 Price 1st Visit: $60.00 Price Follow Up. $40.00

Juliette Perez, D.P.M. (Podiatry / Podiatría) (Perfect Feet Care Podiatry Center) 13651 SW 26th Street. Miami, Fl. 33175 Phone: (305) 225-4277 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00 Victor Herrera, D.P.M. (Podiatry / Podiatría) (Private Medical Center) 10 NW 42 ave # 300 Miami, Fl. 33126 Phone: (305) 442-9866 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00 39

Podiatry / Podiatría

Broward

Dominique Rameau, D.P.M. (Podiatry / Podiatría) 2261 N. University Dr. # 201 Pembroke Pines, Fl. 33024 Phone: (754) 263-2522 Fax: (754) 263-2526 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Psychiatry / Psiquiatría Evelyn Lopez Brignom, M.D. (Psychiatry / Psiquiatría) (Adults and Children ) Miami Community Health Center 2324 SW 8 ST Miami, Fl. 33135 Phone: (305) 643-0535 (305) 767-5635 Fax: (305) 642-9360 Price 1st Visit: $60.00 Price Follow Up. $40.00

Miami - Dade Camilo Pérez, M.D. (Psychiatry / Psiquiatría) (Vida Health Centers) 881 E 2nd ave Hialeah, Fl. 33010 Phone: (305) 882-1100 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Carlos Perez, M.D. (Psychiatry / Psiquiatría) (All Future Medical Center) 3237 NW 7th Street, Suite 101 Miami Fl. 33125 Phone: (305) 805-6903 (305) 879-1753 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Carlos J. Sandoval, M.D. José C. López, M.D. (Psychiatry / Psiquiatría) (Universal Community Mental care) 928 SW 82 Ave. Miami, Fl. 33144 Phone: (305) 265-5744 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Psychology / Psicología

Miami - Dade

Mercedes Llenin, M.D. (Psychologist / Psicológo) 5600 SW 135 Ave, Suite 116 Miami, Fl. 33183 Phone: (305) 387-7850 Price 1st Visit: $ 100.00 Price Follow Up: $ 75.00

Psychology / Psicología Maria Moncayo, M.D. (Psychologist / Psicológo) 10406 Taft St Pembroke Pines, Fl. 33138 Phone: (954) 436-3880 Price 1st Visit: $ 100.00 Price Follow Up: $ 75.00

40

Broward

Pulmonology / Neumología

Miami - Dade

Humberto Hernandez, M.D. (Pulmonary Medicine) 1435 West 49n Place #604 Hialeah, Fl. 33012 Phone: (305) 231-3151 Fax: (305) 885-5884 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Surgery / Cirugía Mauricio Vargas, M.D. (Surgeon / Cirujano) (Private Medical Center Inc). 10 NW 42nd Ave Ste 300 Miami Fl. 33126 Phone:(305) 774-0742 Fee: Florida Medicaid Rate

Miami - Dade John Padron, M.D. (Surgeon / Cirujano) (OPA Medical Center) 1865 NE 163 Street Miami, Fl. 33162 Phone: (305) 948-9958 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Jorge Alvarez Moreno, M.D. (Surgeon / Cirujano) (Vida Health Centers) 881 E 2nd ave Hialeah, Fl. 33010 Phone: (305) 882-1100 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Fernando Lora, M.D. (Surgeon / Cirujano General y Vascular) (Vital Medical Center) 8300 W Flagler, Suite 175 Miami, Fl. 33144 Phone: (305) 220-0300 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Urology / Urología

41

Miami - Dade

Luis Sabogal, M.D. (Urology / Urología) 1800 SW 27 Avenue, Suite 402 Miami, Fl. 33145 Phone: (305) 445-2404 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Juan B Suarez, M.D. (Urology / Urología) 5450 SW 8th St #204 Miami, Fl. 33134 Phone: (305) 443-8041 Fax: (305) 444-2054 Price 1st Visit: $ 60.00 Price Follow Up: $ 60.00

Luis F. Maggiolo, M.D. (Urlogy / Urología) 747 Ponce de Leon Blvd # 502 Coral Gables, Fl. 33134 Phone: (305) 444-2858 Fax: 305-448-3346 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Rafael A. Auntun, M.D. (Urology / Urología) Best Medical Care 920 SW 82 ave Miami, Fl. 33144 Phone: (305) 262 - 3999 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

Eduardo Guzman, M.D. (Urology / Urología) 1800 SW 27 Avenue, Ste 402 Miami, Fl. 33145 Phone: (305) 445-2404 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

URGENT CARE CENTERS

At Med Plans contracted Urgent Care Centers, you’ll find experienced professionals who firmly believe everyone deserves access to affordable medical care. If you or a family member is experiencing life-threatening illness or injury-such as major head trauma, chest pain, severe abdominal pain, or loss of consciousness – you should go directly to an Emergency Room (ER). See the list below for guidance on what situations require ER treatment. • Falls from greater than 7 feet • Loss of consciousness • Infants less than 6 months of age or with a temperature greater than 103 degrees • Pregnancy bleeding or complications • Life-threatening allergic reactions • Severe burns • Severe choking (cannot breathe or talk) • Severe abdominal pain • Signs or symptoms of stroke or heart attack • Amputation of a body part • Near drowning • Electrical shock • Open or angulated fractures

CENTROS DE URGENCIAS

Med Plan tiene contratados “Centros de Cuidado de Urgencias” donde usted encontrará un servicio rápido, económico y eficiente ofrecido por profesionales experimentados que creen firmemente que todos merecen tener acceso a la atención médica. Si usted o algún miembro de la familia está sufriendo una enfermedad potencialmente mortal o lesiones - como: Traumatismos craneales importantes, Dolor torácico, Dolor abdominal intenso o pérdida de la conciencia debe ir directamente a una sala de emergencias (ER). Vea la lista a continuación para obtener orientación sobre las situaciones que requieren un tratamiento (ER). • Caídas de más de 7pies de altura. • Pérdida de conciencia. • Los bebés menores de seis meses de edad o con una temperatura superior a 103 grados. • Sangrado o complicaciones de embarazo. • Reacciones alérgicas que puedan poner en peligro la vida • Quemaduras graves • Asfixia severa que le impide respirar o hablar • Dolor abdominal severo • Signos o síntomas de derrame cerebral o ataque al corazón • Pérdida o desmembramiento de una parte del cuerpo • Si usted está a punto de ahogarse • Una descarga eléctrica • Fracturas abiertas o anguladas

Urgent Care Centers / Centros de Urgencia

Miami - Dade

Med Clinic Inc. 9588 NW 41th St. Miami Fl. 33178 Phone: (305) 477-4475 Fax: (305) 477-4487 Language: English / Spanish

Elite Health & Rehabilitation. 6450 W. 21 Ct. Suite 200 Hialeah, Fl. 33016 Phone: (305) 698-0806 Fax: (305) 698-2325 Language: English / Spanish

Clinica Venamer. (Urgent Care) 10200 NW 25th Street, Suite 114 Doral, Fl. 33172 Phone: (305) 594-6505 Fax: (305) 594-6591

HOURS OF OPERATION: MON – FRI 10AM – 10:00PM SAT – SUN 10:00AM – 10:00PM

HOURS OF OPERATION: MON – FRI 8:AM – 6:00PM SAT – 8:00AM – 2:00PM

HOURS OF OPERATION: MON – FRI 8:00AM – 8:00PM SAT 9:00AM – 4:00PM 42

Urgent Care Centers / Centros de Urgencia Private Medical Center. (Urgent Care) 10 NW 42th Ave. Suite 300 Miami, Fl. 33126 Phone: (305) 774-0742 HOURS OF OPERATION: MON – FRI 8:00AM – 10:00PM SAT 8:00AM – 12:00PM Campbell Urgent Care. 1855 NE 8th Street. Homestead, Fl. 33033 Phone: (305) 242-8025 Fax: (305) 245-1839 HOURS OF OPERATION: MON – FRI 8:00AM – 8:00PM SAT – SUN 10:00AM – 4:00PM

MDD Medical Center. (Urgent Care) 6905 NW 77 ave Miami, Fl. 33166 Phone: (305) 884-1919 Fax: (305) 884-1969 HOURS OF OPERATION: MON – FRI 10:00AM – 6:00PM

HOURS OF OPERATION: MON – FRI 9:00AM – 9:30PM SAT – 9:00AM – 5:00PM

43

South Florida Urgent Care (Urgent Care) 5590 W 20 Ave # 101 Hialeah Fl. 33016 Phone: (786) -827-3303 HOURS OF OPERATION: MON – FRI 8:00AM – 8:00PM

Clinica Venamer Coral Way (Urgent Care) 1757 SW 22 St Miami, Fl. 33145 Phone: (786) 442-1040 HOURS OF OPERATION: MON – FRI 8:00AM – 8:00PM SAT -- 9:00AM – 4:00PM

Urgent Care Centers / Centros de Urgencia Urgent Care Center. (UrgentMed) 2337 S. University Drive Davie, Fl. 33324 Phone: 954-423-9234 Fax: (954) 423-9231 Medicaid Rates after 5:00 PM.

Miami - Dade

Pines Professional Campus (Urgent Care) 302 NW 179 St # 103 Pembroke Pines, Fl. 33029 Phone: (954) 442-8380 HOURS OF OPERATION: MON – FRI 9:00AM – 9:00PM SAT-SUN 9:00AM – 6:00PM

Broward

URGENT CARE TIER PRICING Tier One (Basic Visit) includes: $60.00 • Any and all levels of service, including initial visits and established patient visits. • Instant test(s) performed at the center. - Urine dip. - Instant strep - Mono - Flu - Pregnancy - Hemoccult - Glucose - HIV Tier Two (Intermediate Visit) includes: $120.00 • Tier One (Basic Visit) above PLUS - X-Rays of single body area performed in the center. - Injection of pain meds or antibiotics. - Vaccine administration (vaccine charged as exclusion below) - Venipuncture or specimen collection for any lab outside reference lab (lab test charged as exclusion below) Tier Three (Advanced Visit) includes: • Tier Two (Intermediate Visit) PLUS • Single procedures performed in the center including but not limited to: - Nebulizer treatment - Laceration repair. - Burn dress/debride - Foreign body removal - Cast / Splint application - IV Therapy - EKG

$145.00

DENTAL SERVICES / SERVICIOS DENTALES

Med Plan Dental Providers are offering exclusive pricing to all our members consisting of: • Simple Cleanings that include Oral Examination, X-Rays, Topical anesthesia, for only $49 (Code 1110). For persons under the age of 16 this service is provided for $35 (Code 1120). All minors will receive topical fluoride treatment included with their cleaning. • Deep cleanings are offered for $75 per quadrant (Code 4341) which include oral examination, complete x-rays, and anesthesia. This service does not include panoramic x-rays. All minors will receive topical fluoride treatment included with their cleaning. IF THE CLEANING PROCEDURE REQUIRES THE USE OF ARESTIN AS PART OF THIS SERVICE, THE PATIENT WILL BE PROVIDED AN ALTERNATIVE ORAL ANTIBIOTIC AT A LESSER EXPEND. Los proveedores de servicios dentales asociados a MedPlan están ofreciendo precios exclusivos a nuestros miembros. Entre los más destacados están: • Limpieza Simple que incluye Examen Oral, Rayos X, Anesthesia, todo por el precio de $49.00 para adultos (Código 1110) y $35.00 para menores de 16 años (Código 1120). En el caso de los menores de 16 años se le incluye también la aplicación de fluoride anticarie. • Limpieza Profunda en una dentadura completa por $75.00 el cuadrante (Código 4341). Si la dentadura está incompleta el precio a pagar será de $60.00 (Código 4342). Dicha limpieza incluye Examen Oral, Rayos X (no panorámicos), Anesthesia. En el caso de los menores de 16 años se le incluye también la aplicación de fluoride anticarie. • EL USO DE ANTIBIOTICO ARESTIN EN EL PROCEDIMIENTO DE LA LIMPIEZA ES DECISION PERSONAL DEL PACIENTE. EL PACIENTE TIENE COMO ALTERNATIVA EL USO DE OTRO ANTIBIOTICO RECOMENDADO POR EL DENTISTA.

Dentistry / Odontología Med Dental Associated Inc. 7200 NW 7St Suite 340 Miami, Fl. 33126 Phone: Fax: (Open November 1st, 2012)

Miami - Dade America Dental Clinic 3631 SW 87 Ave Miami, Fl. 33165 Phone: (305) 485-8427 Fax: (305) 9485-8429

Hialeah Dental Care 4240 W 16 ave Hialeah, Fl. 33012 Phone: (305) 823-1882

45

Dentistry / Odontología Maria J. Alvarez, DDS. Dental Group of South Florida II 11336 SW 184 St Miami, Fl. 33157 Phone: (305) 251-4262

Miami - Dade Ernesto Quezada, DDS. Dental Group of South Florida II 11336 SW 184 St Miami, Fl. 33157 Phone: (305) 251-4262

Dentistry / Odontología Life Dental Care Corp. 123 N Powerline Rd. Derfield Beach, Fl. 33442 Phone: (954) 429-8840 Fax: 954-429-8842

Broward Pines Dental Care Inc. 302 NW 179 ave Suite 201-A Pembroke Pines, Fl. 33029 Phone: (954) 450-9383 Fax: 954-450-9385

Pines Dental Care II 17868 NW 2 ST Pembroke Pines, Fl. 33029 Phone: (954) 538-0047 Fax: 954-538-0924

Alberto Despaigne DDS. 2518 E. Hallandale Beach Blvd Hallandale Beach, Fl. 33009 Phone: (954) 454-2504 Fax: 954-454-3289

Dentistry / Odontología Mario Hernandez, DDS. 6815 South Dixie Hwy West Palm Beach, Fl. 33405 Phone: (561) 585-5891 Fax: 561-586-6014

Palm Beach

GENERAL DENTISTRY FEES ADA CODES

DESCRIPTION

Member Fees

D0120

PERIODIC ORAL EXAM

D0140

LIMITED ORAL EVALUATION-PROBLEM FOCUSED

NO CHARGE

D0150

COMPREHENSIVE ORAL EVAL-NEW OR ESTABLISHED PATIENT

D0160

DETAILED & EXTENSIVE EVAL-PROBLEM FOCUSED

NO CHARGE

D0170

RE-EVALUATION-LIMITED, PROBLEM FOCUSED

NO CHARGE

D0180

COMPREHENSIVE PERIODONTAL EVALUATION

$15.00

$10.00 $20.00

RADIOGRAPHY/DIAGNOSTIC DENTISTRY D0210

X-RAY - INTRAORAL - COMPLETE SERIES (INCLUDING BITEWINGS)

$30.00

D0220

X-RAY - INTRAORAL - PERIAPICAL FIRST FILM

$15.00

D0230

X-RAY - INTRAORAL - PERIAPICAL EACH ADDITIONAL FILM

NO CHARGE

D0240

X-RAY - INTRAORAL - OCCLUSAL FILM

NO CHARGE

D0250

X-RAY - EXTRAORAL - FIRST FILM

NO CHARGE

D0260

X-RAY - EXTRAORAL - EACH ADDITIONAL FILM

NO CHARGE

D0270

X-RAY - BITEWING- SINGLE FILM

NO CHARGE

D0272

X-RAY - BITEWING - 2 FILMS

NO CHARGE

NOT TO BE TAKEN IF 274 WAS DONE W/IN PRIOR 6 MOS D0330

PANORAMIC FILM

$25.00

D0340

CEPHALOMETRIC FILM, NON-ORTHODONTIC

$75.00

D0350

DIAGNOSTIC PHOTOGRAPHS

$20.00

D0460

PULP VITALITY TEST

$10.00

D0470

DIAGNOSTIC CASTS

$25.00

D1110

ROUTINE PROPHYLAXIS ADULT (ONCE EVERY 6 MONTHS)

PREVENTIVE DENTISTRY

47

$49.00

D1120

ROUTINE PROPHYLAXIS - CHILDREN UNDER 16 YRS (ONCE EVERY 6 MONTHS)

D1201

TOPICAL APPLICATION OF FLOURIDE FOR CHILDREN UNDER 16

NO CHARGE

$35.00

D1203

TOPICAL APPLICATION OF FLOURIDE FOR CHILDREN UNDER 16

NO CHARGE

D1204

TOPICAL APPLICATION OF FLOURIDE FOR ADULTS

D1310

NUTRITIONAL COUNSELING FOR CONTROL OF DENTAL DISEASE

NO CHARGE

D1320

TOBBACO COUNSELING FOR CONTROL & PREVENTION OF ORAL DISEASES

NO CHARGE

D1330

ORAL HYGIENE INSTRUCTIONS

NO CHARGE

D1351

APPLICATION OF SEALANT PER TOOTH - CHILDREN UNDER 16

$15.00

D1510

SPACE MAINTAINER - FIXED

$120.00

D1515

SPACE MAINTAINER - FIXED

$175.00

D1520

SPACE MAINTAINER - REMOVABLE

$160.00

D1525

SPACE MAINTAINER - REMOVABLE

$250.00

D1550

RE-CEMENTATION OF SPACE MAINTAINER

$25.00

D2330

RESIN-BASED COMPOSITE - 1 SURFACE, ANTERIOR (EMPASTES)

$60.00

D2331

RESIN-BASED COMPOSITE - 2 SURFACES, ANTERIOR (EMPASTES)

$70.00

D2332

RESIN-BASED COMPOSITE - 3 SURFACES, ANTERIOR (EMPASTES)

$80.00

D2335

COMPOSITED RESIN - 4 OR MORE SURFACES (EMPASTES)

$90.00

D2391

RESIN - BASED COMPOSITE - 1 SURFACE, POSTERIOR (EMPASTES)

$60.00

D2392

RESIN-BASED COMPOSITE - 2 SURFACES, POSTERIOR (EMPASTES)

$70.00

D2393

RESIN-BASED COMPOSITE - 3 SURFACES, POSTERIOR (EMPASTES)

$80.00

D2394

RESIN-BASED COMPOSITE - 4 OR + SURFACES, POSTERIOR (EMPASTES)

$90.00

D2410

GOLD FOIL - 1 SURFACE

$75.00

D2420

GOLD FOIL - 2 SURFACES

$95.00

D2430

GOLD FOIL - 3 SURFACES

$125.00

D2510

INLAY - METALLIC - 1 SURFACE

$300.00

$20.00

GENERAL DENTISTRY FEES ADA CODES

DESCRIPTION

Member Fees

D2520

INLAY - METALLIC - 2 SURFACES

$320.00

D2530

INLAY - METALLIC - 3 OR MORE SURFACES

$340.00

D2542

ONLAY - METALLIC - 2 SURFACES

$325.00

D2543

ONLAY - METALLIC - 3 SURFACES

$330.00

D2544

ONLAY - METALLIC - 4 OR MORE SURFACES

$355.00

D2610

INLAY - PORCELAIN/CERAMIC - 1 SURFACE

$325.00

D2620

INLAY - PORCELAIN/CERAMIC - 2 SURFACES

$350.00

D2630

INLAY - PORCELAIN/CERAMIC - 3 OR MORE SURFACES

$375.00

D2642

ONLAY - PORCELAIN/CERAMIC - 2 SURFACES

$395.00

D2643

ONLAY - PORCELAIN/CERAMIC - 3 SURFACES

$415.00

D2644

ONLAY - PORCELAIN/CERAMIC - 4 OR MORE SURFACES

$445.00

D2650

INLAY - RESIN - BASED COMPOSITE - 1 SURFACE

$195.00

D2651

INLAY - RESIN - BASED COMPOSITE - 2 SURFACES

$250.00

D2652

INLAY - RESIN - BASED COMPOSITE - 3 OR MORE SURFACES

$275.00

D2662

ONLAY - RESIN - BASED COMPOSITE - 2 SURFACES

$250.00

D2663

ONLAY - RESIN - BASED COMPOSITE - 3 SURFACES

$275.00

D2664

ONLAY - RESIN - BASED COMPOSITE - 4 OR MORE SURFACES

$290.00

D2710

CROWN - RESIN (INDIRECT)

$210.00

D2720

CROWN - RESIN WITH HIGH NOBLE METAL

$455.00

D2721

CROWN - RESIN WITH PREDOMINNATLY BASE METAL

$405.00

D2722

CROWN - RESIN WITH NOBLE METAL

$425.00

D2740

CROWN - PORCELAIN/CERAMIC SUBSTRATE

$595.00

D2750

CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL

$495.00

D2751

CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL

$495.00

D2752

CROWN - PORCELAIN FUSED TO NOBLE METAL

$495.00

D2780

CROWN - 3/4 CAST HIGH NOBLE METAL

$530.00

D2781

CROWN - 3/4 CAST PREDOMINANTLY BASE METAL

$410.00

D2782

CROWN - 3/4 CAST NOBLE METAL

$520.00

D2783

CROWN - 3/4 PORCELAIN/CERAMIC

$550.00

D2790

CROWN - FULL CAST HIGH NOBEL METAL

$699.00

D2791

CROWN - FULL CAST PREDOMINANTLY BASE METAL

$525.00

D2792

CROWN - FULL CAST NOBLE METAL

$580.00

D2799

PROVISIONAL CROWN

$50.00

D2910

RECEMENT INLAY

$25.00

D2920

RECEMENT CROWN

$25.00

D2930

PREFABRICATED STAINLESS STEEL CROWN-PRIMARY TOOTH

$95.00

D2931

PREFABRICATED STAINLESS STEEL CROWN-PERMANENT TOOTH

$95.00

D2932

PREFABRICATED RESIN CROWN

$95.00

D2933

PREFABRICATED STAINLESS STEEL CROWN WITH RESIN WINDOW

$145.00

D2940

SEDATIVE FILLING

$40.00

D2950

CORE BUILDUP, INCLUDING ANY PINS

$85.00

D2951

PIN RETENTION - PER TOOTH, IN ADDITION TO RESTORATION

$20.00

D2952

CAST POST & CORE IN ADDITION TO CROWN

$155.00

D2953

EACH ADDITIONAL CAST POST - SAME TOOTH

$105.00

D2954

PREFABRICATED POST & CORE IN ADDITION TO CROWN

$125.00

D2955

POST REMOVAL (NOT IN CONJUNTION WITH ENDODONTIC THERAPY)

$30.00

D2957

EACH ADDITIONAL PREFABRICATED POST - SAME TOOTH

$30.00

D2960

LABIAL VENEER (RESIN LAMINATE) - CHAIRSIDE

$205.00

D2961

LABIAL VENEER (RESIN LAMINATE) - LABORATORY

$260.00

48

GENERAL DENTISTRY FEES ADA CODES

49

DESCRIPTION

Member Fees

D2962

LABIAL VENEER (PORCELAIN LAMINATE) - LABORATORY

$425.00

D2970

TEMPORARY CROWN (FRACTURED TOOTH)

$50.00

D2980

CROWN REPAIR/ When crown and/or bridgework exceeds six(6) consecutive units, there will be an additional charge of $30.00 per unit.

$95.00

ENDODONTICS SERVICES

D3110

PULP CAP-DIRECT (EXCLUDING FINAL RESTORATION)

$25.00

D3120

PULP CAP-INDIRECT (EXCLUDING FINAL RESTORATION)

$25.00

D3220

THERAPEUTIC PULPOTOMY (EXCLUDING FINAL RESTORATION)

$75.00

D3221

PUPAL DEBRIDEMENT, PRIMARY AND PERMANENT TEETH

$95.00

D3230

PUPAL THERAPY (RESORB FILLING) - ANTERIOR, PRIMARY

$80.00

D3240

PUPLAM THERAPY (RESORBABLE FILLING) - POSTERIOR, PRIMARY

$90.00

D3310

ROOT CANAL THERAPY - ANTERIOR

$395.00

D3320

ROOT CANAL THERAPY - BICUSPID

$495.00

D3330

ROOT CANAL THERAPY - MOLAR

$595.00

D3331

TREATMENT OF ROOT CANAL OBSTRUCTION, NON-SURGICAL ACCESS

$85.00

D3346

RETREAT, PREV RCT - ANTERIOR

$495.00

D3347

RETREAT, PREV RCT - BICUSPID

$595.00

D3348

RETREAT, PREV RCT - MOLAR

$695.00

D3950

CANAL PREPARATION AND FITTING OF PREFORMED DOWEL OR POST

$75.00

D4211

GINGIVECTOMY/GINGIVOPLASTY - 1 TO 3 TEETH, PER QUAD

D4220

GINGIVAL CURETTAGE PER QUADRANT EXCLUDING ROOT PLANNING

$75.00

D4240

GINGIVAL FLAP PROCEDURE- 4 OR MORE

$325.00

D4241

GINGIVAL FLAP PROCEDURE - 1 TO 3 TEETH PER QUAD

$250.00

D4245

APICALLY POSITIONED FLAP

$150.00

D4341

PERIODONTAL SCALING & ROOT PLANING - 4 OR MORE CONTIGUOUS TEETH

$75.00

D4342

PERIODONTAL SCALING $ ROOT PLANING - 1 TO 3 TEETH, PER QUAD

$60.00

D4355

FULL MOUTH DEBRIDEMENT TO ENABLE COMPREHENSIVE EVALUATION

$80.00

D4381

LOCAL DELIVERY ANTIBIOTIC (ARESTIN)

$30.00

D4910

PERIODONTAL MAINTENANCE

$55.00

PERIODONTICS SERVICES

$50.00

D5110

COMPLETE DENTURE - MAXILLARY BASIC

$495.00

D5120

COMPLETE DENTURE - MANDIBULAR BASIC

$495.00

D5211

MAXILLARY PARTIAL DENTURE - RESIN BASE (INCLUDING CLASPS)

$450.00

D5212

MANDIBULAR PARTIAL DENTURE - RESIN BASE (INCLUDING CLASPS)

$450.00

D5213

PARTIAL DENTURE - MAXILLARY CAST METAL - ACRYLIC

$575.00

D5214

PARTIAL DENTURE - MANDIBULAR VAST METAL - ACRYLIC

$575.00

D5410

ADJUSTMENT - COMPLETE DENTURE - MAXILLARY

$20.00

D5411

ADJUSTMENT - COMPLETE DENTURE - MANDIBULAR

$20.00

D5421

ADJUSTMENT - PARTIAL DENTURE - MAXILLARY

$20.00

D5422

ADJUSTMENT - PARTIAL DENTURE - MANDIBULAR

$20.00

D5510

REPAIR BROKEN COMPLETE DENTURE BASE

$75.00

D5520

REPLACE BROKEN TOOTH - COMPLETE DENTURE (EACH TOOTH)

$70.00

D5610

REPAIR DENTURE RESIN BASE

$50.00

D5620

REPAIR CAST FRAMEWORK

$55.00

D5630

REPAIR OR REPLACE BROKEN CLASP

$55.00

D5640

REPAIR BROKEN TEETH - PER TOOTH

$45.00

D5650

ADD TOOTH TO EXISTING PARTIAL DENTURE

$65.00

D5660

ADD CLASP TO EXISTING PARTIAL DENTURE

$75.00

D5710

REBASE COMPLETE MAXILLARY DENTURE

$195.00

D5711

REBASE COMPLETE MANDIBULAR CENTURE

$195.00

GENERAL DENTISTRY FEES ADA CODES

DESCRIPTION

Member Fees

D5720

REBASE MAXILLARY PARTIAL DENTURE

$175.00

D5721

REBASE MANDIBULAR PARTIAL DENTURE

$175.00

D5730

RELINE COMPLETE MAXILLARY DENTURE (CHAIRSIDE)

$85.00

D5731

RELINE COMPLETE MANDIBULAR DENTURE (CHAIRSIDE)

$85.00

D5740

RELINE PARTIAL COMPLETE MAXILLARY DENTURE (CHAIRSIDE)

$65.00

D5741

RELINE PARTIAL COMPLETE MANDIBULAR DENTURE (CHAIRSIDE)

$65.00

D5750

RELINE COMPLETE MAXILLARY DENTURE (LABORATORY)

$150.00

D5751

RELINE COMPLETE MANDIBULAR DENTURE (LABORATORY)

$150.00

D5760

RELINE PARTIAL MAXILLARY DENTURE (LABORATORY)

$110.00

D5761

RELINE PARTIAL MANDIBULAR DENTURE (LABORATORY)

$110.00

D5810

INTERIM COMPLETE DENTURE - MAXILLARY

$250.00

D5811

INTERIM COMPLETE DENTURE - MANDIBULAR

$250.00

D5820

INTERIM PARTIAL DENTURE - MAXILLARY

$250.00

D5821

INTERIM PARTIAL DENTURE - MANDIBULAR

$250.00

D5850

TISSUE CONDITIONING - MAXILLARY

$55.00

D5851

TISSUE CONDITIONING - MANDIBULAR

$55.00

D5862

PRECISION ATTACHMENT

$150.00

PROSTHODONTICS - FIXED

D6210

PONTIC - CAST HIGH NOBLE METAL

$400.00

D6211

PONTIC - CAST PREDOMINANTLY BASE METAL

$400.00

D6212

PONTIC - CAST NOBLE METAL

$400.00

D6240

PONTIC - PORCELAIN FUSED TO HIGH NOBLE METAL

$400.00

D6241

PONTIC - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL

$400.00

D6242

PONTIC - PORCELAIN FUSED TO NOBLE METAL

$400.00

D6245

PONTIC - PORCELAIN/CERAMIC

$595.00

D6740

CROWN - PORCELAIN/CERAMIC

$595.00

D6750

CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL

$495.00

D6751

CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASED METAL

$495.00

D6752

CROWN - PORCELAIN FUSED TO NOBLE METAL

$495.00

D6780

CROWN - 3/4 CAST HIGH NOBLE METAL

$530.00

D6781

CROWN - 3/4 CAST PREDOMINANTLY BASED METAL

$510.00

D6782

CROWN - 3/4 CAST NOBLE METAL

$520.00

D6783

CROWN - 3/4 PORCELAIN/CERAMIC

$510.00

D6790

CROWN - FULL CAST HIGH NOBLE METAL

$495.00

D6791

CROWN - FULL CAST PREDOMIANTLY BASED METAL

$495.00

D6792

CROWN - FULL CAST NOBLE METAL

$495.00

D6930

RECEMENT FIXED PARTIAL DENTURE

$40.00

D6950

PRECISION ATTACHMENT

$150.00

D6970

CAST POST & CORE ADDITION TO FIXED PARTIAL DENTURE RETAINER

$125.00

D6971

CAST POST AS PART OF A FIXED PARTIAL DENTURE RETAINER

$125.00

D6972

PREFABRICATED POST & CORE IN ADDITION TO FIXED PARTIAL DENTURE

$125.00

D6973

CORE BUILD UP FOR RETAINER, INCLUDING PINS

$95.00

D6975

COPING - METAL

$95.00

D7110

SINGLE TOOTH EXTRACTION (EXTRACCION)

$70.00

D7140

EXTRACTION OF ERUPTED TOOTH OR EXPOSED ROOT

$70.00

D7310

ALVEOLOPLASTY WITH EXTRACTIONS - PER QUADRANT

$95.00

D7320

ALVEOLOPLASTY WITHOUT EXTRACTIONS - PER QUADRANT

$130.00

D7510

INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE

$55.00

ORAL SURGERY

50

GENERAL DENTISTRY FEES ADA CODES

MISCELLANOUS SERVICES

Member Fees

D9215

LOCAL ANESTHESIA

D9230

ANALGESIA NITROUS OXIDE PER 1/2 hour

NO CHARGE

D9630

ORAL IRRIGATION/OTHER DRUGS/MEDICAMENT PER QUAD

$10.00

D9940

OCCLUSAL GUARD

$195.00

D9950

OCCLUSAL ANALYSIS - MOUNTED CASE

$75.00

D9951

OCCLUSAL ADJUSTMENT - LIMITED

$25.00

D9952

OCCLUSAL ADJUSTMENT - COMPLETE

$150.00

$20.00

*The basic cleaning does not apply if you have any periodontal disease. * The dental procedures not listed in your pricing list will apply to a discount of 25%. The dentists and specialists are the only responsible parties for the treatment and its charges. Med Plan is not responsible for payments nor for orthodontics indications performed by the dentists or specialists associated with our plan. *La limpieza simple no aplica si Usted tiene evidencia de enfermedad periodontal. *A los procedimientos que no aparecen en su lista de precios se les aplicara un descuento del 25% de lo usual y razonable. Los dentistas y especialistas son los unicos responsables por el tratamiento y precio del mismo. Med Plan no es responsable por los pagos ni por las indicaciones odontologicas hechas por los dentistas y especialistas asociados a nuestro plan.

51

DENTAL SPECIALTIES FEES

ADA CODES

ENDODONTICS

Member Fees

ED3310

ROOT CANAL THERAPY - ANTERIOR

$695.00

ED3320

ROOT CANAL THERAPY - BICUSPID

$775.00

ED3330

ROOT CANAL THERAPY - MOLAR

$925.00

ED3346

RETREAT, PREV RCT - ANTERIOR

$750.00

ED3347

RETREAT, PREV RCT - BICUSPID

ED3348

RETREAT. PREV RCT - MOLAR

$825.00

PERIODONTICS

$1,125.00

D4210 D4249

GINGIVECTOMY 4 OR + PER QUADRANT CLINIC CROWN LENGTHEN - HARD TISSUE

$450.00 $800.00

D4260

OSSEOUS SURGERY 4 OR + PER QUADRANT

$900.00

D4263

BONE REPLACE GRAFT - 1ST SITE/QU

$650.00

D4264

BONE REPLACE GRAFT - EACH ADD/QU

$500.00

D4266

GUIDED TISS REGEN-RESORB-PER

$900.00

D4275

SOFT TISSUE ALLOGRAFT RB-PER

$1,200.00

D7953

BONE REPL GRAFT RIDGE PRSV/SITE

$400.00

D7960

FRENULECTOMY - SEPARATE PROCEDURE

$500.00

D7210

EXTRACTION - SURGICAL/ERUPT TOOTH

$240.00

D7220

EXTRACTION - IMPACTEDL/SOFT TISSUE

$300.00

D7230

EXTRACTION - IMPACTEDL/PART BONY

$395.00

D7240

EXTRACTION - IMPACTED/COMPLBONY (Cordales)

$450.00

D7241

REMOV IMPACT - COMP BONY W/COMP

$500.00

D7250

SURGIC REMOVL RESID TOOTH ROOT

$250.00

D7285

BIOPSY OF ORAL TISSUE - HARD (BONE, TOOTH)

$120.00

D7286

BIOPSY OF ORAL TISSUE - SOFT (ALL OTHER)

$95.00

BIOPSY LAB

$50.00

ORAL SURGERY

ORTHODONTICS

D8080

COMPREHENSIVE ORTHO, ADOLESCENT

$3,490.00

D8090

COMPREHENSIVE ORTHO, ADULT

$3,490.00

D6010

SURG PLACE IMPLANT, ENDOSTEAL

$1,200.00

COMPLETED CROWN IMPLANT (IMPLANTE Y CORONA)

$1,950.00

D6010/D6059

IMPLANTS

D0000

OVERDENTURE UPPER WITH 4 IMPLANTS

$4,650.00

D0000

OVERDENTURE LOWER WITH 3 IMPLANTS

$3,650.00

*The basic cleaning does not apply if you have any periodontal disease. * The dental procedures not listed in your pricing list will apply to a discount of 25%. The dentists and specialists are the only responsible parties for the treatment and its charges. Med Plan is not responsible for payments nor for orthodontics indications performed by the dentists or specialists associated with our plan. *La limpieza simple no aplica si Usted tiene evidencia de enfermedad periodontal. *A los procedimientos que no aparecen en su lista de precios se les aplicara un descuento del 25% de lo usual y razonable. Los dentistas y especialistas son los unicos responsables por el tratamiento y precio del mismo. Med Plan no es responsable por los pagos ni por las indicaciones odontologicas hechas por los dentistas y especialistas asociados a nuestro plan.

52

VISION CENTERS / CENTROS DE VISION

Our members will receive a comprehensive eye exam(s) with a $35 visit which includes: • Vision Evaluation. • Intraocular Pressure Evaluation to check for Glaucoma. • Dilated Eye Exam to determine eye health and to look for disease such as high blood pressure and diabetes. • External eye health evaluation Nuestros miembros recibirán un (1) examen ocular completo con un costo de $ 35.00 que incluye: • Evaluacion de la vista - (Optometría) • Evaluación de la Presión Intraocular para verificar evidencia de glaucoma. • Dilatación de la pupila para determinar la salud y para identificar enfermedades tales como presión alta o diabetes. • Evaluación externa para determinar la salud de los ojos.

Optical & Vision Centers / Centros Opticos

Miami - Dade

(SOUTH FLORIDA VISION). ** Harrold Forrest, O.D James Hagen, O.D Martha Alfonso, O.D. (Navarro Pharmacy # 32) 366 East 4th Avenue. Hialeah, Fl. 33010 Phone: (305) 888-9910 Language: English / Spanish

(SOUTH FLORIDA VISION). ** Martha Alfonso, OD. Harrold Forrest, OD. James Hagen OD. (Navarro Pharmacy # 25) 11865-A SW 26th Street. Miami, Fl. 33175 Phone: (305) 552-9100 / (305) 225-4004 Language: English / Spanish

(VISION CENTER OPTICA). ** Gerald D. Furnari O.D. F.A.A.O. Robert L. Lofton O.D. F.A.A.O. Patrick F. Vecchio O.D. F.A.A.O. 948 N. Krome Ave Homestead Fl. 33030 Phone: (305) 247-2331 Language: English / Spanish

(TRIANGLE VISION CENTER.) *** (Vision Center/ Optica) 1750 West 39 Place Hialeah, Fl. 33012 Phone: (305) 490-3816 Lang. English / Spanish

(OPTICA ARIAS). ** (Vision Center/ Optica) 9160 NW 122th Street, Suite 28 Hialeah Gardens , Fl. 33018 Phone: (305) 512-4408 Language: English / Spanish

(VISION CENTER OPTICA). ** Gerald D. Furnari O.D. F.A.A.O. Patrick F. Vecchio O.D. F.A.A.O. 8501 SW 124 Ave # 109 Miami Fl. 33183 Phone: (305) 665-5712 Language: English / Spanish

(VISION SPECIALTY CARE) *** (Vision Center/ Optica) 3373 W Flagler St Miami, Fl. 33134 Phone: (305) 263-9050 Lang. English / Spanish

(VISION SPECIALTY CARE) *** (Vision Center/ Optica) 5190 NW 167 St Suite 109 Miami, Fl. 33014 Phone: (305) 263-9050 Lang. English / Spanish

Note: ( ** ) Evaluation includes Intraocular Exam to Detect Glaucoma, Diabetes and High Blood Pressure. Nota: ( ** ) La evaluación incluye Examen Intraocular para verificar si hay Glaucoma, Diabetes y Presión Alta. Note: ( *** ) Evaluation does NOT include Intraocular Exam to Detect Glaucoma, Diabetes and High Blood Pressure. Nota: ( *** ) La evaluación NO incluye Examen Intraocular para verificar si hay Glaucoma, Diabetes y Presión Alta. 53

Optical & Vision Centers / Centros Opticos

Miami - Dade

(VISION SPECIALTY CARE) *** (Vision Center/ Optica) 8300 W Flagler Suite 206 Miami, Fl. 33126 Phone: (305) 263-9050 Lang. English / Spanish

Optical & Vision Centers / Centros Opticos (SOUTH FLORIDA VISION). ** Eric Dupuis, OD. Christopher Boalding, OD. Laurie Lesser, OD. 2551 South University Drive Davie, Fl. 33324 Phone: (954) 370-5883 Fax: (954) 370-8799 Language: English / Spanish

(SOUTH FLORIDA VISION). ** Eric Dupuis, OD. Christopher Boaldin, OD. Robert Coppola, OD. 2900 W. Cypress Creek Rd. # 1 Ft. Lauderdale Fl. 33309 Phone: (954) 979-2191 Fax: (954) 979-8988 Language: English / Spanish

(SOUTH FLORIDA VISION). ** Laura DeMarco, OD. 1666 East Oakland Park Blvd.. Ft. Luderdale Fl. 33334 Phone: (954) 566--1404 Fax: (954) 566-0291 Language: English / Spanish

(SOUTH FLORIDA VISION). ** Christopher Boaldin, OD. Harold Forrest, OD. Laurie Lesser, OD. 12538 Pines Blvd. Pembroke Pines, Fl. 33027 Phone: (954) 430-4030 Language: English / Spanish

Optical & Vision Centers / Centros Opticos (SOUTH FLORIDA VISION). ** Ashley Nochomson, OD. Karen Puchalski, OD. Miriam Farag, OD. 9851- B South Military Trail. Boynton Beach, Fl. 33436 Phone: (561) 742-8701 Fax: (561) 742-4212 Language: English / Spanish

(SOUTH FLORIDA VISION). ** Christopher Boaldin, OD. 143 N. Powerline Road Deerfield Beach, Fl. 33442 Phone: (954) 429-9600 Fax: (954) 429-9956 Language: English / Spanish

(SOUTH FLORIDA VISION). ** Mitchell Biderman, OD. Karen Puchalski, OD. Lori Raynor, OD. 6618 West. Atlantic Ave. Delray Beach, Fl. 33446 Phone: (561) 498-5007 Fax: (561) 496-3088 Language: English / Spanish

(SOUTH FLORIDA VISION). ** Mitchell Biderman, OD. Christopher Boaldin, OD. Lori Raynor, OD. Ashley Nochomson, OD. 6266 S. Congress Ave. # 9 Lantana, Fl. 33462 Phone: (561) 966-9000 Language: English / Spanish

Broward (SOUTH FLORIDA VISION). ** Mirian Faraq, OD. Christopher Boaldin, OD. Jerrold Mills, OD. 3181 North State Rd. # 7 Margate Fl. 33063 Phone: (954) 974-7695 Fax: (954) 974-4211 Language: English / Spanish (SOUTH FLORIDA VISION). ** Robert Coppola, OD. Christopher Boaldin, OD. 1205 S. Powerline Rd. Pompano Beach, Fl. 33069 Phone: (954) 977-6636 Fax: (954) 977-3822 Language: English / Spanish

Palm Beach (SOUTH FLORIDA VISION). ** Ronie Zaruches, OD. 143 N. Powerline Road Deerfield Beach, Fl. 33442 Phone: (954) 429-9600 Fax: (954) 429-9956 Language: English / Spanish

(SOUTH FLORIDA VISION). ** Karen Puchalski, OD. Jason Aronson, OD. 2905-G N. Military Trail West Palm Beach, Fl. 33409 Phone: (561) 684-5548 Fax: (561) 684-6229 Language: English / Spanish

Note: ( ** ) Evaluation includes Intraocular Exam to Detect Glaucoma, Diabetes and High Blood Pressure. Nota: ( ** ) La evaluación incluye Examen Intraocular para verificar si hay Glaucoma, Diabetes y Presión Alta. 54

Optical & Vision Centers / Centros Opticos

St. Lucie

(ST. LUCIE VISION CENTER). ** Mitchell Biderman, OD. ** 10077 South Federal Hwy. Port St. Lucie, Fl. 34952 Phone: (772) 398-3244 Fax: (772) 398-8090 Language: English / Spanish

Optical & Vision Centers / Centros Opticos

Ft. Myers

(VISTA VISION EYE CARE). ** 12320 South Cleveland Ave. Ft. Myers Fl. 33907 Phone: (239) 936-5591 Language: English / Spanish

Note: ( ** ) Evaluation includes Intraocular Exam to Detect Glaucoma, Diabetes and High Blood Pressure. Nota: ( ** ) La evaluación incluye Examen Intraocular para verificar si hay Glaucoma, Diabetes y Presión Alta. 55

56

CLINICAL LABS / LABORATORIOS CLINICOS

Services Details Over One thousand “1000” Lab tests available 80% of the tests are priced below $20.00. Five Complementary Lab tests free for all Med Plan members and their family once a year. Included tests are: • CBC. • Comprehensive Metabolic Panel. • Lipid Profile. • TSH • Urinalysis. All Laboratories require that the tests being requested are ordered by a licensed healthcare professional that is authorized to practice medicine in the State of Florida. The order must be written in a Physicians prescription or on the Laboratories requisition form that is signed by the ordering physician. All Laboratory results will be sent to the office of the Physician or Specialist that has ordered the test. This procedure is to protect the confidential information regarding the outcome or the test results.

Detalles de los Servicios De las pruebas de laboratorio disponibles, el 80% de su totalidad están bajo precios fijos. MedPlan ha coordinado con sus laboratorios asociados que ofrecen precios preferenciales a nuestros miembros en varios exámenes y además cinco (5) exámenes complementarios cada año sin costo alguno para usted. • CBC. • Panel metabólico completo. • Perfil de lípitdos. • TSH (Tiroides) • Análisis de orina. Todos los laboratorios requieren que los exámenes que se solicitan hayan sido previamente indicados por un profesional de la salud con licencia que le autoriza a ejercer la práctica de la medicina en el Estado de la Florida. La indicación del examen debe estar escrita en una receta médica o en su lugar en el formulario de solicitud establecida para los Laboratorios y firmada por el médico que la indica. Todos los laboratorios cumplirán el procedimiento legal establecido de confidencialidad del paciente y para proteger este derecho enviaran los resultados de su/s examen a la oficina de su doctor.

57

Clinical Labs / Laboratorio Clínico

Miami - Dade

Complete Bio Solutions 7200 NW 7 ST # 202 Miami, Fl. 33126 Phone: (305) 267-7784 Language: English / Spanish Veni puncture Fee: $10.00

Florida Reference Laboratory. 4278 SW 71 ave Miami, Fl. 33155 Phone: (305) 662-2626 Fax: (305) 667-5870 Language: English / Spanish Veni puncture Fee: Free

Florida Reference Laboratory. 8740 N. Kendall Dr. # 107 A Miami, Fl. 33176 Phone: (305) 270-9944 Language: English / Spanish Veni puncture Fee: Free

Florida Reference Laboratory. 50 NW 15 ST # 103 Homestead, Fl. 33033 Phone: (305) 245-5188 Language: English / Spanish Veni puncture Fee: Free

Florida Reference Laboratory. 3150 Northside Drive, Building F Key West, Fl. 33040 Phone: (305) 292-3231 Language: English / Spanish Veni puncture Fee: Free

Complete Bio Solutions 10550 NW 77 Court Hialeah, Fl. 33016 Phone: (305) 826-3072 Language: English / Spanish Veni puncture Fee: $10.00

Complete Bio Solutions 5850 West Flagler ST Miami, Fl. 33144 Phone: (305) 263-9590 Language: English / Spanish Veni puncture Fee: Free

Complete Bio Solutions 3720 SW 107 ave Miami, Fl. 33165 Phone: (305) 554-4270 Language: English / Spanish Veni puncture Fee: $10.00

Complete Bio Solutions 8651 NW 56 ST Miami, Fl. 33166 Phone: (305) 477-6520 Language: English / Spanish Veni puncture Fee: $5.00

ECCO LAB GROUP 8370 W Flagler St Suite # 206 Miami, Fl. 33144 Phone: 305-220-3805 ANNUAL FREE PANELS (5 per member) AT ALL FLORIDA REFERENCE LABS AND COMPLETE BIO SOLUTIONS LABS. 5 PANELES GRATIS AL ANO EN TODOS LOS FLORIDA REFERENCE LABS Y COMPLETE BIO SOLUTIONS LABS.

Clinical Labs / Laboratorio Clínico CM Lab, Inc. 9872 Pines Blvd. Pembroke Pines, Fl. 33024 Phone: (954) 704-9116 Fax: (954) 704-8823 Language: English / Spanish Refer to Fee Schedule

CM Lab, Inc. 2523 North State Road 7 Margate, Fl. 33063 Phone: (754) 224-4152 Fax: (954) 590-6551 Language: English / Spanish Refer to Fee Schedule

Broward Lab Test Discount (Venipuncture only) 5311 NW 79 ave Doral, Fl. 33166 Phone: (305) 646-1363 Fee $10.00 plus test price.

First Quality Lab* 11460 Interchange Circle North Miramar, Fl. 33025 Phone: (954) 430-4424 Language: English / Spanish Refer to Fee Schedule First Quality Lab and CM Lab will charge $10 for venipuncture. First Quality Lab y CM Lab cobran $10.00 por la extraccion de sangre ANNUAL FREE PANELS (5 per member) ONLY AT “FIRST QUALITY LAB” 5 PANELES DE LABORATORIO GRATIS AL ANO SOLAMENTE EN “FIRST QUALITY LAB” HOME LABORATORY SERVICES UP TO WEST PALM BEACH FLEBOTOMIA A DOMICILIO HASTA WEST PALM BEACH

58

Clinical Labs / Laboratorio Clínico

Palm Beach

Venipuncture Center for Med Plan Members at a cost of $10.00 only on Mondays, Thursdays and Saturdays Centro habilitado para la extraccion de sangre a los miembros de Med Plan con un costo de $10.00 solamente los Lunes, Jueves y Sabados. Vital Care Medical Center 2188 Jog Road Green Acres, Fl. 33415 Phone: (561) 439-0850

Clinical Labs / Laboratorio Clínico

Collier

Complete Bio Solutions (Only Venipuncture/Sólo extracción de sangre) (Tuesdays 8:30 am to 1:00 pm) (Martes 8:30 am - 1:00 pm) 4947 Tamiami Trail N Suite # 206 Naples, Fl. 34103 Phone: 239-304-9290

Clinical Labs / Laboratorio Clínico

Lee / Cape Coral

Venipuncture Center for Med Plan Members at a cost of $10.00 only on Mondays. Centro habilitado para la extraccion de sangre a los miembros de Med Plan con un costo de $10.00. Este servicio se ofrece sólo los Lunes. Del Prado Medical Center. 2500 Del Prado Blvd South Cape Coral Fl. 33954 Phone: (239) 772-1194 / 1195

Clinical Labs / Laboratorio Clínico

Orange

Venipuncture Center for Med Plan Members at a cost of $10.00 ECCO LAB GROUP 1130 South Semoran Blvd Orlando, Fl. 32807 Phone: (407) 480-2938 ANNUAL FREE PANELS (5 per member) AT ALL ECCO LAB GROUP AND VENIPUNCTURE FOR $10.

Clinical Labs / Laboratorio Clínico Venipuncture Center for Med Plan Members at a cost of $10.00 ECCO LAB GROUP 2801 Waters Ave Suite B-1 Tampa, Fl. 33614 Phone: (813) 932-9525 Contact: Nadina Rodriguez ANNUAL FREE PANELS (5 per member) AT ALL ECCO LAB GROUP AND VENIPUNCTURE FOR $10.

Hillsborough

INDEPENDENT LABORATORY SERVICES FEE SCHEDULE ANNUAL FREE PANEL FOR PATIENTS ANALISIS GRATIS UNA VEZ AL AÑO CBC COMP. METABOLIC PANEL TSH LIPID PANEL URINE

PATHOLOGY TEST / EXAMENES DE PATOLOGIA TEST NAME PAP SMEAR (slide) PAP LIQUID SUREPATH HUMAN PAPILOMA VIRUS hc2 CHLAMYDIA & GC DNA CHLAMYDIA & GC DNA hc2 PAP PANEL (liquid pap+HPVhc2+chlamydia&GC hc2

TEST CODE 9161 9142 1845 5344 9193 9190

PRICE $12.00 $25.00 $38.00 $25.00 $35.00 $99.00

TEST CODE

PRICE

9181 9182 9183 9184

$30.00 $40.00 $65.00 $85.00

All the Gynecology collections will cost $20. Todas las colecciones ginecologicas tendran un costo de $20.

*The prices of the biopsies level (I-II-III-IV-V-VI) will be determined by the specimen site, number of the specimens and any special stains required for the final diagnosis. BIOPSY Level I - Gross only BIOPSY Level II BIOPSY Level III BIOPSY Level IV

60

INDEPENDENT LABORATORY SERVICES FEE SCHEDULE TEST NAME A

TEST CODE

PRICE

AMYLASE ACTH (ADRENOCORTICOTROPIC HORMONE) AFP TUMOR MARKER ALBUMIN ALCOHOL IN URINE ALDOLASE ALKALINE PHOSPHATASE ALLERGEN FOOD PANEL (ADULT) each allergen ($9) ALLERGEN RESPIRATORY PANEL(SUB-TROPICAL) each allergen ($9) ALLERGY PANEL PER ALLERGEN each allergen ($9) ALPHA PHETO PROTEIN QUAD SCREEN ALPHA PHETO PROTEIN TRIPLE SCREEN ALT (SGPT) AMIKACIN SERUM AMMONIA ANA ANTIBODY SCREENING ASO

1106 7200 1274 8170 3525 1102 8160 7302 7304 1673 8260 8154 1695 1104 5200 4259 4201

$6.00 $37.00 $15.50 $2.50 $12.00 $9.50 $2.50 $9.00 $9.00 $9.00 $82.00 $56.00 $8.00 $15.50 $12.50 $12.00 $11.50 $15.00

AST (SGOT)

8152

$8.00

B-12 & FOLID ACID

8794

$30.00

B-12

7272

$12.50

BASIC METAB PANEL

8118

$8.00

BETA 2 MICROGLOBULIN

1404

$16.50

BILIRUBIN DIRECT

8149

$4.50

BILIRUBIN TOTAL

8166

$4.50

BIOPSY (see comments at the end)

9181

BLEEDING TIME

4108

$4.50

BLOOD TYPE & RH

4200

$18.00

BNP

1430

$40.00

BUN

8142

$5.00

CBC

4110

$7.00

C3 COMPLEMENT

6115

$20.00

C4 COMPLEMENT

6126

$20.00

CA 125

1462

$19.50

CA 15-3

1462

$19.50

CA 19-9

1463

$19.50

B

C

61

INDEPENDENT LABORATORY SERVICES FEE SCHEDULE TEST NAME

TEST CODE 1664 8172 2130 1318 3119 7214 6119 5346 5344 8146 8156 1353 5210 8112 4214 4215 7206 1431 6127

PRICE $19.50 $4.50 $11.00 $27.00 $15.00 $19.50 $36.00 $60.00 $25.00 $4.50 $7.00 $14.50 $12.50 $9.00 $10.00 $10.00 $17.50 $15.00 $12.50

C-REACTIVE PROTEIN - QUANT C-REACTIVE PROTEIN (CRP)

3595 4216

$12.50 $5.00

C-REACTIVE PROTEIN (CRP) ULTRASENSITIVE

6657

$12.50

CREATININE 24 HRS

2115

$10.00

CREATININE CLEARANCE

2127

$9.50

CREATININE SERUM

8150

$4.00

CULTURE & SENSIT

5145

$14.00

CYSTIC FIBROSIS

6442

$250.00

DEPAKENE (VALPROIC ACID)

1938

$14.00

DHEA (DEHYDROEPIANDROSTERONE

7171

$26.00

DHEA-S

1655

$26.00

CA 27-29 CALCIUM CALCIUM IONIZED CALCULUS (stone) ANALYSIS CARBAMAZEPIN CEA CERULOPLASMIN CHLAMYDIA & GC IN URINE CHLAMYDIA & GC DNA CHOLESTEROL CK (CPK TOTAL) CMV IgG CMV IgM COMPRENH. METABOLIC PANEL COOMBS DIRECT COOMBS INDIRECT CORTISOL C-PEPTIDE CPK - MB (CREATINE KINASE MB FRACTION)

D

DIHYDROTESTOSTERONE DHT

$26.50

D-DIMER

$22.50

DILANTIN LEVEL

3126

$15.00

DRUG SCREEN IN URINE

3223

$23.00

ELECTROLYTE PANEL

8200

$6.50

EPSTEIN BARR VIRAL CAPSIDE ANTIGEN (VCA) IgG & IgM

1920

$14.00

EPSTEIN BARR VIRUS EARLY

1632

$14.00

E

62

INDEPENDENT LABORATORY SERVICES FEE SCHEDULE TEST NAME EPSTEIN BARR VIRUS NUCLEAR ANTIGEN IgG ANTIBODY EPSTEIN BARR VIRUS NUCLEAR ANTIGEN IgM ANTIBODY ERYTHROPOIETIN ESTRADIOL ESTRIOL ESTROGEN TOTAL ESR (SED RATE) EYE CULTURE & SENSITIVITY F FERRITIN FIBRINOGEN FOLIC ACID FREE T3 FREE T4 FSH FSH&LH FINE NEEDLE ASPIRATION FTA AG FUNGUS CULTURE

TEST CODE 1861 1902 5215 7226 7224 7227 4160 5145

PRICE $17.50 $17.50 $18.50 $22.00 $28.00 $22.00 $8.00 $12.00

7275 4223 7229 1603 7120 7228 7261 5220 5114

$14.00 $22.00 $13.00 $7.00 $7.00 $17.00 $34.00 $69.00 $35.00 $35.00

GAMMA GT (GGTP)

1116

$5.00

GC CULTURE

5118

$35.00

GENTAMYCIN

7232

$28.00

GLIADIN IgA, IgG

1432

$80.00

GLUCOSE 2 HRS P.P

8180

$7.00

GLUCOSE 2 HRS TOLERANCE TEST

8188

$13.00

GLUCOSE 3 HRS

8189

$17.00

GLUCOSE GRAY TUBE

8141

$3.50

GLUCOSE SERUM

8140

$3.50

GLYCOHEMOGLOBIN

6145

$9.00

H. PYLORI AB IgG

1295

$15.00

H.PYLORI AB IgM

1297

15.00

H.PYLORI IN STOOL (ANTIGEN)

1294

$43.00

HAPTOGLOBULIN

6147

$25.00

HCG QUAL

7282

$7.00

HCG QUANT

7240

$15.50

HEMOGLOBIN A1C

6145

$9.50

HEMOGLOBIN ELECTROPHORESIS

6151

$12.00

G

H

63

INDEPENDENT LABORATORY SERVICES FEE SCHEDULE TEST NAME HEMOGLOBIN/HEMATOCRIT HEPATIC FUNCTION PANEL HEPATITIS A IgM HEPATITIS A TOTAL HEPATITIS B CORE IgM ANTIBODIES HEPATITIS B CORE TOTAL ANTIBODY HEPATITIS Bs ANTIBODY HEPATITIS Bs ANTIGEN HEPATITIS C ANTIBODY HEPATITIS PANEL ABC HERPES CULTURE HERPES I SELECT HERPES SELT II IgG HIV 1 & 2 SCREEN HLA-B-27 HOMOCYSTEINE HUMAN GROWTH HORMONE HUMAN PAPILOMA VIRUS hc2 I

TEST CODE 4132 8698 1376 1621 1799 1614 7237 7236 1711 2298 1716 1439 1440 1437 1398 1227 7238 1846

PRICE $12.00 $7.50 $11.50 $10.50 $11.50 $11.50 $11.00 $10.00 $13.50 $44.00 $35.00 $12.50 $18.50 $9.50 $70.00 $28.00 $16.00 $39.00

IgA (Immunoglobulin) IgE (Immunoglobulin E)

6140 7248

$9.00 $16.00

IgG (Immunoglobulin)

6142

$9.00

IgM (Immunoglobulin M)

6143

$9.00

IMMUNOELECTROPHORESIS

6160

$21.50

IMMUNOGLOBULIN IgG-A-M

6156

$27.00

INSULINE LEVEL

7250

$11.50

INSULINE LIKE GROWTH FACTOR I SOMATOMEDIN-C IgF1

1666

$30.00

IRON

8162

$5.00

IRON & IBC

8161

$8.50

LEAD BLOOD

2160

$10.50

L.E. SCREEN

3662

$10.00

LDH

8158

$4.00

LH

7244

$19.50

LIPASE

1126

$6.50

LIPID PANEL

6188

$9.00

LIPOPROTEIN A

6165

$33.20

LITHIUM

2163

$7.00

LIVER PROFILE I

8158

$10.00

L

64

INDEPENDENT LABORATORY SERVICES FEE SCHEDULE TEST NAME M

TEST CODE

PRICE

MAGNESIUM SERUM MEASLES ANTIBODY IgG MEASLES ANTIBODY IgM METANEPHRINE 24 HRS URINE MICROALBUMIN 24 HRS URINE MICROALBUMIN RANDOM MITOCHONDRIAL TOTAL AUTOANTIBODIES MONO TEST MUMPS ANTIBODY IgG MUMPS ANTIBODY IgM MYCOPLASMA IgM TITER PNEUMONIAE ANTIBODY MYCOPLASMA PNEUMONIAE ANTIBODY IgG, IgM MYELIN BASIC PROTEIN (MBP) AUTOANTIBODIES MYSOLINE (PRIMIDONE) N NEURONTIN (GABAPENTIN) NICOTINE METABOLITE URINE O

2166 2362 2361 2169 1208 1209 5226 4213 1362 1317 1985 1363 1404 3162

$6.50 $12.50 $12.50 $80.00 $35.00 $4.00 $55.00 $12.00 $12.50 $12.50 $60.00 $65.00 $90.00 $55.00

1609 3198

$50.00 $24.50

OBSTETRIC PANEL OCCULT BLOOD PER SPECIMEN

8136 4320

$45.23 $5.00

OVA AND PARASITES

4321

$9.00

OXALATES - 24HRS

2173

$13.00

OXALATES - URINE RANDOM

2172

$13.00

PAP SMEAR

9161

$15.00

PAP LIQUID SUREPATH

9142

$25.00

PHENOBARBITAL

3155

$11.00

PHOSPHORUS

8174

$4.00

PLATELET COUNT

4149

$6.00

POTASIUM

8210

$4.00

POTASIUM IN URINE

8223

$4.00

PRE - ALBUMIN

2011

$7.00

PREGNANCY TEST IN URINE

4330

$6.50

PRIMIDONE

3162

$15.00

PROCAINAMIDE (PRONESTYL + NAPA)

3163

$16.50

PROGESTERONE

7256

$26.00

PROLACTIN

7252

$19.50

PROTEIN ELECTROPHORESIS

6129

$10.00

P

65

INDEPENDENT LABORATORY SERVICES FEE SCHEDULE TEST NAME

TEST CODE 2305 8168 2216 1937 4254 1373 4253

PRICE $3.50 $5.00 $29.00 $15.00 $3.50 $35.00 $3.50

2183

$14.50

R A LATEX RENAL FUNCTION PANEL RENIN RETIC COUNT RH FACTOR (ONLY) RHEUMATOID FACTOR RUBELLA ANTIBODY IgG RUBELLA ANTIBODY IgM RPR

4257 8108 7258 4154 4202 4257 5230 1752 4272

$7.00 $8.00 $18.50 $4.00 $5.50 $6.00 $15.00 $15.00 $4.50

RUBELLA ANTIBODY IgM

1752

$15.00

SED RATE

4160

$3.50

SEMEN ANALYSIS

4331

$50.00

SEROTONIN (5-HIAA)

2186

$11.00

SICKLE CELL SCREEN

4161

$6.00

SMOOTH MUSCLE ANTIBODY

1601

$30.00

SODIUM (U) 12 HRS

2334

$4.50

SODIUM (U) 24 HRS

2335

$4.50

SODIUM IN URINE

8221

$4.50

SODIUM SERUM

8205

$4.00

STONE ANALYSIS (KIDNEY)

1318

$27.00

STOOL CULTURE

5113

$13.50

T-3 FREE

1603

$7.00

T3 TOTAL

7260

$7.00

T3-UPTAKE

7105

$6.00

T4

7110

$6.00

TACROLIMUS (PROGRAF)

1282

$16.00

TESTOSTERONE

7268

$25.00

PROTEIN TOTAL 24HRS PROTEIN TOTAL SERUM PSA FREE & TOTAL PSA SCREEN PT PTH INTACT PTT Q QUINIDINE R

S

T

66

INDEPENDENT LABORATORY SERVICES FEE SCHEDULE TEST NAME TESTOSTERONE FREE & TOTAL THEOPHYLLINE THIAMINE LEVEL (VITAMIN B1) THROAT CULTURE THYROGLOBULIN Abs SCREEN THYROGLOBULIN QUANT. THYROID II PANEL (TSH) THYROID PEROXIDE AB (TPO) THYROID STIMULATING IMMUNOGLOBULINS (TSI) THYROXIDE BINDING GLOBULIN TOBRAMYCIN TORCH PANEL TOXOPLASMA IgG TRANSFERRIN TRAZODONE TREPONEMA PALLIDUM TOTAL ANTIBODIES (FTA) TRIGLYCERIDES TROPONIN I TSH

TEST CODE 7269 3174 7175 5155 5202 1201 7121 5205 1389 1391 3185 8420 5236 6175 1798 5220 8148 8157 7264

PRICE $27.50 $14.50 $6.00 $13.50 $16.00 $14.00 $29.00 $15.00 $12.50 $11.00 $16.00 $60.00 $15.00 $15.00 $70.00 $22.00 $6.00 $15.50 $14.00

URINALYSIS

4340

$2.00

URIC ACID

8144

$3.00

URINE CULTURE

5113

$13.50

U

URINE CYTOLOGY

$25.00 V

VARICELLA ANTIBODY IgG

2772

$15.00

VITAMIN D25

1300

$33.50

VITAMIN D

1301

$33.50

VITAMIN B-6

1346

$14.00

VAGINAL CULTURE

5156

$13.50

VARICELLA ZOSTER ANTIBODY IgM

2772

$15.00

VITAMIN B-1 (THIAMINE)

7175

$6.00

VMA (VANILLYLMANDELIC ACID 24 HRS URINE)

2196

$12.50

VALPROIC ACID

1938

$14.00

VITAMIN B-12

7272

$15.00

1833

$35.00

W WESTERN BLOT ANALYSIS WET MOUNT

$4.00

WBC IN STOOL

4319

$8.00

2199

$11.50

Z ZINC

67

DIAGNOSTICS / CENTROS DE DIAGNOSTICO

Services Details

Over 300 Diagnostic Tests available which include: • Digital Mammography • MRI • CT Scans • PET CT Scans • Ultra Sound • X-Rays • Sleep Studies All Diagnostic Centers requires that the tests being requested are ordered by a licensed healthcare professional that is authorized to practice medicine in the State of Florida. The order must be written in a Physicians prescription or on the Diagnostic Centers requisition form that is signed by a physician. All test results will be sent to the office of the Physician or Specialist that ordered the test. This procedure is to protect the confidential information regarding your health.

Detalles de los Servicios Más de trescientos (300) procedimientos de diagnóstico están disponible e incluyen: • Mamografia Digital • Tomografia computaizada • CT Scans • PCT Scans • Ultrasonido • Rayos X • Estudios del sueno Todos los Centros de Diagnóstico requieren que los exámenes que se solicitan hayan sido previamente indicados por un profesional de la salud con licencia que le autoriza a ejercer la práctica de la medicina en el estado de la Florida. La indicación del procedimiento debe estar escrita en una receta médica o en su lugar en el formulario de solicitud establecida para los procedimientos de Diagnósticos y firmada por el médico que la indica. Todos los laboratorios cumplirán el procedimiento legal establecido de confidencialidad del paciente y para proteger este derecho enviaran los resultados de sus exámenes a la oficina del doctor que lo indicó.

Diagnostic Radiology / Centro de Diagnóstico Digital Medical Diagnostic 41 Tamiami Canal Rd Miami Fl. 33166 Phone: (305) 269-0833 Fax: (305) 269-0851 Language: English / Spanish

Digital Mammography Mamografía digital por sólo $50.00

68

CT Imaging Inc. 395 West 10 Street, Suite 2 Hialeah Fl. 33010 Phone: (305) 887-7562 Language: English / Spanish Refer to Fee Schedule

Miami - Dade Eiber Radiology. 49 West 49th Street. Hialeah, Fl. 33012 Phone: (305) 557- 0330 Fax: (305) 556-5133 Language: English / Spanish

Diagnostic Radiology / Centro de Diagnóstico

Miami - Dade

Bay Imaging Group. (Radiologist) 1755 NE 127th Street. North Miami Fl. 33181 Phone: (305) 891-1900 Language: English / Spanish Refer to Fee Schedule

Virtual Imaging Service. (Radiologist) 3320 Palm Avenue. Hialeah, Fl. 33012 Phone: (305) 596-9992 Language: English / Spanish Refer to Fee Schedule Transportation Available

Universal Imaging of Florida. (Radiologist) 14462 Commerce Way. Miami Lakes, Fl. 33016 Phone: (305) 821-8585 Language: English / Spanish Refer to Fee Schedule Transportation Available

Pinnacle Imaging (Radiologist) 2390 NW 7 St, Suite 103 Miami, Fl. 33125 Phone: (305) 642-7388 Language: English / Spanish

Virtual Imaging. (Radiologist) (Sleep Studies / Estudio del Sueño) 9835 SW 72th Street, Suite 107 Miami, Fl. 33173 Phone: (305) 596-9992 Fax: (305) 779-9096 Precio: $500.00

Virtual Imaging Service. (Radiologist) 7101 SW 99 Avenue, Suite 106 Miami, Fl. 33173 Phone: (305) 596-9992 Language: English / Spanish Refer to Fee Schedule Transportation Available

Systems Associate Inc. (Neurological Diagnostic) Home and Office Service 7374 SW 93 Ave, Suite 201 Miami, Fl. 33173 Phone: (305) 270-7771

CMS Open MRI 9601 SW 40 St Miami, Fl. 33165 Phone: (305) 227-2500 Language: English / Spanish

LifeStream Mobile. 9745 Sunset Drive, Suite 201 Miami, Fl. 33173 Phone: (305) 264-2021 Language: English / Spanish Servicios móbiles a domicilio u oficinas médicas. Ultrasonido Cargo por visita: $15.00

South Florida Perinatal Medicine. 6200 Sunset Drive, Suite 301 Miami, Fl. 33143 Phone: (305) 669-9521 Language: English / Spanish (Llamar a Customer Service para otras seis localizaciones)

Virtual imaging 692 N. Homestead Blvd, Ste 106 Homestead, Fl. 33030 Phone: (305) 596-9992 Language: English / Spanish

Lab Test Discount 5311 NW 79 ave Doral, Fl. 33166 Phone: (305) 646-1363 Ultrasound Only

All X Ray Diagnostic Service, Corp 5040 NW 7 ST # 170 Miami, Fl. 33126 Phone: (305) 445-9462 Language: English / Spanish Refer to Fee Schedule

Diagnostic Radiology / Centro de Diagnóstico Diagnostic Professional, Inc. 7301 NW 4th Street #107 Plantation, Fl. 33317 Phone: (954) 449-7023 Fax: (954) 449-7027 Language: English / Spanish Refer to Fee Schedule

Diagnostic Professional, Inc. 1799 West Oakland Park Blvd 105 Ft Lauderdale Fl. 33311 Phone: (954) 777-3466 Fax: (954) 777-3510 Language: English / Spanish Refer to Fee Schedule

Broward Diagnostic Professional, Inc. 10950 Pines Boulevard Pembroke Pines, Fl. 33026 Phone: (954) 430-2044 Fax: (954) 430-2055 Language: English / Spanish Refer to Fee Schedule 69

Diagnostic Radiology / Centro de Diagnóstico Diagnostic Professional, Inc. 6808 N. State Road 7 Coconut Creek, Fl. 33073 Phone: (954) 570-5560 Fax: (954) 571- 5240 Language: English / Spanish Refer to Fee Schedule

Broward Pet Imaging Center 4850 W. Oakland Park Blvd Suite 1A Lauderdale Lakes, Fl. 33313 Phone: (954) 735-6330 Language: English / Spanish

Diagnostic Radiology / Centro de Diagnóstico

Broward Bersa Mobil X Ray 7300 W Menab Rd Suite 112 Tamarac, Fl. 33121 Phone: (954) 515-7080 Language: English / Spanish RX, Eco-Cardiac, Ultrasound EKG Mobile Services / Servicio Movil

West Palm Beach

All X Ray Diagnostic Service, Corp 1800 Forest Hill Blvd Suite # A 1-2 West Palm Beach, Fl. 33406 Phone: (561) 318-5493 Language: English / Spanish Refer to Fee Schedule

A1 Imaging Centers, LLC -- Florida Locations (MRI Only) (MRI solamente) A1 Imaging of Boynton Beach 3795 Boynton Beach Blvd Ste. C Boynton Beach, Fl. 33436 Phone: (561) 740-9305 Fax: (561) 740-9305 Services: Open MRI

A1 Imaging of Orange Park 1566 Kingsley ave Orange Park, Fl. 32073 Phone: (904) 278-2128 Fax: (904) 278-2129 Services: Closed and Open MRI

A1 Imaging of Deerfield 1890 W. Hillsboro Blvd. Deerfield Beach, Fl. 33442 Phone: (954) 429-8381 Fax: (954) 429-2705 Services: Open MRI

A1 Imaging of Ft. Lauderdale 5100 N federal Hwy, Ste 102 Ft. Lauderdale, Fl. 33308 Phone: (954) 202-3400 Fax: (954) 202-3448 Services: Open MRI

A1 Imaging of Pembroke Pines 8384 Pines Blvd Pembroke Pines, Fl. 33024 Phone: (954) 450-4020 Fax: (954) 432-8674 Services: Open MRI

A1 Imaging of Orlando 500 N Semoran Blvd., Ste 103 Orlando, Fl. 32807 Phone: (407) 275-6072 Fax: (407) 275-7301 Services: Open MRI

A1 Imaging of Ocoee 9450 W. Colonial Dr. Ste 12 Ocoee, Fl. 34761 Phone: (407) 822-0999 Fax: (407) 822-0990 Services: Open MRI

A1 Imaging of St. Augustine 200 S. Park Blvd.,Ste 210 St. Augustine, Fl. 32086 Phone: (904) 819-0920 Fax: (904) 819-0299 Services: Open MRI

A1 Imaging of West Palm Beach 1117 N. Olive Ave #101 West Palm Beach, Fl. 33401 Phone: (561) 651-7410 Fax: (561) 651-7417 Services: Open MRI

A1 Imaging of Plantation 150 N. University Dr. Ste 110 Plantation, Fl. 33324 Phone: (954) 423-3674 Fax: (954) 916-0674 Services: Closed and Open MRI

A1 Imaging of Mandarin 3753 Cardinal Point Dr. Jacksonville, Fl. 32223 Phone: (904) 636-5674 Fax: (904) 448-4674 Services: Open MRI

A1 Imaging of Cape Coral 1003 Del Prado Blvd., Unit 102 cape Coral, Fl. 33990 Phone: (239) 573-6333 Fax: (239) 573-8674 Services: Open MRI

A1 Imaging of Kissimmee 810 North John Young Pkwy Kissimmee, Fl. 34741 Phone: (407) 847-6745 Fax: (407) 847-8749 Services: Open MRI

A1 Imaging of Ocala 301 SE 17th St., Unit 102 Ocala, Fl. 34471 Phone: (352) 622-7459 Fax: (352) 622-9238 Services: Open MRI

A1 Imaging of Aventura 20880 W. Dixie Hwy, Suite 111/106 North Miami Beach, Fl. 33180 Phone: (305) 933-9565 Fax: (305) 933-8105 Services: Closed and Open MRI

70

71

72

72

73

74

74

PRECIOS DE MEDICINA PERINATAL Ultrasound 76801 76802 76805 76810 76811 76812 76813 76814 76815 76816 76817 76818 76819 76820 76821 76830 76856 76945 76946

SFPM Rates 1st Tri1 Tri HighRisk Detailed Targ - New >1 Tri HgRk Detailed Tgt eachAdd Gest w/76811 OB/US Nuchal Measurement I Gest Nuchal Measurement each additional Gestation Limited-quick look @1or more elements Follow Up (re-eva org susp abnormal) OB Transvag (use in addition to transadom code) BPP w/NST BPP w/out NST Doppler UA Doppler CA Vag. Ultra (non-obstetrical purposes) Pelvic TR CVS Guidance Amnio Guidance

Member Fees $240.00 $140.00 $245.00 $230.00 $415.00 $265.00 $230.00 $155.00 $175.00 $160.00 $230.00 $245.00 $230.00 $180.00 $225.00 $265.00 $225.00 $245.00 $230.00

59000

Amnio

$300.00

59015

CVS

$370.00

99211

Minor 5 minute established

$70.00

99241

Minor 15 minute

$125.00

99242

Low 30 Min

$160.00

99243

Moderate 40 Min

$210.00

99244

Mod High 60 Min

$265.00

99251

Inpatient Consult 20 Min

$115.00

99252

Inpatient Consult 40 Min

$175.00

99254

Inpatient Consult 80 Min

$280.00

59025

NST

$125.00

AMNIO

Includes Counceling, U/S, Guidance, Amnio TWINS

$1,645.00

Includes Counceling,U/S, Guidance, CVS TWINS

$1,665.00

CVS

$2,700.00

1ST TRIMESTER

Includes Counceling, 1st Trimester U/S, Labs

$2,775.00 $805.00

SCREENING

& Nuchal Translucency TWINS

$1,100.00

INTEGRATED

Includes Counceling, 1st Trimester U/S, NT

$900.00

SCREENING

1st & 2nd Labs Included TWINS

$1,195.00

SEQUENTIAL

Includes Counceling, 1st Trimester U/S, NT

$825.00

SCREENING

and first part Labs TWINS

$1,120.00 75

ANCILLARY SERVICES / SERVICIOS AUXILIARES DURABLE MEDICAL SUPPLIES

Services Details When ordering medical equipment you must have a valid prescription signed by a licensed and authorized healthcare professional in the State of Florida indicating the supplies or equipment needed. You must present your Med Plan membership card with a picture ID so that your eligibility can be verified before your supplies are delivered. In order to receive the exclusive pricing offered to Med Plan members at contracted provider locations your monthly membership fee needs to be current. The durable medical supply offered to Med/Plan members are: • • • •

Wheel Chairs Walkers Hospital Beds Oxygen Concentrators

Offered 80% savings off of Providers Usual and Customary Fees. Unlimited Access to all Durable Medical Services.

SERVICIOS DE EQUIPOS MEDICOS Detalles de los Servicios

Al pedir suministro de algún equipo médico debe tener una receta de prescripción válida firmada por su Doctor donde se indique los suministros y equipos que necesita. Usted tendrá que presentar su tarjeta de miembro conjuntamente con una identificación (ID) con foto para que su elegibilidad pueda ser verificada en el momento y pueda beneficiarse de las tarifas preferenciales exclusivas que aplican únicamente a los miembros de MedPlan. Entre los equipos medicos duraderos ofrecidos por Med/Plan estan: • • • •

Sillas de ruedas Andadores Camas de hospital Concentradores de oxígeno

Estos servicios ofrecen un ahorro del 80% de descuento de los proveedores habituales y tarifas habituales. Acceso ilimitado a todos los servicios de equipos medicos duraderos.

76

ORTHOPEDIC SUPPLIES / SUPLEMENTOS ORTOPEDICOS Podortis Corp. (Orthopedic Supplies) 4701 SW 8 St Miami, Fl. 33134 Phone: (305) 446-2995 Fax: (305) 446-2996

PROSTHETIC ORTHOTIC FEES L CODE

DESCRIPTION

Member Fees $100.80

A5500 X 2

OFF THE SHELF DIAB SHOE / ZAPATOS PARA DIABETICOS

A5512 X 2

DIAB MULTIDENSITY INSERTS / SOPORTES DE DIAB PREFAB

$38.74

A5513 X 2

DIAB MULTIDENSITY CUSTOM INSERTS / SOPORTES DE DIABETICO

$57.82

L3002 X 2

DIAB PLASTAZOTE CUSTOM INSERT / SOPORTES ACOMODATIVOS DE DIABETICOS

$155.20

L5000 X 1

INSERT FOR MISSING TOES / SOPORTE PARA DEDOS AMPUTADOS

$129.96

A6530 X 2

BELOW KNEE 18-30 COMRESSION STOCKING / MEDIAS PARA CIRCULACION A LA RODILLA 18-30

$55.87

A6531 X 2

BELOW KNEE 30-40 COMRESSION STOCKING / MEDIAS PARA CIRCULACION A LA RODILLA 30-40

$62.30

A6532 X 2

BELOW KNEE 40-50 COMRESSION STOCKING / MEDIAS PARA CIRCULACION A LA RODILLA 40-50

$115.82

A6533 X 2

THIGH LENGTH 18-30 COMPRESSION STOCKING / MEDIAS PARA LA CIRCULACION AL MUSLO 18-30

$73.33

A6534 X 2

THIGH LENGTH 30-40 COMPRESSION STOCKING / MEDIAS PARA LA CIRCULACION AL MUSLO 30-40

$73.33

A6535 X 2

THIGH LENGTH 40-50 COMPRESSION STOCKING / MEDIAS PARA LA CIRCULACION AL MUSLO 40-50

$77.40

A6539 X 2

WAIST LENGTH 18-30 COMPRESSION STOCKING / MEDIAS PARA CIRCULACION PANTY 18-30 MMHG

$200.79

A6540 X 2

WAIST LENGTH 30-40 COMPRESSION STOCKING / MEDIAS PARA CIRCULACION PANTY 30-40 MMHG

$200.79

A6541 X 2

WAIST LENGTH 40-50 COMPRESSION STOCKING / MEDIAS PARA CIRCULACION PANTY 40-50 MMHG

$211.95

L4350 X 1

AIR CAST PREFAB

$57.13

L4360 X 1

PNEUMATIC CAM WALKER PREFAB / BOTA DE MARCHA INMOVILIZADORA-NEUMATICA

$166.30

L4386 X 1

REGULAR CAM WALKER PREFAB / BOTA DE MARCHA INMOVILIZADORA CORTA O LARGA

$107.73

L4396 X 1

NIGTH SPLINT PREFAB

$94.62

L3000 X 2

UCBL CUSTOM FOOT ORTHOTIC / SOPORTE A LA MEDIDA TIPO UCB

$337.56

L3010 X 2

CUSTOM LONGITUDINAL ARCH SUPPORT / SOPORTE ARCO LONGITUDINAL

$155.20

L3020 X 2

CUSTOM METATARSAL ARCH SUPPORT / SOPORTE LONGITUDINAL METATARSIANO

$155.20

L1902 X 2

AFO GAUNLET PREFAB / AFO, APARATO PARA EL PIE TIPO GUANTE PREFAB

$39.29

L1906 X 1

AFO FOR PPTD PREFAB / AFO, PARA ESTABILIZAR EL PIE PREFAB

$83.91

L1930 X 1

AFO PLASTIC PREFAB

$79.06

L1940 X 1

AFO CUSTOM FAB / AFO A LA MEDIDA

$215.34

L1960 X 1

AFO POSTERIOR SOLID ANKLE CUSTOM / AFO A LA MEDIDA CON REFUERZO EN EL TOBILLO

$251.23

L8000 X 1

MASTECTOMIE BRAS / AJUSTADOR DE MASTECTOMIA

$26.13

L8020 X 1

BREAST PROSTHESIS MASTECTOMIE FORM FOAM / PROTESIS DE SENO DE FOAM

$128.65

L8030 X 1

BREAST PROSTHESIS SILICONE OR EQUAL / PROTESIS DE SENO EN SILICONA

$139.15

L1810 X 1

KO, ELASTIC WITH JOINTS PREFAB / RODILLERA SENCILLA PREFAB

$79.06

L1832 X 1

KO, ADJUSTABLE KNEE JOINTS, RIGID SUPPORT, PREFAB /RODILLERA CON ARTICULACION PREFAB

$531.35

L1845 X 1

KO, DOUBLE UPRIGHT, THIGH AND CALF, PREFAB / RODILLERA CON AJUSTABLE ARTICULACION FLEXION Y EXTENSION

$543.69

L1847 X 1

KO, DOUBLE UPRIGHT, AIR, PREFAB / RODILLERA CON AIRE, PREFAB

$348.25

77

PROSTHETIC ORTHOTIC FEES L CODE

Member Fees $12.13

DESCRIPTION

L0120 X 1

CERVICAL COLLAR, FOAM, PREFAB

L0190 X 1

CERVICAL COLLAR TAYLOR TYPES / COLLAR CERVICAL TIPO TAYLOR

L0700 X 1

CTLSO, MINERVA TYPE, CUSTOM / CTLSO, TIPO MINERVA, A LA MEDIDA

$1,406.50

L0710 X 1

CTLSO, ANTERIOR/POSTERIOR CONTROL MINERVA TYPE, CUSTOM

$1,552.00

L1300 X 1

SCOLIOSIS JACKET CUSTOM / SCOLIOSIS JACKET A LA MEDIDA

$727.50

L0462 X 1

TLSO, TRIPLANAR, 3 PLASTIC SHELLS / TLSO, TRIPLANAR, 3 MODULOS PLASTICOS

$518.99

$281.30

L0464 X 1

TLSO, MODULAR SEGMENTED, 4 PLASTIC SHELLS / TLSO MODULAR SEGMENTADO, 4 PLASTICOS

$518.99

L0482 X 1

TLSO,TRIPLANAR CONTROL, ONE PIECE RIGID PLASTIC SHELL / TLSO, CONTROL TRIPLANAR UNA PIEZA RIGIDA PLASTICA

$933.85

L0486 X 1

TLSO,TRIPLANAR CONTROL, TWO PIECES RIGID PLASTIC SHELL / TLSO, CONTROL TRIPLANAR, 2 PIEZAS RIGIDAS EN PLASTICO

L0488 X 1

TLSO,TRIPLANAR CONTROL, ONE PIECE RIGID PLASTIC SHELL / TLSO, CONTROL TRIPLANAR UNA PIEZA RIGIDA PLASTICA

$227.53

L0627 X 1

LSO, SAGITAL CONTROL, RIGID PANELS / LSO, CONTROL SAGITAL PANELES RIGIDOS

$299.45

L0631 X 1

LSO, SAGITAL CONTROL, POSTERIOR EXTENDS, REDUCE LOAD

$747.83

L1686 X 1

HIP ORTHIOSIS, ABDUCTION CONTROL, PREFAB / APARATO DE CADERA, CONTROLA ABDUCTION

$539.08

L2112 X 1

AFO TIBIAL FRACTURE ORTHOSIS, SOFT, PREFAB / AFO, APARATO PARA FRACTURA TIBIAL SUAVE

$331.74

L2114 X 1

AFO TIBIAL FRACTURE ORTHOSIS, SEMI RIGID, PREFAB / APARATO PARA FRACTURA TIBIAL SEMIRIGIDO, PREFAB

$465.60

L2116 X 1

AFO TIBIAL FRACTURE ORTHOSIS, RIGID, PREFAB / APARATO PARA FRACTURA TIBIAL RIGIDO

$465.60

L2128 X 1

KAFO FEMORAL FRACTURE CAST ORTHOSIS, CUSTOM / KAFO, APARATO PARA FRACTURA FEMORAL A LA MEDIDA

$976.31

L2134 X 1

KAFO FEMORAL FRACTURE CAST ORTHOSIS SEMIRIGID, PREFAB / APARATO PARA FRACTURA FEMORAL, SEMIRIGIDO, PREFAB

$439.11

L3670 X 1

SO, (CANVAS AND WEBBING TYPE) PREFAB / CABESTRILLO DE BRAZO, PREFAB

$55.29

L3760 X 1

ELBOW ORTHOSIS, WITH ADJUSTABLE POSITION, PREFAB / APARATO DE CODO AJUSTABLE

$268.57

L3908 X 1

WRIST HAND ORTHOSIS PREFAB / MUNEQUERA PREFAB

$17.46

L3931 X 1

WRIST HAND FINGER ORTHOSIS PREFAB / MUNEQUERA CON DEDO GORDO PREFAB

$128.55

L3980 X 1

HUMERAL FRACTURE ORTHOSIS PREFAB / APARATO DE FRACTURA DE HUMERUS PREFAB

$121.25

L3982 X 1

RADIUS/ULNAR FRACTURE ORTHOSIS PREFAB / APARATO DE FRACTURA DE RADIO, ULNAR PREFAB

$218.25 $244.44

L3984 X 1

WRIST FRACTURE ORTHOSIS PREFAB / APARATO DE FRACTURA DE MUNECA, PREFAB

L3995 X 1

ADDIT FRACTURE SOCK OR EQUAL

L8300 X 1

SINGLE ABDOMINAL BINDER / FAJA ABDOMINAL SENCILLA

L8310 X 1

BILATERAL ABDOMINAL BINDER / FAJA ABDOMINAL BILATERAL

$11.64 $59.90 $161.26

HEARING AIDS / SUPLEMENTOS AUDITIVOS Belgica Mock (Hearing Specialist) (Crystal Clear Hearing) 11342 Quail Roost Drive Miami, Fl. 33157 Phone: (305) 235-4035 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

78

$1021.88

Ali Asghar Danesh, M.D. (Audiology)) 1500 NW 10 Ave. Suite #104 Boca Raton, Fl. 33486 Phone: (561) 807-7873 Price 1st Visit: $ 60.00 Price Follow Up: $ 40.00

79

Home Health Service

Miami - Dade / Broward

ALC Home Health. Home Health Services (Physical Therapy) 13275 SW 124 St. Miami Fl. 33186 Phone: (305) 828-5310 Home Health Aid: $ 15.00 per Visit RN: $ 29.00 per Visit Physical Therapy: $ 80.00 per Visit Occupational Therapy: $ 80.00 per Visit Speech Therapy: $ 95.00 per Visit HHA or CAN Visit: $15.00 per visit

C&O Home Healthcare Corp (Home Health Services) (Physical Therapy) 1100 West 29th street Suite H Hialeah Fl. 33012 Tel: (305) 360-4104 Home Health Aid: $ 30.00 per Visit Skilled Nursing: $ 45.00 per Visit Physical Therapy: $ 80.00 per Visit Occupational Therapy: $ 80.00 per Visit Speech Therapy: $ 80.00 per Visit

Home Health Care. Preferred Home Health Agency, Inc. 13903 NW 67 Avenue, Suite 420 Miami Lakes, Fl. 33014 Phone: (305) 231-4250 Language: English / Spanish Home Health Aid: $ 30.00 per Visit Skilled Nursing: $ 45.00 per Visit Physical Therapy: $ 80.00 per Visit Occupational Therapy: $ 80.00 per Visit Speech Therapy: $ 80.00 per Visit

Capital Health Services Inc. (Home Health Services) 85 Gran Canal Dr. Suite 201 Miami, Fl. 33144 Tel: (305) 261-3831 Home Health Aid: $ 34.00 per Visit License Practice Nurse per Visit $27.00 Home Health AIDE per Visit $18.00

Physical Therapy

Holistic Nursing Care Agency Home Health Services 7400 NW 7 St. Miami Fl. 33126 Phone: 305-265-9618 Skilled Nursing: $30.00 Home health Aid: $15.00 Physical Therapy: $80.00 Occupational Therapy: $80.00 Speech Therapy: $80.00 HHA or CAN: $15.00

Miami - Dade

Claudius Galen Therapy Center (Physical and Speech Therapy) 489 E Hialeah Drive #10 Hialeah, Fl. 33010 Phone: (786) 953-6302 Language: English/Spanish

Davila Medical Center (Family Medicine) 782 NW 42 Av. Ste 318 Miami, Fl. 33126 Phone: (305) 441-2760 Fax: (305) 441-2760

Continental Rehabilitation Center Inc. (Physical Therapy) 85 Gran Canal Dr. Suite 200 Miami, Fl. 33144 Tel: (305) 264-6688 Language: English / Spanish

Larskin Rehabilitation Center (Physical Therapy) 3450 SW 137 ave Miami Fl. 33175 Phone: (305) 228-2842 Language: English / Spanish

Sunrise Relax Health Care Corp. (Physical Therapy) 636 SW 109 avenue Miami Fl. 33174 Phone: (305) 221-8500 Language: English / Spanish

ABC Medical Group (Physical Therapy) 1393 SW 1st St.Suite 320 Miami Fl. 33135 Phone: (305) 644-0977 Language: English / Spanish

The New City Medical Center (Physical Therapy) 4118 W 12 Ave Miami Fl. 33012 Phone: (305) 824-8787 Language: English / Spanish

Selecta Physical Therapy (Physical Therapy) 1393 SW 1 St Suite #415 Miami, Fl. 33135 Phone: (786) 953-6735 Language: English/Spanish

Neuromusucular Physical Therapy Inc (Physical Therapy) 7200 NW 7 St Suite 320 Miami, Fl. 33126 Phone: (305) 261-1171 Language: English/Spanish

Leal Medical Center, M.D. (Physical Therapy) 925 NE 30 Terr # 206 Homestead, Fl. 33033 Phone: (305) 246-1265

80

CODES 97010 97010 97012 97014 97018 97026 97032 97034 97035 97039 97110 97112 97124 97139 97140 97140 E0217 E0218 97535

THERAPY SERVICES SERVICIOS DE TERAPIA Hot / Cold Pack Ice / Cryo therapy Mechanical Traction E.M.S Paraffin Bath Infrared E.M.S Attended Contrast Bath Ultrasound Vibratory Massage Therapeutic Exercise Neuromuscular Re-Education Massage Hydro massage Manual Therapy Manual Traction Water Circulating Cold Water Circulating Hot Self / Home Care

Member Fees $12.00 $12.00 $33.34 $26.50 $18.40 $13.20 $34.16 $32.00 $27.50 $17.50 $57.00 $63.00 $47.00 $17.00 $65.00 $65.00 $91.00 $91.00 $41.00

81

Alternative Medicine / Medicina Alternativa

Lab Test Discount (Acupuncture) 5311 NW 79 ave Doral, Fl. 33166 Phone: (305) 646-1363 Language: English / Spanish Initial Visit (60 min) $60.00 Follow Up (45 min) $50.00 Services: Weight Management, Pain Management, Depression, Anexity, Insomnia, Allergy and Respiratory Problems, Muscle-skeletal treatments, etc

Miami - Dade

Ines Valencia, M.D. South Florida Rehabilitation & Wellness Center (Acupuncture) 7990 SW 117 ave #205 Miami, Fl. 33183 Phone: (305) 271-7447 Initial Visit (60 min) $60.00 Follow Up (45 min) $50.00

Alternative Medicine / Medicina Alternativa

Broward

Miramar Medical Center (Acupuncture) 11904 Miramar Parkway Miramar, Fl. 33025 Phone: (954) 639-7560 Language: English / Spanish Initial Visit (60 min) $60.00 Follow Up (45 min) $50.00 Services: Weight Management, Pain Management, Depression, Anexity, Insomnia, Allergy and Respiratory Problems, Muscle-skeletal treatments, etc

Magnet Therapy / Terapia Magnética Panamerican Sports Medicine Institute of Miami (Magnet Therapy) 3850 SW 87 ave Ste 201 Miami, Fl. 33165 Phone: (305) 227-3350 Consultation plus 4 sessions $80.00 Follow Up Sessions: $20.00 each

82

Miami-Dade

DIABETES SUPPLY SERVICES

DIABETES SUPPLY (CLEVER CHOICE PLUS SYSTEM) Diabetes Supply (Clever Choice Plus) Glucose Meter (Glucometro) Test Strips

$2.50 $2.50 $14.99

Lancing Device Box of 10 Lancets Box of 50 strips

Services Details Free Home Delivery. Unlimited Access to all Diabetic Supplies. When ordering diabetic supplies you must have a valid prescription signed by a licensed and authorized healthcare professional in the State of Florida indicating the supplies needed. Note: Free Delivery service is provided as a courtesy to Med Plan members but is subject to the Diabetes Medical Supply provider ability and the distance to the Members pick up point. Please call the provider for more details.

SUPLEMENTOS PARA LA DIABETES Detalles de los Servicios

Entrega gratis a domicilio. Acceso ilimitado de todos los suministros para diabéticos. Al pedir suministros para Diabetes o algún equipo médico debe tener una receta de prescripción válida firmada por su Doctor donde se indique los suministros y equipos que necesita. Nota: El servicio a domicilio es gratuito y se ofrece como una cortesía para los miembros de Med Plan, pero está sujeto a la capacidad del proveedor de los suministros y la distancia donde se encuentre el miembro como punto de entrega. Por favor, llame al proveedor para obtener más detalles.

Our Provider / Nuestro Proveedor:

DIRECT MEDS OF FLORIDA

Telf: 954-454-8118 Fax: 954-454-9898 Free Shipping Anywhere in the United States 83

PHARMACY SERVICES

Services Details • • • • • •

Exclusive Pharmacy Services in Miami Dade County with Navarro Pharmacy. Rx Savings Plus program available for out of State Pharmacy services. 400 Medication Formulary of the most frequently used medications for $9.99 for 100 pills or tablets. Over 65,000 medications offered at Florida MAC plus $3.73 for Dispensing. Prescription Assistance Program available for most brand medications. Home Delivery Program available to all Med Plan members.

When visiting your Pharmacy to fill a prescription you must have a valid prescription signed by a licensed and authorized healthcare professional in the State of Florida. Med Plans “Prescription Assistance Program” are services provided directly by the pharmaceutical medi cation manufacturer. These programs are designed to help pay for the high cost of Brand medications that our members may not be able to afford. These “PAP” programs can greatly reduce the cost of the medications or in some case the member can get their medication completely free. Med Plan will help its members identify which programs are available and assist them in filling the necessary documents as part of our commitment to our members. Rx SavingsPlus Program is offered as an added value service which provides Med Plan members access to pharmacy services outside of Med Plans Florida coverage area. Your membership kit contains a brochure with your “Rx SavingsPlus” card inside. You can use this card outside of Florida at any Pharmacy as listed on the back of the brochure. Please note that pricing for medications under this program differs from the Florida Pharmacy providers. For medication pricing under this program you can go to www.medplan.rxsavingsplus.com to get specific cost. This service is only to be used if the member is outside the Med Plans Florida coverage area.

SERVICIOS DE FARMACIA Detalles de los Servicios • • • • • •

Servicios exclusivos en el condado Miami Dade brindados por Navarro Pharmacy Programa Rx Savings Plus disponible para los servicios de Farmacia fuera de la Florida. 400 medicamentos genéricos usados con más frecuencia a un costo de $ 9.99 por 100 pastillas. Más de 65.000 medicamentos se ofrecen en Florida MAC además de $3.73 para la distribución. Programa de asistencia de receta médica para todos los medicamentos (no genéricos). Programa de entrega de medicamentos a domicilio para todos los miembros de Med Plan.

Para obtener algún medicamento pre-escrito por su Doctor, deberá presentar en la farmacia participante una receta válida firmada por un medico licenciado y autorizado en el Estado de la Florida. El Programa de Asistencia de receta médica es un servicio prestado directamente por el fabricante de medicamentos farmacéuticos. Este programa está diseñado para ayudar a pagar el alto costo de los medicamentos no genéricos que nuestros miembros no pueden pagar. Este programa puede reducir considerablemente el costo de los medicamentos o en algunos casos el miembro puede obtener sus medicamentos completamente gratis. Med Plan ayudará a sus miembros a identificar los programas que están disponibles y los ayudará a completar los documentos necesarios como parte del compromiso con sus miembros. Rx Savings Plus se ofrece como un servicio de valor añadido que provee a los miembros el acceso a los servicios de farmacia fuera de área de la Florida. Su paquete de membrecía contiene un folleto en su interior “Rx SavingsPlus”. Usted puede utilizar esta tarjeta fuera de la Florida en cualquier farmacia como aparece en el reverso del folleto. Tenga en cuenta que los precios de los medicamentos dentro de este programa se diferencian de los proveedores de farmacia locales de la Florida. 84

Pharmacy / Farmacia

Miami - Dade

Navarro Discount Pharmacy. (North Miami Lakes) 6410 NW 186 St. Hialeah Fl. 33015 Phone: (305) 825-3386 Fax: (786) 621-1097 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (Miami Lakes) 16801 NW 67 Ave. Miami Fl. 33015 Phone: (305) 822-9522 Fax: (305) 822-9775 Mon - Sun: 6:00 Am To 12:00 Am

Navarro Discount Pharmacy. (Okeechobee) 2399 W 52 St. Hialeah Fl. 33016 Phone: (305) 822-3385 Fax: (786) 621-0866 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (East Hialeah) 366 E 4 Ave. Hialeah Fl. 33010 Phone: (305) 883-0852 Fax: (786) 621-0861 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (Hialeah Palm) 3915 Palm Ave. Hialeah Fl. 33012 Phone: (305) 822-2210 Fax: (786) 621-7863 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (West Hialeah) 3960 W 12 Ave. Hialeah Fl. 33012 Phone: (305) 556-3117 Fax: (786) 621-0860 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (Hialeah) 775 W 49 St. Suite 1 Hialeah Fl. 33012 Phone: (305) 823-0823 Fax: (305) 823-0030 Mon - Sun: 6:00 Am To 12:00 Am

Navarro Discount Pharmacy. (Hialeah Gardens) 3141 W 76 St Suite 5 Hialeah Fl. 33018 Phone: (305) 231-8200 Fax: (305) 557-4707 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (Flamingo Plaza) 4410 West 16 Ave. Hialeah Fl. 33012 Phone: (305) 556-8585 Fax: (305) 824-9601 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. 13250 Biscayne Blv. North Miami , Fl. 33181 Phone: (305) 891-3551 Fax: (305) 891-3902 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (Doral) 11402 NW 41 St # 127. Doral Fl. 33178 Phone: (305) 471-8184 Fax: (305) 471-8189 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (Miracle Mile) 93 Miracle Mile, Coral Gables Fl. 33134 Phone: (305) 445-1059 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (Ponce De Leon) 3949 SW 8 St., Miami Fl. 33134 Phone: (305) 444-7530 Fax: (305) 442-2805 Mon - Sun: 6:00 Am To 12:00 Am

Navarro Discount Pharmacy. (Sunset) 10720 SW 72 St., Miami Fl. 33173 Phone: (305) 271-9909 Fax: (305) 412-1851 24 Hrs

Navarro Discount Pharmacy. (Little Havana) 1243 SW 8th St. Miami Fl. 33135 Phone: (305) 854-8544 Fax: (305) 854-6463 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

85

Pharmacy / Farmacia

Miami - Dade

Navarro Discount Pharmacy. (Flagler) 5252 West Flagler St. Miami Fl. 33134 Phone: (305) 442-9946 Fax: (305) 442-7320 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 10:00 Pm

Navarro Discount Pharmacy. (Sweetwater) 10044 West Flagler St. Miami Fl. 33174 Phone: (305) 223-3555 Fax: (305) 485-8037 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (FIU) 12000 SW 8th St. Miami Fl. 33184 Phone: (305) 225-8900 Fax: (305) 485-9009 Mon - Sun: 6:00 Am To 12:00 Am

Navarro Discount Pharmacy. (Hammocks) 14665 SW 104th St. Miami Fl. 33186 Phone: (305) 752-0600 Fax: (305) 752-4272 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 10:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (Country Walk) 13796 SW 152th St. Miami Fl. 33177 Phone: (305) 256-9800 Fax: (786) 249-0014 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 10:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (Westchester) 9686 SW 24th St. Miami Fl. 33165 Phone: (305) 225-9307 Fax: (786) 621-0859 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (Coral Way) 11865 SW 26th St. Miami Fl. 33175 Phone: (305) 227-0023 Fax: (305) 227-3021 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (West Sunset) 15000 SW 72th St. Miami Fl. 33193 Phone: (305) 387-1300 Fax: 305) 388-2310 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (East Flagler) 1601 West Flagler St. Miami Fl. 33135 Phone: (305) 643-9762 Fax: (786) 621-5810 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (Sunny Isles) 18500 Collins Ave. Sunny Isles Fl. 33160 Phone: (305) 792-4099 Fax: (305) 792-4492 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (North Shore) 631 71th St. Miami Beach Fl. 33141 Phone: (305) 865-0075 Fax: (305) 865-1886 Mon - Sun: 6:00 Am To 12:00 Am

Navarro Discount Pharmacy. (West Bird Rd) 14491 SW 42 St. Miami Fl. 33175 Phone: (305) 229-1044 Fax: (305) 229-9039 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Navarro Discount Pharmacy. (Galloway) 8760 SW 40 St. Miami Fl. 33165 Phone: (305) 552-1498 Fax: (305) 559-3193 Mon - Sat: 8:00 Am To 10:00 Pm Sun: 9:00 Am To 7:00 Pm

Presidente Pharmacy. 10845 SW 40th St Miami, Fl. 33165 Phone: (305) 485-8888

President Pharmacy 11340 Quail Roost Drive Miami, Fl. 33157 Phone: (305) 235-8244

Cardenas Pharmacy. 2741 Coral Way. Miami, Fl. 33145 Phone: (305) 529-0003 Fax: (305) 529-1022

My Pharmacy of Homestead. 806 N. Krome Ave. Homestead, Fl. 33030 Phone: (305) 247-6949 Fax: (305) 247-6072

Pro Pharmacy 11478 Quail Roost Drive Miami, Fl. 33157 Phone: (305) 971-3388

Las Villas Pharmacy 716 W 29th ST Hialeah, Fl. 33012 Phone: (305) 883-7476

Redondo Pharmacy Discount 19533 N.W 57 Ave. Miami, Fl. 33055 Phone: (305) 625-0225 86

Pharmacy / Farmacia Direct Meds of Florida 800 E. Hallandale Beach Blvd Hallandale Beach Fl. 33009 Tel: (954) 454-8118 Fax: (954) 454-9898 Language: English / Spanish Refer to Drug Pricing Fee Schedule Home Delivery Service Free Mail Order Delivery Service

Broward Navarro Pharmacy 15895 Pines Blvd Pembroke Pines Fl. 33028 Tel: (954) 251- 6270 Language: English / Spanish Mon - Sun: 6:00 Am To 12:00 Am

Pharmacy / Farmacia

Palm Beach

Garcia Pharmacy 2525 N. Dixie Hwy Lake Worth Fl. 33460 Phone: (561) 588-2252

Pharmacy / Farmacia Cape Coral Express Pharmacy 4419 Del Prado Blvd North Cape Coral Fl. 33904 Tel: (239) 574-8846 Fax: (239) 574-7080 Language: English / Spanish Refer to Drug Pricing Fee Schedule Home Delivery Service Free Mail Order Delivery Service

87

Lee / Cape Coral St. Jude Pharmacy 1202 N.E Pine Island Road Ste 1V Cape Coral Fl. 33909 Tel: (239) 673-7777 Language: English / Spanish Refer to Drug Pricing Fee Schedule Home Delivery Service Free Mail Order Delivery Service

88

89

90

91

92

Seduction Cosmetic Center

COSMETIC PROCEDURES / TRATAMIENTOS ESTETICOS 2500 NW 107 Ave # 102 Doral, Fl. 3172 Phone: 305-406-9055 Los precios de los siguientes tratamientos son solo para miembros de Med Plan. COSMETIC PLASTIC SURGERY AND TREATMENT LIST PRICE PROCEDURES / PROCEDIMIENTOS Aumento de senos (Implantes de agua salina) Aumento de senos (Implantes de silicona) Levantamiento de senos (Implantes de agua salina) Levantamiento de senos (Implantes de silicona) Aumento de seno con Aeroplastia Saline Aumento de seno con Aeroplastia Silicona Levantamiento de senos sin implantes Reduccion de senos (Hipertrofia) Breast Aug w/Exchange Implants Saline Aumento de senos con intercambio (Implantes de agua salina) Aumento de senos con intercambio (Implantes de silicona) Aumento de senos con intercambio de implantes encapsulados MiniTummy Tuck (Mini-Abdominoplastia) Tummy Tuck I (Abdominoplastia) Tummy Tuck II (Abdominoplastia) Tummy Tuck III (Abdominoplastia) Lipoescultura Lipoescultura + Transferencia de grasa Lipo x Áreas (cada área) minimo 4 áreas Lipo brazos (cada brazo) Cirugía de brazos (los dos brazos) Lipo interior de muslos Lipo exterior de muslos Lipo (papada) en combo Lipo (papada) solamente Cirugía de cuello surgery tipo “Z” Cirugía de cuello tipo “Z” en combo Levantamiento de cara Levantamiento de cejas Párpados (arriba y abajo) Párpados (arriba) Párpados (abajo) Nariz (cartílago solamente) Nariz (hueso + cartílago) Láser rejuvenecimiento facial Microdermabración Implante de mentón Otoplastia (orejas) Rejuvenecimiento vaginal Banda gástrica Terapias Levantamiento de torso por muslos

93

% DESC 20 21 25 21 21 20 28 20 20 20 20 20 25 20 18 21 19 20 50 25 23 25 25 25 20 19 18 38 25 25 25 25 25 38 28 25 20 30 44 28 26 36

ORIGINAL PRICE $3,500 $4,900 $6,000 $7000 $4,800 $5,800 $5,500 $7,500 $4,200 $5,400 $4,900 $5,900 $3,300 $4,900 $5,500 $7,000 $3,700 $5,000 $600 $1,200 $3,900 $1,200 $1,200 $1,200 $3,000 $3,700 $1,700 $6,500 $4,000 $4,000 $2,000 $2,000 $4,000 $6,500 $3,500 $800 $2,500 $4,000 $4,500 $14,000 $750 $4,700

MED PLAN $2,800 $3,900 $4,500 $5,500 $3,800 $4,600 $4,000 $6,000 $3,400 $4,300 $3,900 $4,700 $2,500 $3,900 $4,500 $5,500 $3,000 $4,000 $300 $900 $3,000 $900 $900 $900 $2,400 $3,000 $1,400 $4,500 $3,000 $3,000 $1,500 $1,500 $3,000 $4,000 $2,500 $600 $2,000 $2,800 $2,500 $9,900 $550 $3,000

MED PLAN / Cosmetic Plastic Products Only for Members PRICE LIST (II) PRODUCTOS GENERICOS PRODUCTOS Botox (Regular) 40 unidades Juvederm (1 jeringuilla) Arnica Lipocell Kelocote Latisse Scarguard (para proteger heridas) Procolagen Cocoa Butter ORO GOLD (CREMAS DE ORO) 50% Off Internet Price INTERNET PRICE Conjunto cuidado de los ojos 24K Oro Intenso TRATAMIENTOS CON CREMAS Peeling Profundo Crema de dia Crema de oro para rejuvenecer celulas Crema de oro antienvejecimiento Mascarillas de Oro Facial TRATAMIENTO DE VENAS Una sección (una cada vez) Paquete Seis (6) Tratamiento Paquete Seis (8) Tratamiento Paquete Seis (10) Tratamiento Paquete Seis (12) Tratamiento

PRECIOS REGULARES $350.00 $550.00 $30.00 $35.00 $70.00 $125.00 $70.00 $60.00 $25.00

MED PLAN $325.00 $500.00 $25.00 $28.00 $60.00 $100.00 $60.00 $50.00 $18.00

$389.95 $249.00

$194.97 $124.97

$114.95 $112.95 $124.95 $299.95 $999.95 $75.00

$54.47 $56.47 $62.47 $149.97 $55.00 each $50.00

$75.00 $450.00 $600.00 $750.00 $1020.00

$55.00 $330.00 $440.00 $550.00 $600.00

94