Advocate Hospital Name Provider Name or Provider Office Name FAP Coverage Status

Transkript

1 עקסהיביט 1 FAP פראוויידער\דאקטער ליסטע אין איינקלאנג מיט AHC ס' ווערדן פון מיטגעפיל און סערוויס, איז AHC ס' פאליסי צוצושטעלן פינאנציעלע הילף פאר פאציענטן אין נויט. די פינאנציעלע הילף פאליסי )FAP( גילט אויף אלע עמערדזשענסי אדער מעדיציניש נויטיגע באהאנדלונג וואס ווערט צוגעשטעלט דורך דעם שפיטאל, אבער איז נישט בינדנד אויף אנדערע אינדיווידועלע פראוויידערס )ד.מ. דאקטוירים( פון מעדיצינישע סערוויסעס אינדרויסן פונעם שפיטאל. עס איז אויך נישט בינדנד אויף א פראוויידער, אזוי ווי אבער נישט באגרעניצט צו, א טויש אין זייער ארבעטס סטאטוס מיט AHC אדער א טויש אינעם מאס פון זייער פראקטיצירונג. דערפאר, צוליב דעם וואס די דאקטוירים און אנדערע פראוויידערס וואס זענען אויף די ליסטע קענען זיך טוישן פון צייט צו צייט, וועט AHC אפדעיטן און ארויפלייגן א נייע ווערסיע אויף איר וועבזייטל ) אמווייניגסטנס איין מאל אין א פערטל יאר. אויב דער פראוויידער'ס FAP דעקונג סטאטוס ווערט אויסגערעכנט אלס "געדעקט אונטער דעם,"FAP דאן איז דער פראוויידער אדער דער פראוויידער'ס פראקטיס'ס קעיר )צוגעשטעלט אינעם שפיטאל פאסיליטי( געדעקט אונטער די פינאנציעלע הילף פאליסי. אויב דער פראוויידער'ס FAP דעקונג סטאטוס ווערט אויסגערעכנט אלס "נישט געדעקט", דאן ווערט דער פראוויידער אדער דער פראוויידער פראקטיס'ס קעיר )צוגעשטעלט אינעם שפיטאל פאסיליטי( נישט געדעקט אונטער די פינאנציעלע הילף פאליסי. Bromenn Medical Center Central Illinois Neuroradiology Ltd-Advanced MRI NOT COVERED Bromenn Medical Center Central Illinois Orthopedic Surgery, LLC NOT COVERED Bromenn Medical Center Central Illinois Pediatric Associates, LLC NOT COVERED Bromenn Medical Center Central Illinois Pulmonary NOT COVERED Bromenn Medical Center Chang, Grace Huei-MD NOT COVERED Bromenn Medical Center Chase, Carmen D.-MD NOT COVERED Bromenn Medical Center Chest Medicine Consultants, SC NOT COVERED Bromenn Medical Center Chicago Anesthesia Associates, SC NOT COVERED Bromenn Medical Center Children's Center for Dentistry NOT COVERED Bromenn Medical Center Children's Hospital of Illinois Medical Group NOT COVERED Bromenn Medical Center Christie Clinic, LLC NOT COVERED Bromenn Medical Center CIMPAR, SC NOT COVERED Bromenn Medical Center Cogent Hospitalists NOT COVERED Bromenn Medical Center Cole, Bradley J.-NP NOT COVERED Bromenn Medical Center Community Cancer Center, LLC NOT COVERED Bromenn Medical Center Comphrensive Kidney Care, LLC NOT COVERED Bromenn Medical Center Cortese Foot & Ankle Clinic, P.C NOT COVERED Bromenn Medical Center Cross, Chadrick Antony-MD NOT COVERED Bromenn Medical Center Dangles, Chris John-MD NOT COVERED Bromenn Medical Center Daniel A Nord MD Obstetrics and Gynecology, LLC NOT COVERED Bromenn Medical Center David M Skillrud MD LTD NOT COVERED Bromenn Medical Center Definitive Neurodiagnostics, LLC NOT COVERED Bromenn Medical Center Dermatology and Mohs Surgery Institute, Ltd NOT COVERED Bromenn Medical Center Digestive Disease Consultants, LTD NOT COVERED Bromenn Medical Center Dobransky, Paul A.-MD NOT COVERED Bromenn Medical Center Draksler, David J.-CRNA NOT COVERED Bromenn Medical Center Dreyer Clinic - Rush Copley NOT COVERED Bromenn Medical Center Dustman, John Anthony-MD NOT COVERED Bromenn Medical Center Espina, Toni-Denise Panganiban-MD NOT COVERED Bromenn Medical Center Adeoye, Oriade K.-MD NOT COVERED Bromenn Medical Center Advanced Women's Healthcare, SC NOT COVERED Bromenn Medical Center Advocate Eureka Hospital Family Practice - El Paso COVERED UNDER FAP Bromenn Medical Center Advocate Eureka Hospital Family Practice - Eureka COVERED UNDER FAP Bromenn Medical Center Advocate Health & Hospital Corp - Advocate Intensivist Partners COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group - Burbank - Palliative Medicine COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group - Chicago - Trinity - Emergency Medicine COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group - Normal Franklin Ave - Hospitalists COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group - Normal Franklin - Endovascular Neuro COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group - Normal - College Ave - Family Medicine COVERED UNDER FAP Page 1

2 Bromenn Medical Center Advocate Medical Group - Normal - Franklin - Endocrinology COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group - Normal - Franklin - Family Medicine COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group - Normal - Pediatric Cardiology COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group - Oak Lawn West 95th Street - Behavioral Health COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group - Oak Lawn -Cicero Avenue COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group - Park Ridge Dempster - Neurology COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Bloomington Eastland COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Bloomington Empire Behavioral Health COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Bloomington Pediatrics COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group BroMenn Psychiatry COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Downers Grove 3825 Highland COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Emergency Medicine COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Emergency Medicine CMC - Peds COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group ENT Surgical Associates COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group General & Colorectal Surgery Central IL COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Hospitalists COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Illinois Heart & Lung Cardiology COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Illinois Heart & Lung Pulmonology COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Immediate Care/ Occ Medicine COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Irving and Western COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group LeRoy COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Lexington COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Midwest Pediatric Cardio COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Midwest Pediatric Cardiology COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Neonatology COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Oak Lawn - Trauma Surgery COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Parkside General Surgery COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Trauma COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Trauma Surgery COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Wound Healing & Hyperbaric Medicine COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group Yacktman Peds Neurology COVERED UNDER FAP Bromenn Medical Center Advocate Medical Group-1300 Franklin Ave-Hospitalist COVERED UNDER FAP Bromenn Medical Center Afifi, M. Sherif-MD NOT COVERED Bromenn Medical Center Ahmad, Wakas -DO NOT COVERED Bromenn Medical Center Ahn, Joseph Y.-MD NOT COVERED Bromenn Medical Center Al-Ani, Ismail -MD NOT COVERED Bromenn Medical Center Ambulatory Anesthesiology, Ltd. NOT COVERED Bromenn Medical Center Anesthesiology Consultants NOT COVERED Bromenn Medical Center Applied Pain Institute, LLC NOT COVERED Bromenn Medical Center Associated Anesthesiologists, SC NOT COVERED Bromenn Medical Center Associates In Dermatology, SC NOT COVERED Bromenn Medical Center Bajaj, Madhuri -MD NOT COVERED Bromenn Medical Center Bari, Naveed -MD NOT COVERED Bromenn Medical Center Battle-Miller, Kimberly M.-MD NOT COVERED Bromenn Medical Center Bechir, George Habachi Metry-MD NOT COVERED Bromenn Medical Center Bloomington Pediatrics & Allergy NOT COVERED Bromenn Medical Center Bloomington Primary Care, LTD NOT COVERED Bromenn Medical Center Bloomington Radiology, SC NOT COVERED Bromenn Medical Center Bloomington Rehabilitation Associates, LLC NOT COVERED Bromenn Medical Center Bloomington-Normal Anesthesia NOT COVERED Bromenn Medical Center Bloomington-Normal ENT LTD NOT COVERED Bromenn Medical Center Bokarius, Andrew V.-MD NOT COVERED Bromenn Medical Center BroMenn Family Health Clinic COVERED UNDER FAP Bromenn Medical Center Cancer Care Associates NOT COVERED Bromenn Medical Center Cardiac Surgery Associates, SC NOT COVERED Bromenn Medical Center Cardiovascular Health Specialists NOT COVERED Bromenn Medical Center Carle Physician Group NOT COVERED Bromenn Medical Center Center for Cosmetic and Laser Surgery, LLC NOT COVERED Page 2

3 Bromenn Medical Center Central Illinois Center for Wellness LLC NOT COVERED Bromenn Medical Center Central Illinois Neuro Health Sciences, Ltd NOT COVERED Bromenn Medical Center Eye Surgical Associates, SC NOT COVERED Bromenn Medical Center Farooki, Basheeruddin M.-MD NOT COVERED Bromenn Medical Center Feinzimer, Benjamin Alan-DO NOT COVERED Bromenn Medical Center Gailey Eye Clinic NOT COVERED Bromenn Medical Center Galvan OBGYN & Associates, LLC NOT COVERED Bromenn Medical Center Gerardo A. Grieco, MD, SC NOT COVERED Bromenn Medical Center Gleason-Dintaman, Catherine -CRNA NOT COVERED Bromenn Medical Center Gorostiza-Tolod, Emelinda -MD NOT COVERED Bromenn Medical Center Griffin, Anthony D.-CRNA NOT COVERED Bromenn Medical Center Guardian Headache and Pain Management Institute, LLC NOT COVERED Bromenn Medical Center Hall, Thomas D.-DMD NOT COVERED Bromenn Medical Center Hameeduddin, Rafiya -DO NOT COVERED Bromenn Medical Center Harold A Nord OB-Gyn S.C. NOT COVERED Bromenn Medical Center Hartman, Eric Thomas-MD NOT COVERED Bromenn Medical Center Hashmi, Faiza -MD NOT COVERED Bromenn Medical Center Hauter, Dru D.-MD NOT COVERED Bromenn Medical Center HeartCare Midwest, Ltd. NOT COVERED Bromenn Medical Center Hendrix, Jessica Nicole-PA NOT COVERED Bromenn Medical Center Housner, Ryan Joseph-PA NOT COVERED Bromenn Medical Center Illinois CancerCare, PC NOT COVERED Bromenn Medical Center Irwin, George Stephen-MD NOT COVERED Bromenn Medical Center Jantzen, David -MD NOT COVERED Bromenn Medical Center Januzik, Scott J.-MD NOT COVERED Bromenn Medical Center Jeffrey Jones, DDS, LLC NOT COVERED Bromenn Medical Center Jweied, Eias -MD NOT COVERED Bromenn Medical Center Katta, Solomon Ravikumar-MD NOT COVERED Bromenn Medical Center Kidney Care Center NOT COVERED Bromenn Medical Center Kidney Care Center Bloomington, LLC NOT COVERED Bromenn Medical Center Kidney Care Center Olympia Fields, LLC NOT COVERED Bromenn Medical Center Kidney Care Center Rockford, LLC NOT COVERED Bromenn Medical Center Klich, Janice Ruth-MD NOT COVERED Bromenn Medical Center KMB, SC NOT COVERED Bromenn Medical Center Knepp, Marc Douglas-MD NOT COVERED Bromenn Medical Center Kummerer, Robert G.-MD NOT COVERED Bromenn Medical Center Laura C. Randolph, MD SC NOT COVERED Bromenn Medical Center Lewis, Julie A.-MD NOT COVERED Bromenn Medical Center Lincoln B Pain Clinic, Ltd. NOT COVERED Bromenn Medical Center Lira, Sorel -MD NOT COVERED Bromenn Medical Center Mann, Stewart Ralph-MD NOT COVERED Bromenn Medical Center McLean County Foot and Ankle, Ltd NOT COVERED Bromenn Medical Center McLean County Orthopedics, Ltd NOT COVERED Bromenn Medical Center Medical Group - College Avenue NOT COVERED Bromenn Medical Center Medical Hills Internists, LLC NOT COVERED Bromenn Medical Center Mehmood, Sajid -MD NOT COVERED Bromenn Medical Center Metro Infectious Disease Consultants, LLC NOT COVERED Bromenn Medical Center Mid-Illinois Hematology & Oncology Associates Ltd NOT COVERED Bromenn Medical Center Midstate Podiatry Associates, Ltd NOT COVERED Bromenn Medical Center Midwest Allergy Sinus Asthma, SC NOT COVERED Bromenn Medical Center Midwest Lung and Sleep Consultants LLC NOT COVERED Bromenn Medical Center Midwest Pulmonary Associates, SC NOT COVERED Bromenn Medical Center Midwest Pulmonary, Critical Care & Sleep Consultants LLC NOT COVERED Bromenn Medical Center Miiller, Kim Marie-PsyD NOT COVERED Bromenn Medical Center Millennium Pain Center, LLC NOT COVERED Bromenn Medical Center Miller Urogynecology, SC NOT COVERED Bromenn Medical Center Minneapolis VA Medical center NOT COVERED Bromenn Medical Center Mitchell, Winston Adrian-MD NOT COVERED Page 3

4 Bromenn Medical Center Mobile Anesthesiologists LLC NOT COVERED Bromenn Medical Center Mohammad, Zulfiqar -MD NOT COVERED Bromenn Medical Center Nephrology Associates of Northern Illinois, LTD NOT COVERED Bromenn Medical Center Nevin, James Laverne-MD NOT COVERED Bromenn Medical Center Nona Fulk MD, SC NOT COVERED Bromenn Medical Center Normal Bloomington Anesthesiologists, Ltd NOT COVERED Bromenn Medical Center Obstetrics & Gynecology II, Ltd. NOT COVERED Bromenn Medical Center Obstetrics and Gynecology Care Associates, SC NOT COVERED Bromenn Medical Center Ontrop, Nathan D.-MD NOT COVERED Bromenn Medical Center Orthopedics & Shoulder Center NOT COVERED Bromenn Medical Center Orthopedics of Illinois NOT COVERED Bromenn Medical Center OSF Cardiovascular Institute NOT COVERED Bromenn Medical Center OSF Children's Hospital of Illinois Medical Group NOT COVERED Bromenn Medical Center OSF Medical Group - College Avenue NOT COVERED Bromenn Medical Center OSF Multi-Specialty Group NOT COVERED Bromenn Medical Center Otis Allen, MD, SC NOT COVERED Bromenn Medical Center Paige C. Holt MD Ltd NOT COVERED Bromenn Medical Center Pappas, Patroklos S.-MD NOT COVERED Bromenn Medical Center Paschold, Bryce Andrew-DPM NOT COVERED Bromenn Medical Center Patel, Subhash R.-MD NOT COVERED Bromenn Medical Center Physicians Care Midwest, SC NOT COVERED Bromenn Medical Center Pope, Brian R.-DO NOT COVERED Bromenn Medical Center Prasad, Bharati -MD NOT COVERED Bromenn Medical Center Premier Medical Group - Kulb, Chalian and Leak Urology, Ltd NOT COVERED Bromenn Medical Center Premier Medical Group, LLC NOT COVERED Bromenn Medical Center Premier Medical Group, LLC Mid-Central Illinois Gastroenterology NOT COVERED Bromenn Medical Center Presence Medical Group NOT COVERED Bromenn Medical Center PRO Podiatry LLC - Premier Podiatry NOT COVERED Bromenn Medical Center Pulmonary Medicine NOT COVERED Bromenn Medical Center Rauen Dardis, Sara Renee-DDS NOT COVERED Bromenn Medical Center RenalCare Associates, SC NOT COVERED Bromenn Medical Center Retina Consultants of Central Illinois, SC NOT COVERED Bromenn Medical Center Richard W Wellman, MD LLC NOT COVERED Bromenn Medical Center Rufus, Deborah J.-NP NOT COVERED Bromenn Medical Center Safdar, Saima -MD NOT COVERED Bromenn Medical Center Saleem, Moeen A.-MD NOT COVERED Bromenn Medical Center Sarah Dutta, OB-GYN, SC NOT COVERED Bromenn Medical Center Seidl, Robert K.-MD NOT COVERED Bromenn Medical Center Semakula, Barbara Nabatanzi-MD NOT COVERED Bromenn Medical Center Sharma, Ajay -DO NOT COVERED Bromenn Medical Center Sharon R. Weaver, MD, SC NOT COVERED Bromenn Medical Center Singh, Amarjit -MD NOT COVERED Bromenn Medical Center Sinks, Jessica Lee-NP NOT COVERED Bromenn Medical Center Smith, Bonnie J.-MD NOT COVERED Bromenn Medical Center Smith, Kevin S.-MD NOT COVERED Bromenn Medical Center Solhkhah, Cyrus Darius-MD COVERED UNDER FAP Bromenn Medical Center Sriram, Krishnan -MD NOT COVERED Bromenn Medical Center Stern, David Ross-MD NOT COVERED Bromenn Medical Center Subramanian, Sanjay -MD NOT COVERED Bromenn Medical Center Summit Family Medical Center NOT COVERED Bromenn Medical Center Susan Svientek MD SC - Women for Women NOT COVERED Bromenn Medical Center Tannebaum, Ross D.-MD NOT COVERED Bromenn Medical Center Tattini, Chad Douglas-MD NOT COVERED Bromenn Medical Center Test, Bob Smith-MD NOT COVERED Bromenn Medical Center The Center for Outpatient Medicine NOT COVERED Bromenn Medical Center Thoracic Surgical Associates, LLC NOT COVERED Bromenn Medical Center Virtual Radiologic Professionals NOT COVERED Bromenn Medical Center Virtual Radiologic Professionals, LLC NOT COVERED Page 4

5 Bromenn Medical Center Williamson, John Jeffrey-PA COVERED UNDER FAP Christ Medical Center and Children's Hospital A2Z Care Med-Meds Specialist, PC NOT COVERED Christ Medical Center and Children's Hospital Abdessalam, Nadia F.-NP NOT COVERED Christ Medical Center and Children's Hospital Abramson, Brad L.-DO COVERED UNDER FAP Christ Medical Center and Children's Hospital Adeniji, Adejimi O.-MD NOT COVERED Christ Medical Center and Children's Hospital Adhikari, Sujeen -DO NOT COVERED Christ Medical Center and Children's Hospital Adult Medicine Center NOT COVERED Christ Medical Center and Children's Hospital Adult Primary Care Center, Ltd NOT COVERED Christ Medical Center and Children's Hospital Advanced Allergy & Asthma Clinic SC NOT COVERED Christ Medical Center and Children's Hospital Advanced Reproductive Health Centers, Ltd NOT COVERED Christ Medical Center and Children's Hospital Advocate Health & Hospital Corp - Advocate Intensivist Partners COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Burbank - Palliative Medicine COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group W Wellington - Congestive Heart Failure COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Burbank West 79th Street - Obstetrics & Gynecology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Chicago - Trinity - Emergency Medicine COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Chicago N Clark - Cardiology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Chicago N Halsted - Neurosurgery COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Des Plaines 8901 W Golf Road COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Downers Grove Highland Ave - Neurosurgery COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Downers Grove 1441 Branding COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Hazel Crest - Kedzie Avenue COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Oak Lawn W 95th St - Pediatric Subspecialties COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Oak Lawn West 95th Street COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Oak Lawn W 95th St - Behavioral Health COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Oak Lawn W 95th Street - Hospitalists COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Oak Lawn W 95th Street - Pediatric Orthopedics COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Oak Lawn West 95th Street - Behavioral Health COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Oak Lawn Southwest Hwy - Family Practice COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Oak Lawn West 95th Street - Pediatrics COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Oak Lawn -Cicero Avenue COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Oak Lawn, 4440 West 95th Street - Obstetrics & Gynecology -ED Tri COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Park Ridge Dempster - Pediatric Critical Care COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Park Ridge Dempster - Neurology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Park Ridge - Luther Lane - Bone Marrow Transplant COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group - Park Ridge - Pediatric Neurosurgery COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Beverly COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Burbank COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Chicago 2315 E 93rd Street Neurology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Christ Peds Hospitalist COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Clinical Ethics and Pallative Medicine COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group CMC Pediatric Infectious Disease COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group CMC Pediatric Pulmonology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group CMC Pediatric Urology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Downers Grove 3825 Highland COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Emergency Medicine COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Emergency Medicine CMC - Peds COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Emergency Medicine LGH - Peds COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Evergreen COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Evergreen Peds COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Hazel Crest Gastro COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Hospitalists COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Irving and Western COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Maternal Fetal COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Merrionette Park COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group MidAmerica Cardio HazelCrest COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Midwest Pediatric Cardio COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Midwest Pediatric Cardiology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Neurointerventional Surgery COVERED UNDER FAP Page 5

6 Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn West 95th Street - Pediatric Critical Care COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn - Trauma Surgery COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn - West 95th Street - Pediatric Cardiovascular Surgery COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn - West 95th Street - Pediatric Hematology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn 95th Maternal/Fetal COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn 95th St ENT COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn 95th St Pediatrics COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn 95th Street COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn General Surgery COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn Infectious Disease COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn Maternal/Fetal COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn Nephrology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn Neurosurgery COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn Pediatrics General Surgery COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Oak Lawn Plastic Surgery COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group OB/GYN COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Orland Park COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Palos COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Park Ridge 1775 Dempster Street Pediatric Critical Care COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Parkside General Surgery COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Parkside Genetics COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Parkside Maternal Fetal COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Pediatric Cardiovascular Surgery COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Pediatrics Developmental Center COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Peds Hospitalist COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group South Holland Hospitalist COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Sykes COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Sykes Hospitalist COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Trauma COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Trauma Surgery COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Yacktman Pediatrics COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Yacktman Peds Cardiology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Yacktman Peds General Surgery COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Yacktman Peds Hem/Onc COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Yacktman Peds Nephrology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Yacktman Peds Neurology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Yacktman Peds Plastic Surg COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Yacktman Peds Pulmonology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Yacktman Peds Rheumatology COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Yacktman Psychiatry COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group Yacktman Sleep Medicine COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group-Chicago-93rd Street COVERED UNDER FAP Christ Medical Center and Children's Hospital Advocate Medical Group-Oak Lawn W 95th St - Pediatric Subspecialties COVERED UNDER FAP Christ Medical Center and Children's Hospital Afifi, M. Sherif-MD NOT COVERED Christ Medical Center and Children's Hospital Agrawal, Caitlin Jane-MD NOT COVERED Christ Medical Center and Children's Hospital Ahmed, Farida -MD NOT COVERED Christ Medical Center and Children's Hospital Ahmed, Syed Sohail-MD NOT COVERED Christ Medical Center and Children's Hospital Ahuja, Akash -MD NOT COVERED Christ Medical Center and Children's Hospital Aicher, Tracy Marie-NP NOT COVERED Christ Medical Center and Children's Hospital Aippersbach, Elke D.-MD NOT COVERED Christ Medical Center and Children's Hospital Akhtar, Rasheed -MD NOT COVERED Christ Medical Center and Children's Hospital Al-Ani, Ismail -MD NOT COVERED Christ Medical Center and Children's Hospital Alawad Medical Center, Ltd NOT COVERED Christ Medical Center and Children's Hospital Albertine, Paul Joseph-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Aldaas, Fadi -MD NOT COVERED Christ Medical Center and Children's Hospital Alex, Charles G.-MD NOT COVERED Christ Medical Center and Children's Hospital Alexander, Jonathan M.-MD NOT COVERED Page 6

7 Christ Medical Center and Children's Hospital Alexander, Philip J.-MD NOT COVERED Christ Medical Center and Children's Hospital Ali, Abid M.-MD NOT COVERED Christ Medical Center and Children's Hospital Al-Khaled, Nouri -MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Allam, Talha Samie-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Alpha Med Physicians Group, LLC NOT COVERED Christ Medical Center and Children's Hospital Al-Qawasmi, Fouad A.-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Altman, Igor A.-DO NOT COVERED Christ Medical Center and Children's Hospital Alzein Medical, Ltd NOT COVERED Christ Medical Center and Children's Hospital Alzein, Mohamad Riad-MD NOT COVERED Christ Medical Center and Children's Hospital American Anesthesiology Associates of Illinois, SC NOT COVERED Christ Medical Center and Children's Hospital Amit Vyas, MD, SC NOT COVERED Christ Medical Center and Children's Hospital Amita Health Cancer Center NOT COVERED Christ Medical Center and Children's Hospital Amita Health Medical Group NOT COVERED Christ Medical Center and Children's Hospital Anastos, John P.-DO COVERED UNDER FAP Christ Medical Center and Children's Hospital Anderst, James D.-MD NOT COVERED Christ Medical Center and Children's Hospital Andina & Irabagon, SC NOT COVERED Christ Medical Center and Children's Hospital Andrade, Ambar Afshar-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Angspatt-Pisit, MD, SC NOT COVERED Christ Medical Center and Children's Hospital Anita Arora, MD, PC NOT COVERED Christ Medical Center and Children's Hospital Anneken, Steven M.-MD NOT COVERED Christ Medical Center and Children's Hospital Annes, John G.-MD NOT COVERED Christ Medical Center and Children's Hospital Annes, Nicole -PA NOT COVERED Christ Medical Center and Children's Hospital Annita John, MD, PC NOT COVERED Christ Medical Center and Children's Hospital Arbor Center for Eyecare, SC NOT COVERED Christ Medical Center and Children's Hospital Ares Maisonet, Guillermo Javier-MD NOT COVERED Christ Medical Center and Children's Hospital Aronson, Andrew James-MD NOT COVERED Christ Medical Center and Children's Hospital Arthur L. Ostrowski, MD, SC NOT COVERED Christ Medical Center and Children's Hospital Arun, Haleyur P.-MD NOT COVERED Christ Medical Center and Children's Hospital Arundel, Cali A.-NP NOT COVERED Christ Medical Center and Children's Hospital Asima, Sika S.-CRNA NOT COVERED Christ Medical Center and Children's Hospital Associated Allergists & Asthma Specialists, Ltd NOT COVERED Christ Medical Center and Children's Hospital Associated Cardiovascular Physicians, SC NOT COVERED Christ Medical Center and Children's Hospital Associated Urological Specialists, LLC NOT COVERED Christ Medical Center and Children's Hospital Associates in Nephrology, SC NOT COVERED Christ Medical Center and Children's Hospital Associates in Pediatric Neurology, SC NOT COVERED Christ Medical Center and Children's Hospital Associates in Rehabilitation Medicine, SC NOT COVERED Christ Medical Center and Children's Hospital Avant Obstetrics and Gynecology Ltd. NOT COVERED Christ Medical Center and Children's Hospital Aziz, George F.-MD NOT COVERED Christ Medical Center and Children's Hospital Bajwa, Ajwad Saeed-MD NOT COVERED Christ Medical Center and Children's Hospital Balandrin, Jorge E.-MD NOT COVERED Christ Medical Center and Children's Hospital Balanlayos, Ivy Ignas-CNS NOT COVERED Christ Medical Center and Children's Hospital Ballany, Wassim -MD NOT COVERED Christ Medical Center and Children's Hospital Bane, Christopher D.-MD NOT COVERED Christ Medical Center and Children's Hospital Bari, Naveed -MD NOT COVERED Christ Medical Center and Children's Hospital Battle-Miller, Kimberly M.-MD NOT COVERED Christ Medical Center and Children's Hospital Bauer, Richard Marcus-MD NOT COVERED Christ Medical Center and Children's Hospital Baylis, William J.-DO COVERED UNDER FAP Christ Medical Center and Children's Hospital Beata I. Styka MD, SC NOT COVERED Christ Medical Center and Children's Hospital Beaumont, Laura A.-PsyD NOT COVERED Christ Medical Center and Children's Hospital Beck, Michael E.-MD NOT COVERED Christ Medical Center and Children's Hospital Beckett, James E.-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Bedikian, Sarkis Michael-DO NOT COVERED Christ Medical Center and Children's Hospital Bell, Jeremy Thomas-PA NOT COVERED Christ Medical Center and Children's Hospital Bell, Nathan Howard-PA NOT COVERED Christ Medical Center and Children's Hospital Belmonte, Frank William-DO NOT COVERED Christ Medical Center and Children's Hospital Bender, Jessica Lyn-DO NOT COVERED Christ Medical Center and Children's Hospital Berns, Dana Mara-DPM NOT COVERED Christ Medical Center and Children's Hospital Bero, Jennifer Lynn-MD NOT COVERED Page 7

8 Christ Medical Center and Children's Hospital Berwyn Pediatrics NOT COVERED Christ Medical Center and Children's Hospital Best Practices Inpatient Care, Ltd NOT COVERED Christ Medical Center and Children's Hospital Beth Ledvora, MD, SC NOT COVERED Christ Medical Center and Children's Hospital Bielinski Dermatology Group LLC NOT COVERED Christ Medical Center and Children's Hospital Bisaga, Mary Katherine-NP NOT COVERED Christ Medical Center and Children's Hospital Biskup & Segui Pediatric Partners PC NOT COVERED Christ Medical Center and Children's Hospital Bite Size Pediatric Dentistry NOT COVERED Christ Medical Center and Children's Hospital Blevins, Bonnie A.-CNS NOT COVERED Christ Medical Center and Children's Hospital Blumstein, Andrea M.-MD NOT COVERED Christ Medical Center and Children's Hospital Bojedla, Kiran -DO COVERED UNDER FAP Christ Medical Center and Children's Hospital Bonaminio, Robert M.-DO NOT COVERED Christ Medical Center and Children's Hospital Borhani, Martin -MD NOT COVERED Christ Medical Center and Children's Hospital Boumendjel, Yelena -DPM COVERED UNDER FAP Christ Medical Center and Children's Hospital Bousman, Tina M.-PA NOT COVERED Christ Medical Center and Children's Hospital Bowersox, Keith D.-MD NOT COVERED Christ Medical Center and Children's Hospital Boyd, Christine D.-MD NOT COVERED Christ Medical Center and Children's Hospital Boysen, Lawrence D.-MD NOT COVERED Christ Medical Center and Children's Hospital Brann, Donald Duane-DPM NOT COVERED Christ Medical Center and Children's Hospital Branovacki, George -MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Brennan, Sharon -NP NOT COVERED Christ Medical Center and Children's Hospital Bresticker, Michael A.-MD NOT COVERED Christ Medical Center and Children's Hospital Brisbin, Beverlee Ann-MD NOT COVERED Christ Medical Center and Children's Hospital Brooker, Jay M.-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Brown, Henry Gordon-MD NOT COVERED Christ Medical Center and Children's Hospital Brown, Joanne K.-NP NOT COVERED Christ Medical Center and Children's Hospital Bump, Thomas Elting-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Burda, Diana M.-MD NOT COVERED Christ Medical Center and Children's Hospital Burke, John H.-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Burke, Nancy E.-NP NOT COVERED Christ Medical Center and Children's Hospital Butler-MooYoung, Nichole M.-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Captain James A. Lovell Federal Health Care Center NOT COVERED Christ Medical Center and Children's Hospital Cardiac Surgery Associates, SC NOT COVERED Christ Medical Center and Children's Hospital Cardiology Medical Group NOT COVERED Christ Medical Center and Children's Hospital Cardiovascular Associates, SC NOT COVERED Christ Medical Center and Children's Hospital Cardiovascular Care Consultants, SC NOT COVERED Christ Medical Center and Children's Hospital Cardiovascular Consultants, LLP NOT COVERED Christ Medical Center and Children's Hospital Carli, Erin D.-NP NOT COVERED Christ Medical Center and Children's Hospital Carlos Smith, DPM, PC NOT COVERED Christ Medical Center and Children's Hospital Carrillo, Tami Catherine-MD NOT COVERED Christ Medical Center and Children's Hospital Casciato, Christina M.-PA NOT COVERED Christ Medical Center and Children's Hospital Castelli, Michael Edward-PA NOT COVERED Christ Medical Center and Children's Hospital Center for Adult and Pediatric Wellness NOT COVERED Christ Medical Center and Children's Hospital Center for Heart Transplant and Assist Devices NOT COVERED Christ Medical Center and Children's Hospital Center for Internal Medicine NOT COVERED Christ Medical Center and Children's Hospital Center for Oral Surgery NOT COVERED Christ Medical Center and Children's Hospital Center for Pediatric Gastroenterology NOT COVERED Christ Medical Center and Children's Hospital Center for Pediatric Gastroenterology & Nutrition, MD, SC NOT COVERED Christ Medical Center and Children's Hospital Center for Women s Care NOT COVERED Christ Medical Center and Children's Hospital Century Ear Nose and Throat-Head and Neck Surgery Associates, Ltd NOT COVERED Christ Medical Center and Children's Hospital Chaar, Bassem T.-MD NOT COVERED Christ Medical Center and Children's Hospital Chagnon, Kari Lynn-PA NOT COVERED Christ Medical Center and Children's Hospital Chandran, Sangili -MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Chang, Grace Huei-MD NOT COVERED Christ Medical Center and Children's Hospital Chapman, Chris Edward-DO NOT COVERED Christ Medical Center and Children's Hospital Charuk, George E.-DO NOT COVERED Christ Medical Center and Children's Hospital Chen, Shih-Hua -PA NOT COVERED Christ Medical Center and Children's Hospital Chest Medicine Consultants, SC NOT COVERED Christ Medical Center and Children's Hospital Chicago Anesthesia Associates, SC NOT COVERED Page 8

9 Christ Medical Center and Children's Hospital Chicago Center for Women's Health, SC NOT COVERED Christ Medical Center and Children's Hospital Chicago Foot and Ankle, PC NOT COVERED Christ Medical Center and Children's Hospital Chicago kidds Pediatric Dentistry NOT COVERED Christ Medical Center and Children's Hospital Chicago Movement Specialists, LLC COVERED UNDER FAP Christ Medical Center and Children's Hospital Chickerillo, Krystina Marie-NP NOT COVERED Christ Medical Center and Children's Hospital Children's Wellness Center, LLC NOT COVERED Christ Medical Center and Children's Hospital Chowaniec, Jaime Ann-DMD NOT COVERED Christ Medical Center and Children's Hospital Christopher T. Kardasis, MD, SC NOT COVERED Christ Medical Center and Children's Hospital Christopoulos, Niki A.-MD NOT COVERED Christ Medical Center and Children's Hospital Christy Cardiology, Ltd NOT COVERED Christ Medical Center and Children's Hospital Chronopoulos, Foti T.-MD NOT COVERED Christ Medical Center and Children's Hospital Chua-Apolinario, Susan -MD NOT COVERED Christ Medical Center and Children's Hospital Clark, Steven T.-MD NOT COVERED Christ Medical Center and Children's Hospital Claveria, Joanne Kristine-MD NOT COVERED Christ Medical Center and Children's Hospital Coenen, Allison Marie-PA NOT COVERED Christ Medical Center and Children's Hospital Collins, Mary Ann Jugovic-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Collins, Steven M.-PA NOT COVERED Christ Medical Center and Children's Hospital Comphrensive Kidney Care, LLC NOT COVERED Christ Medical Center and Children's Hospital Continental Anesthesia, Ltd. NOT COVERED Christ Medical Center and Children's Hospital Cook, Danae Raschelle-PA NOT COVERED Christ Medical Center and Children's Hospital Copak, Irene Amy Macaya-CNS NOT COVERED Christ Medical Center and Children's Hospital CortiCare NOT COVERED Christ Medical Center and Children's Hospital CorVita Health and Associates NOT COVERED Christ Medical Center and Children's Hospital Cotts, William Gerritt-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Coury, Christopher Anthony-MD NOT COVERED Christ Medical Center and Children's Hospital Crosby, Jennifer L.-CNS NOT COVERED Christ Medical Center and Children's Hospital Cross, Chadrick Antony-MD NOT COVERED Christ Medical Center and Children's Hospital Crossan, Paul D.-MD NOT COVERED Christ Medical Center and Children's Hospital Curran, Ronald Dennis-MD NOT COVERED Christ Medical Center and Children's Hospital Czupek, Deborah A.-PhD NOT COVERED Christ Medical Center and Children's Hospital Dado, Ralph N.-MD NOT COVERED Christ Medical Center and Children's Hospital Danielsky, Paul Joseph-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Dar, Nabeel Saleem-MD NOT COVERED Christ Medical Center and Children's Hospital David Gerst, DPM, SC COVERED UNDER FAP Christ Medical Center and Children's Hospital DeFrino, Paul F.-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital DeJong, Megan Joy-MD NOT COVERED Christ Medical Center and Children's Hospital Desai, Chaitanya Rajendra-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital DeStefano & Stamat Pediatrics, LLC NOT COVERED Christ Medical Center and Children's Hospital Diabetes and Endocrine Care, Ltd NOT COVERED Christ Medical Center and Children's Hospital Diabetes, Osteoporosis, Obesity, INC. NOT COVERED Christ Medical Center and Children's Hospital Diamond, Terrence P.-MD NOT COVERED Christ Medical Center and Children's Hospital Dickinson, John Douglas-DO NOT COVERED Christ Medical Center and Children's Hospital Dixon-Grevious, Dolores Louise-MD NOT COVERED Christ Medical Center and Children's Hospital Do, MaryAnhthu T.-DO COVERED UNDER FAP Christ Medical Center and Children's Hospital Dobransky, Paul A.-MD NOT COVERED Christ Medical Center and Children's Hospital Donte Medical, SC & Home Health Medical, LLC NOT COVERED Christ Medical Center and Children's Hospital Doshi, Taral Jitendra-MD NOT COVERED Christ Medical Center and Children's Hospital Dr Joseph's Medical Serv. SC NOT COVERED Christ Medical Center and Children's Hospital Dr. Ashraf Abourahma, MD, Ltd NOT COVERED Christ Medical Center and Children's Hospital Dr. Matthew E. Schmidt and Associates Ophthalmologists, SC NOT COVERED Christ Medical Center and Children's Hospital Dr. Robert J. Familaro & Assoc. Ltd. NOT COVERED Christ Medical Center and Children's Hospital Draths-Hanson, Kathleen G.-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Dreyer Clinic - Highland NOT COVERED Christ Medical Center and Children's Hospital Dreyer Clinic - Rush Copley NOT COVERED Christ Medical Center and Children's Hospital Du Page Medical Group, LTD NOT COVERED Christ Medical Center and Children's Hospital Duback, Kimberly M.-CNS NOT COVERED Christ Medical Center and Children's Hospital DuMais Pediatrics, SC NOT COVERED Christ Medical Center and Children's Hospital DuPage Children's ENT and Allergy NOT COVERED Page 9

10 Christ Medical Center and Children's Hospital DuPage Emergency Physician Convenient Care, LLC NOT COVERED Christ Medical Center and Children's Hospital DuPage Medical Group, Ltd NOT COVERED Christ Medical Center and Children's Hospital Eapen, Joyce M.-NP NOT COVERED Christ Medical Center and Children's Hospital Ear, Nose, and Throat Associates, SC NOT COVERED Christ Medical Center and Children's Hospital EBS Pediatrics NOT COVERED Christ Medical Center and Children's Hospital Ellenby, Martin I.-MD NOT COVERED Christ Medical Center and Children's Hospital EM Strategies, Ltd. COVERED UNDER FAP Christ Medical Center and Children's Hospital Ennis, William J.-DO NOT COVERED Christ Medical Center and Children's Hospital EP Consultation, Ltd NOT COVERED Christ Medical Center and Children's Hospital Erickson, Kurt W.-MD NOT COVERED Christ Medical Center and Children's Hospital Errek, Henry K.-PhD NOT COVERED Christ Medical Center and Children's Hospital Evans, Diana M.-PA NOT COVERED Christ Medical Center and Children's Hospital Evans, Kaleigh Lynette-MD NOT COVERED Christ Medical Center and Children's Hospital Fairview Ogden Medical Group NOT COVERED Christ Medical Center and Children's Hospital Fajardo, Ashley Renae-NP NOT COVERED Christ Medical Center and Children's Hospital Fakhouri, Anton J.-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Family Eye Physicians, Ltd NOT COVERED Christ Medical Center and Children's Hospital Family Med Care Center NOT COVERED Christ Medical Center and Children's Hospital Farooki, Basheeruddin M.-MD NOT COVERED Christ Medical Center and Children's Hospital Fatima, Aelia -MD NOT COVERED Christ Medical Center and Children's Hospital Feria, Araceli Ilagan-MD NOT COVERED Christ Medical Center and Children's Hospital Ferragut, Justin Scott-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Fertility Centers of Illinois, SC NOT COVERED Christ Medical Center and Children's Hospital Finkelstein, Kenneth -DO NOT COVERED Christ Medical Center and Children's Hospital Foosaner, David E.-MD NOT COVERED Christ Medical Center and Children's Hospital Foot & Ankle Health Center, PC NOT COVERED Christ Medical Center and Children's Hospital Foster, Vanessa R.-MD NOT COVERED Christ Medical Center and Children's Hospital Fox, Christa M.-NP NOT COVERED Christ Medical Center and Children's Hospital Frank, Michael W.-MD NOT COVERED Christ Medical Center and Children's Hospital Frazier, Terra N.-DO NOT COVERED Christ Medical Center and Children's Hospital Galatanu, Mirela -MD NOT COVERED Christ Medical Center and Children's Hospital Garras, David -MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Gavani, Uma Devi-MD NOT COVERED Christ Medical Center and Children's Hospital Gelsomino, Steven L.-DPM NOT COVERED Christ Medical Center and Children's Hospital George J. Dangles MD, PC NOT COVERED Christ Medical Center and Children's Hospital George Skarpathiotis, MD, SC NOT COVERED Christ Medical Center and Children's Hospital GI Partners of Illinois NOT COVERED Christ Medical Center and Children's Hospital GI Partners of Illinois, LLC NOT COVERED Christ Medical Center and Children's Hospital Gierbolini, Mayte Paloma-Margarita-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Ginde, Jayant V.-MD NOT COVERED Christ Medical Center and Children's Hospital Ginsburg, Michael -MD NOT COVERED Christ Medical Center and Children's Hospital Glowicki, Allyson Elizabeth-PA NOT COVERED Christ Medical Center and Children's Hospital Gnatenco, Carmen -MD NOT COVERED Christ Medical Center and Children's Hospital Gopal Madhav, MD, SC NOT COVERED Christ Medical Center and Children's Hospital Gordon, Melanie Jaynee-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Gourineni, Prasad V.-MD NOT COVERED Christ Medical Center and Children's Hospital Govostis, Dean M.-MD NOT COVERED Christ Medical Center and Children's Hospital Grady, John F.-DPM NOT COVERED Christ Medical Center and Children's Hospital Grissom, Alyssa Ann-CNS NOT COVERED Christ Medical Center and Children's Hospital Grote, Christina -NP NOT COVERED Christ Medical Center and Children's Hospital Guajardo, Aaron -MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Gunderson, Candice L.-NP NOT COVERED Christ Medical Center and Children's Hospital Guzzetta, Paul Michael-MD NOT COVERED Christ Medical Center and Children's Hospital Gynecological Cancer Institute of Chicago, LLC NOT COVERED Christ Medical Center and Children's Hospital Haddad, Rami Yacoub-MD NOT COVERED Christ Medical Center and Children's Hospital Hager, Cheryl A.-CNS NOT COVERED Christ Medical Center and Children's Hospital Hahn Pediatric Group, LLC NOT COVERED Christ Medical Center and Children's Hospital Hall, Laurie A.-NP NOT COVERED Page 10

11 Christ Medical Center and Children's Hospital Hamad, Amar -MD NOT COVERED Christ Medical Center and Children's Hospital Hamadeh, Muhammad A.-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Hamilton, John F.-MD NOT COVERED Christ Medical Center and Children's Hospital Hammadeh, Rasheed -MD NOT COVERED Christ Medical Center and Children's Hospital Haraldsson, Catherine A.-PA NOT COVERED Christ Medical Center and Children's Hospital Harley, J. Preston-PhD NOT COVERED Christ Medical Center and Children's Hospital Harris, Shannon M.-NP NOT COVERED Christ Medical Center and Children's Hospital Hashmi, Faiza -MD NOT COVERED Christ Medical Center and Children's Hospital Hassan, Ahmed N.-MD NOT COVERED Christ Medical Center and Children's Hospital He, Theresa -MD NOT COVERED Christ Medical Center and Children's Hospital Healthonomic Primary Care NOT COVERED Christ Medical Center and Children's Hospital Healthy Kids, S.C. NOT COVERED Christ Medical Center and Children's Hospital Heller, William A.-MD NOT COVERED Christ Medical Center and Children's Hospital Hendrix, Jessica Nicole-PA NOT COVERED Christ Medical Center and Children's Hospital Herbert C. Becker Jr., MD SC NOT COVERED Christ Medical Center and Children's Hospital Hermann, Kelly J.-PA NOT COVERED Christ Medical Center and Children's Hospital Hicks, Sarah M.-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Hill Creek Pediatrics Inc NOT COVERED Christ Medical Center and Children's Hospital Hodakowski, George T.-MD NOT COVERED Christ Medical Center and Children's Hospital Homsi Pediatric Neurology NOT COVERED Christ Medical Center and Children's Hospital Hook, Jonathan Lee-DPM COVERED UNDER FAP Christ Medical Center and Children's Hospital Housner, Ryan Joseph-PA NOT COVERED Christ Medical Center and Children's Hospital Hussain, Zoya -DO NOT COVERED Christ Medical Center and Children's Hospital Illinois Dermatology Institute, LLC NOT COVERED Christ Medical Center and Children's Hospital Illinois Eye Institute NOT COVERED Christ Medical Center and Children's Hospital Illinois Institute of Pediatric Cardiology, Ltd NOT COVERED Christ Medical Center and Children's Hospital Ilyas, Zubair -MD NOT COVERED Christ Medical Center and Children's Hospital Imbarrato, Gregory James-DO NOT COVERED Christ Medical Center and Children's Hospital Ingersoll, Michael J.-PsyD NOT COVERED Christ Medical Center and Children's Hospital Institute of Neurobehavioral Services, SC NOT COVERED Christ Medical Center and Children's Hospital Integrated Imaging Associates NOT COVERED Christ Medical Center and Children's Hospital Integrated Imaging Associates NOT COVERED Christ Medical Center and Children's Hospital Integrative Health Group NOT COVERED Christ Medical Center and Children's Hospital Iqbal, Nasir -MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Iqbal, Naveed Syed-MD NOT COVERED Christ Medical Center and Children's Hospital Islam, Sherazad -MD NOT COVERED Christ Medical Center and Children's Hospital Itkin, Arthur -MD NOT COVERED Christ Medical Center and Children's Hospital Ivey-Brown, Jacqueline R.-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Ivkov, Nestor M.-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital J & M Tang, MD's & Associates, SC NOT COVERED Christ Medical Center and Children's Hospital J.R. Nephrology & Associates, PC NOT COVERED Christ Medical Center and Children's Hospital Jacob, Pradeep Kumer-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Jacobson, Daniel R.-MD NOT COVERED Christ Medical Center and Children's Hospital Jameria, Zenith A.-MD NOT COVERED Christ Medical Center and Children's Hospital Jedd, Anthony Sebastian-MD COVERED UNDER FAP Christ Medical Center and Children's Hospital Jeziorkowski, Christopher J.-MD NOT COVERED Christ Medical Center and Children's Hospital John McInerney, DO, SC NOT COVERED Christ Medical Center and Children's Hospital John, Jobin Koshy-MD NOT COVERED Christ Medical Center and Children's Hospital Johnson, Karen Denise-MD NOT COVERED Christ Medical Center and Children's Hospital Johnson, Naythea M.-NP NOT COVERED Christ Medical Center and Children's Hospital Johnson, Sarah A.-MD NOT COVERED Christ Medical Center and Children's Hospital Joshi, Anjali Anil-MD NOT COVERED Christ Medical Center and Children's Hospital Jurek & Jurek Family Practice NOT COVERED Christ Medical Center and Children's Hospital Jweied, Eias -MD NOT COVERED Christ Medical Center and Children's Hospital Kadar, Rachel Elizabeth Burt-MD NOT COVERED Christ Medical Center and Children's Hospital Kakavas, Peter W.-MD NOT COVERED Christ Medical Center and Children's Hospital Kale, Alka -MD NOT COVERED Christ Medical Center and Children's Hospital Kalimuthu, Ramasamy -MD COVERED UNDER FAP Page 11