Title: Financial Assistance – Hospital Facilities 1.BR.34

Effective Date: 09/09/05; Rev: 04/07, 12/07, 10/10, 08/11, 02/12, 01/16

POLICY: Iowa Health System, d/b/a UnityPoint Health (UPH) Hospitals and Hospital Organizations shall fulfill their charitable missions by providing emergency and other medically necessary health care services to all individuals without regard to their ability to pay. UPH Hospitals and Hospital Organizations shall provide financial assistance to eligible patients.

SCOPE: All UPH Hospitals and Hospital Organizations (referred to collectively as “UPH Hospitals”) that are 501(c)(3) tax-exempt. Schedule C, attached, describes what services and provider practices are covered at UPH Hospitals.

PRINCIPLES: As charitable tax-exempt organizations under Internal Revenue Code (IRC) Section 501(c)(3), UPH Hospitals meet the medically necessary health care needs of all patients who seek care, regardless of their financial abilities to pay for services provided. Similarly, patients have an obligation to obtain insurance coverage and pay for a portion of their health care services, and UPH Hospitals have a duty to seek payment from patients.

Pursuant to Internal Revenue Code Section 501(r), in order to remain tax-exempt, each UPH Hospital is required to adopt and widely publicize its financial assistance policy.

The purpose of this policy is to outline the circumstances under which UPH Hospitals will provide discounted care to financially needy patients.

1. Definitions.

1.1 Hospital. A facility that is required by a state to be licensed, registered, or similarly recognized as a hospital. Multiple buildings operated by a Hospital Organization under a single state license are considered to be a single Hospital.

1.2 Hospital Organization. An organization recognized, or seeking to be recognized, as described in Section 501(c)(3) that operates one or more Hospitals. This includes any other organization that has the principal function or purpose of providing Hospital care.

1.3 Allowed Amounts. Maximum amount of payment for covered health care services. This may be called “eligible expense,” “payment allowance” or “negotiated rate.”

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1.4 Amounts Generally Billed to Individuals Who Have Insurance (AGB). The following method is used by Hospitals to calculate Amounts Generally Billed to Individuals Who Have Insurance in this policy.

1.4.1 AGB% = (Sum of all Allowed Amounts by Medicare Fee For Service + Sum of all Allowed Amounts by private health insurers during a prior 12-month period) / (Sum of Gross Charges For the Same Claims)

1.4.2 AGB = (Gross Charges for Medically Necessary Care or Emergency Medical Care) X (AGB %)

1.4.3 The current AGB amounts for each UPH Hospital are attached at Schedule B to this policy. The AGB amounts will be updated annually.

1.5 Medically Necessary Care. Services that are (1) consistent with the diagnosis and treatment of the patient’s condition; (2) in accordance with standards of good medical practice; (3) required to meet the medical need of the patient and be for reasons other than the convenience of the patient or the patient’s practitioner or caregiver; and (4) the least costly type of service which would reasonably meet the medical need of the patient.

1.6 Emergency Medical Care. As defined in the Emergency Medical Treatment and Labor Act (EMTALA), a medical condition manifesting itself by acute symptoms of sufficient severity such that the absence of immediate medical attention could reasonably be expected to result in placing the health of the patient in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ part. It also includes a pregnant woman who is having contractions.

1.7 Patient(s). Includes either the patient and/or the patient’s responsible party (parent, guardian, guarantor).

1.8 FINA-Eligible Patients. Patients who follow the procedures outlined in this policy and are determined to be eligible for financial assistance under this policy.

2. Eligibility for Financial Assistance.

2.1 Financial assistance is available for only Medically Necessary Care and Emergency Medical Care provided to FINA-Eligible Patients. Financial assistance shall be based on the following guidelines, unless subject to conflicting state law requirements that will take precedence as outlined in Schedule A attached to this policy.

2.2 FINA-Eligible Patients who are below 600% of the current Federal Poverty Income Guidelines (FPIG) may be FINA-Eligible. FINA-Eligible Patients will

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not be billed more than the Amounts Generally Billed to Patients who have insurance.

2.3 Hospital bills will be further reduced by the following amounts for patients in each FPIG category below:

0-200% of FPIG: 100% discount off AGB

201-225% of FPIG: 65% discount off AGB

226-250% of FPIG: 45% discount off AGB

251-300% of FPIG: 25% discount off AGB

301-400% of FPIG: 5% discount off AGB

401-600% of FPIG: AGB only

2.4 Household income will be considered in determining whether a Patient is eligible for assistance. Household income includes but is not limited to the following: Traditional married couples, children (biological, step, or adoption) and couples living together. (Married or couples living together requires that the parties present as a couple and share expenses, whether same sex or male/female.)

2.5 In addition to household income, the Hospital will consider the extent to which the Patient’s household has assets that could be used to meet his or her financial obligation. Assets may include, but are not limited to, cash, savings and checking accounts, certificates of deposit, stocks and bonds, individual retirement accounts (IRAs), trust funds, real estate (excluding the Patient’s home) and motor vehicles. The Hospital will also take into account any liabilities that are the responsibility of the Patient’s household.

2. 6 Information from a Patient’s (or member of Patient’s household) prior financial assistance applications may be used to determine current eligibility for assistance. UPH also uses third party agencies to assist with collections. If those agencies provide UPH with a statement regarding a Patient’s likely FPIG level, UPH will use that information in determining the FINA-Eligibility status and the level of discount available.

2.7 Presumptive Eligibility. Patients who meet presumptive eligibility criteria under this Section may be granted financial assistance without completing the financial assistance application. Documentation supporting the Patient’s qualification for or participation in a program listed below at 2.7.1 must be obtained and kept on file. Documentation may include a copy of a government issued card or other documentation listing eligibility or qualification, or print

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screen of web page listing the Patient’s eligibility. Unless otherwise noted, a Patient who is presumed eligible under these presumptive criteria will continue to remain eligible for six months following the date of the initial approval, unless Hospital personnel have reason to believe the Patient no longer meets the presumptive criteria.

2.7.1 Patients who qualify and are receiving benefits from the following programs may be presumed eligible for 100% financial assistance:

2.7.1.1 The U.S. Department of Agriculture Food and Nutrition Service Food Stamp Program.

2.7.1.2 Limited eligibility – Illegal undocumented persons/ 3-day emergency window. The Iowa Department of Human Services allows for up to three days of Medicaid benefits to pay for the cost of emergency services for undocumented persons who do not meet citizenship, alien status, or social security number requirements. The emergency services must be provided in a Hospital that can provide the required care after the emergency medical condition has occurred. Presumptive eligibility for this category will be considered valid 6 months from the date of the emergent event.

2.7.1.3 Medicaid program (excluding lock-in and/or spend-down)

2.7.1.4 Women, Infants, and Children (WIC) nutrition assistance

3. Communicating Financial Assistance Information.

3.1 Each Hospital will communicate the availability of financial assistance to all Patients and within the community. Copies of the financial assistance policy (Policy 1.BR.34), financial assistance application and Plain Language Summary will be available by mail, on each Hospital’s website, and in person at each Hospital.

3.2 The UPH Central Billing Office is available by phone at (888) 343-4165 to answer questions about the policy, or Patients should go to the cashier’s office at the Hospital to obtain this information.

3.3 UPH Hospitals will develop a Plain Language Summary of this policy.

3.3.1 The Plain Language Summary will be available by mail, on each Hospital’s website, and in person at each Hospital.

3.3.2 The Plain Language Summary will be offered as part of the Patient intake and/or discharge process.

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3.3.3 The Plain Language Summary must be included when a Patient is sent written notice that Extraordinary Collection Actions may be taken against him/her. UPH Policy 1.BR.40, Billing and Collections, contains additional detail about billing & collection practices, and may be obtained at each Hospital and on each Hospital’s website.

3.4 This financial assistance policy, the Plain Language Summary, and all financial assistance forms must be available in English and in any other language in which limited English proficiency (LEP) populations constitute the lesser of 1,000 persons or more than 5% of the community served by the Hospital. These translated documents will be available by mail, on each Hospital’s website, and in person at each Hospital.

3.5 These notices and documents may be provided electronically.

4. Method for Applying for Financial Assistance.

4.1 Patient Applies For Insurance Coverage or Seeks Third-Party Responsibility. In order to be considered for financial assistance, the Patient must also furnish information to identify other financial resources that may be available to pay for the Patient’s health care, such as Medicaid, Medicare, third party liability, etc. Patients with valid health care coverage through non-UPH network providers are required to access their primary network before being considered for financial assistance.

4.1.1 This policy does not apply to the portion of a Patient’s services that have been, or may be, paid for by a first or third party payer such as an automobile insurance company or worker’s compensation. As allowed by the States of Iowa, Illinois, and Wisconsin, when a Patient presents for services following an accident or injury, the Hospital may place a hospital lien against the third party settlement.

4.2 Patient Must Complete the Financial Aid Application. To be considered for financial assistance, the Patient must furnish the Hospital with a completed financial assistance application and required supporting documentation. The application may be completed using information that is collected in writing, orally, or through a combination of both.

4.3 Patient Notified of Eligibility. After receiving the Patient’s financial information, the Hospital will notify the Patient of his/her eligibility determination within a reasonable period of time.

4.3.1 If the Patient does not initially qualify for financial assistance, the Patient may reapply if there is a change in income, assets, or family responsibilities.

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4.3.2 A Patient who qualifies for financial assistance must cooperate with the Hospital to establish a reasonable payment plan that takes into account available income and assets, the amount of the discounted bill(s), and any prior payments.

4.3.2.1 A Patient who qualifies for financial assistance must make a good faith effort to honor the payment plans. The Patient is responsible for communicating any change in his/her financial situation that may impact his/her ability to pay the discounted health care bills or to honor the provisions of any payment plans.

______William B. Leaver UPH President

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SCHEDULE A - Illinois Laws

Hospital Uninsured Patient Discount Act*: In Illinois, the Hospital Uninsured Patient Discount Act requires all Illinois hospitals to provide discounts to uninsured Illinois patients who meet certain eligibility criteria.

Under the law, patients with a family income up to 200% FPL in urban areas and 125% in rural areas (or at critical access hospitals) will receive a 100% discount. Patients with a family income between 201-600% FPL in urban areas and 126-300% FPL in rural areas (or at critical access hospitals) will receive a discount to 135% of the hospital’s cost. The act also has a maximum collectible amount of 25% of annual family income for those who meet the eligibility criteria and do not have significant assets.

These discounts only apply to medically necessary health care services that would be covered under Medicare; it does not apply to elective cosmetic surgery or non-medical services such as social and vocational services. The discount does not apply to physician services.

Patients may be required to apply for Medicare, Medicaid, AllKids, SCHIP, or other public programs if they might qualify.

*IL Public Act 95-965

Fair Patient Billing Act*: In Illinois, the Fair Patient Billing Act also requires Illinois hospitals to provide discounts to uninsured patients who meet certain eligibility criteria.

Uninsured patients with a family income up to 200% FPL in urban areas and up to 125% in rural areas will receive a 100% charitable discount for services exceeding $300.

Uninsured patients with a family income between 201-600% FPL in urban areas and up to 126- 300% in rural areas will receive a discount from charges for services exceeding $300.

This act also has a maximum collectible amount of 25% of annual family income for those who meet the eligibility criteria.

Patients may be required to apply for insurance and/or assistance in order to qualify for these discounts.

*IL Public Act 94-885

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SCHEDULE B – AMOUNTS GENERALLY BILLED

Amounts Generally AGB Billed (AGB) Discount as a % of Charges

ALLEN MEMORIAL HOSPITAL CORP 40% 60% IOWA LUTHERAN 29% 71% IOWA METHODIST 27% 73% JONES REGIONAL MEDICAL CENTER 54% 46% Methodist Medical Center Of Il 29% 71% Proctor Hospital 24% 76% ST. LUKES METHODIST HOSPITAL 34% 66% ST. LUKES REGIONAL MEDICAL CT 45% 55% THE FINLEY HOSPITAL 38% 62% TRINITY MEDICAL CENTER 35% 65% TRINITY MUSCATINE 42% 58% TRINITY REGIONAL MEDICAL CTR 37% 63% MERITER 37% 63%

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SCHEDULE C – Covered Services and Provider Practices by Hospital

The following UnityPoint Health Hospitals and Hospital Organizations are covered under the UPH Financial Assistance Policy 1.BR.34. Generally, services that patients receive at these Hospitals/Hospital Organizations are covered under the policy; however, please see the separate sections by hospital below for clarification of what services a Patient may receive at a specific Hospital/Hospital Organization that are not covered under this policy. Also, as part of UPH’s mission, we want to make our Hospitals/Hospital Organizations are available to all providers in our communities who may or not be employed by UnityPoint Health. Providers can be physicians, nurse practitioners, physician assistants, etc. To assist in understanding which of these providers are covered under this policy the comprehensive Provider Practice Listing following the chart below details whether:

(1) Their professional services are covered under this Financial Assistance Policy 1.BR.34 (2) Their professional services are covered under separate UPH Policy 1.BR.34(a), Financial Assistance – Non-Hospital Entities, because they are employed by UnityPoint Health Clinic or Trimark Physicians Group. (3) Their professional services are not covered under any UnityPoint Health financial assistance policies as they are not employees of Unity Point Health.

Services Not Covered under Financial Assistance Policy (see UnityPoint Health Hospital separate Provider Listing below as well) UnityPoint Health Anamosa - St. Luke's/Jones Anamosa Area Ambulance Service Regional Medical Center provides services to hospital patients which are not covered under this policy. UnityPoint Health Cedar Rapids - Continuing Care The physician/professional portion Hospital at St. Luke's L.C. of services for radiology/imaging will not be covered under this financial assistance policy and be billed separately. UnityPoint Health Cedar Rapids - St. Luke's The physician/professional portion Methodist Hospital of services for radiology/imaging will not be covered under this financial assistance policy and be billed separately. UnityPoint Health Des Moines - John Stoddard The physician/professional portion Cancer Center of services for pathology, radiology/imaging, and anesthesiology will not be covered

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Services Not Covered under Financial Assistance Policy (see UnityPoint Health Hospital separate Provider Listing below as well) under this financial assistance policy and be billed separately. UnityPoint Health Des Moines - Blank Children's The physician/professional portion Hospital of services for pathology, radiology/imaging, and anesthesiology will not be covered under this financial assistance policy and be billed separately. UnityPoint Health Des Moines - Iowa Lutheran The physician/professional portion Hospital of services for pathology, radiology/imaging, and anesthesiology will not be covered under this financial assistance policy and be billed separately. UnityPoint Health Des Moines - Iowa Methodist The physician/professional portion Medical Center of services for pathology, radiology/imaging, and anesthesiology will not be covered under this financial assistance policy and be billed separately. UnityPoint Health Des Moines - Methodist West The physician/professional portion Hospital of services for pathology, radiology/imaging, and anesthesiology will not be covered under this financial assistance policy and be billed separately. UnityPoint Health Dubuque - Finley Hospital United Clinical Laboratories is located in our hospital and if you receive services from them they are not covered under our policy unless you are also receiving our hospital services. The physician/professional portion of services for pathology, radiology/imaging, and anesthesiology will not be covered under this financial assistance policy and be separately billed. UnityPoint Health Fort Dodge - Trinity Regional The physician/professional portion Medical Center of services for pathology, radiology/imaging, and

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Services Not Covered under Financial Assistance Policy (see UnityPoint Health Hospital separate Provider Listing below as well) anesthesiology will not be covered under this financial assistance policy and be billed separately. UnityPoint Health Peoria - Greater Peoria Specialty No services covered Hospital UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Health Peoria - Proctor Hospital

UnityPoint Health Quad Cities/Muscatine - Trinity Metro Lab is located in our Medical Center – Bettendorf hospital and if you receive services from them they are not covered under our policy unless you are also receiving our hospital services. The physician/professional portion of services for pathology and radiology/imaging will not be covered under this financial assistance policy and be billed separately. UnityPoint Health Quad Cities/Muscatine - Trinity Metro Lab is located in our Medical Center – Moline hospital and if you receive services from them they are not covered under our policy unless you are also receiving our hospital services. The physician/professional portion of services for pathology and radiology/imaging will not be covered under this financial assistance policy and be billed separately. UnityPoint Health Quad Cities/Muscatine - Trinity Metro Lab is located in our Medical Center - Rock Island hospital and if you receive services from them they are not covered under our policy unless you are also receiving our hospital services. The physician/professional portion of services for pathology and

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Services Not Covered under Financial Assistance Policy (see UnityPoint Health Hospital separate Provider Listing below as well) radiology/imaging will not be covered under this financial assistance policy and be billed separately. UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Health Sioux City - St. Luke's Regional The physician/professional portion Medical Center of services for pathology, radiology/imaging, and anesthesiology will not be covered under this financial assistance policy and be separately billed. UnityPoint Health Waterloo - Allen Memorial The physician/professional portion Hospital of services for pathology, radiology/imaging, and anesthesiology will not be covered under this financial assistance policy and be billed separately. UnityPoint Health Madison, Wisconsin - Meriter The physician/professional portion Hospital, Inc. of services for pathology, radiology/imaging, and anesthesiology will not be covered under this financial assistance policy and will be billed separately. Turville Bay is located within our hospital and if you receive services from them they are not covered under our policy.

THE FOLLOWING PROVIDER PRACTICE LISTING IS UPDATED QUARTERLY

1.BR.34 Page 12 of 12 01/01/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Waterloo - Allen Memorial Hospital Advanced Diagnostic Imaging Center x UnityPoint Health Waterloo - Allen Memorial Hospital Allen Center for Pain Medicine x UnityPoint Health Waterloo - Allen Memorial Hospital Allen Child Protection Center x UnityPoint Health Waterloo - Allen Memorial Hospital Allen Memorial Hospital x UnityPoint Health Waterloo - Allen Memorial Hospital Allen Memorial Hospital - ER DEPT x UnityPoint Health Waterloo - Allen Memorial Hospital Allen Memorial Hospital - NICU x UnityPoint Health Waterloo - Allen Memorial Hospital Allen Memorial Hospital Occupational Health x UnityPoint Health Waterloo - Allen Memorial Hospital Allen Memorial Hospital-Ambulatory Surgery Ctr. x UnityPoint Health Waterloo - Allen Memorial Hospital Allen Memorial HospitalEmergency Department x UnityPoint Health Waterloo - Allen Memorial Hospital Allen Memorial Hospital-Wound & Ostomy Clinic x UnityPoint Health Waterloo - Allen Memorial Hospital Allen Women's Health x UnityPoint Health Waterloo - Allen Memorial Hospital Annie M. Kontos D.O., P.C. x UnityPoint Health Waterloo - Allen Memorial Hospital Barnard Plastic Surgery, P.C. x UnityPoint Health Waterloo - Allen Memorial Hospital Blank Children's Pediatric Neonatology x UnityPoint Health Waterloo - Allen Memorial Hospital Brent M. Hintz, M.D. x UnityPoint Health Waterloo - Allen Memorial Hospital Cedar Valley Bone Institute x UnityPoint Health Waterloo - Allen Memorial Hospital Cedar Valley Cancer Center x UnityPoint Health Waterloo - Allen Memorial Hospital Cedar Valley Medical Specialists, P.C. x UnityPoint Health Waterloo - Allen Memorial Hospital Cedar Valley Pediatric Dentistry x UnityPoint Health Waterloo - Allen Memorial Hospital Cedar Valley Podiatry x UnityPoint Health Waterloo - Allen Memorial Hospital Clinical Radiologists, PC x UnityPoint Health Waterloo - Allen Memorial Hospital Corridor Surgery PLC x UnityPoint Health Waterloo - Allen Memorial Hospital Covenant Clinic x UnityPoint Health Waterloo - Allen Memorial Hospital Covenant Clinic Arrowhead Medical Center x UnityPoint Health Waterloo - Allen Memorial Hospital Covenant Clinic Division Street x UnityPoint Health Waterloo - Allen Memorial Hospital Covenant Clinic Family Practice x UnityPoint Health Waterloo - Allen Memorial Hospital Covenant Clinic Internal Medicine/Pediatrics x UnityPoint Health Waterloo - Allen Memorial Hospital Covenant Clinic Kimball x UnityPoint Health Waterloo - Allen Memorial Hospital Covenant Clinic Nephrology x UnityPoint Health Waterloo - Allen Memorial Hospital Covenant Clinic Pulmonology x UnityPoint Health Waterloo - Allen Memorial Hospital Covenant Clinic Rehab Services x UnityPoint Health Waterloo - Allen Memorial Hospital Covenant Clinic Traer x UnityPoint Health Waterloo - Allen Memorial Hospital David W. Kabel, MD, FACC, P.C. x UnityPoint Health Waterloo - Allen Memorial Hospital Dermatology Associates, P.C. x UnityPoint Health Waterloo - Allen Memorial Hospital Family Foot Health Care P.L.C. x UnityPoint Health Waterloo - Allen Memorial Hospital Gundersen Clinic x UnityPoint Health Waterloo - Allen Memorial Hospital Heartland Neurosurgical Services, PLLC x UnityPoint Health Waterloo - Allen Memorial Hospital Intranerve x UnityPoint Health Waterloo - Allen Memorial Hospital Iowa Adult Medical Clinic x UnityPoint Health Waterloo - Allen Memorial Hospital Iowa Radiology West x UnityPoint Health Waterloo - Allen Memorial Hospital John Deere Seed and Cylinder x UnityPoint Health Waterloo - Allen Memorial Hospital John W. Musgrave, M.D. x UnityPoint Health Waterloo - Allen Memorial Hospital Kent D. Miller, D.O. x UnityPoint Health Waterloo - Allen Memorial Hospital Kettman Pranger Family Medicine, PLLC x UnityPoint Health Waterloo - Allen Memorial Hospital Matthew J. Smith, M.D. x UnityPoint Health Waterloo - Allen Memorial Hospital Mauer Eye Center, P.C. x UnityPoint Health Waterloo - Allen Memorial Hospital Mir Waziri, MD x UnityPoint Health Waterloo - Allen Memorial Hospital Nagarathnamma Nadipuram, M.D., P.C. x UnityPoint Health Waterloo - Allen Memorial Hospital Northeast Iowa Family Practice Center x UnityPoint Health Waterloo - Allen Memorial Hospital Northeast Iowa Pathology Associates x UnityPoint Health Waterloo - Allen Memorial Hospital Northeast Iowa Podiatry, P.C. x UnityPoint Health Waterloo - Allen Memorial Hospital Northern Iowa Cardiovascular and Thoracic Surgery Clinic, P.C. x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Waterloo - Allen Memorial Hospital Northern Iowa Urological Associates, PC x UnityPoint Health Waterloo - Allen Memorial Hospital Only Kids Dentistry, PC x UnityPoint Health Waterloo - Allen Memorial Hospital Peoples Community Health Clinic, Inc. x UnityPoint Health Waterloo - Allen Memorial Hospital Physical Medicine & Rehab Assoc./NE Iowa x UnityPoint Health Waterloo - Allen Memorial Hospital Robert S. Grittmann, D.O. x UnityPoint Health Waterloo - Allen Memorial Hospital St. Luke's Division of Neonatal Medicine x UnityPoint Health Waterloo - Allen Memorial Hospital St. Luke's Physical Med/Rehab/Neuropsych x UnityPoint Health Waterloo - Allen Memorial Hospital Total Health of Iowa x UnityPoint Health Waterloo - Allen Memorial Hospital Trinity Medical Center Moline-Neonatal Medicine x UnityPoint Health Waterloo - Allen Memorial Hospital Trinity Medical Center-Bettendorf x UnityPoint Health Waterloo - Allen Memorial Hospital Trinity Medical Center-Moline x UnityPoint Health Waterloo - Allen Memorial Hospital Trinity Regional Medical Center x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Diab & Endo-United Med. Park x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Family Medicine-Cedarloo x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Family Medicine-Denver (RHC) x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Family Medicine-Evansdale x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Family Medicine-Greenhill x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Family Medicine-Internal Medicine-Cedar Falls x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Family Medicine-Parkersburg (RHC) x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Family Medicine-Rohlf Memorial (RHC) x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Family Medicine-United Medical Park x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Hospitalists-Cedar Rapids x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Hospitalist-Waterloo x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Internal Medicine-Waterloo x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Neurology-Waterloo x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-OB/Gyn-Cedar Falls x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-OB/Gyn-Waterloo x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Pediatric Cardiology x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Psychiatry-Waterloo x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Urgent Care Prairie Medical Park x UnityPoint Health Waterloo - Allen Memorial Hospital UnityPoint Clinic-Urgent Care United Medical Park x UnityPoint Health Waterloo - Allen Memorial Hospital Virtual Radiologic Professionals, LLC (vRad) x UnityPoint Health Waterloo - Allen Memorial Hospital Wolfe Eye Clinic, P.C. x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Abbe Center for CMH x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Associates for Behavioral Healthcare x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Cedar Valley Medical Specialists, P.C. x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Cedar Valley Pathologists-St. Luke's Hospital x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Daniel E. McGrail, M.D. x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Dermatology Clinic of Iowa, P.C. x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Eastern IA Physical Medicine & Rehab PC x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Eastern Iowa Anesthesia, PC x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Eastern Iowa Foot Specialist, PC x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Foot & Ankle Specialists of Iowa x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Forefront Dermatology x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Gastroenterologists, P.C. x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Ghosh Center for Oncology & Hematology x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Hawkeye Anesthesia x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Internist Associates of Iowa x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Internist Associates of Iowa #988 x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Iowa Foot & Ankle Clinic x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. John VanderZee, M.D., P.C. x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. John Wollner M.D. x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Jones Regional Medical Center x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. LCA, P.L.C. x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Linn County Anesthesiologists, P.C. x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Linn County Anesthesiologists, P.C. - Pain Clinic x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Mary Nelson, MD, PC x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Mercy Cardiology Clinic x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Mercy Care Second Avenue x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Mercy Diabetes Center x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Mercy Pulmonology Clinic x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Norma Schmoker Women's Center x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Oncology Associates x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Physicians' Clinic of Iowa, P.C. - Urology x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Physicians' Clinic of Iowa, P.C. -Hematology/Oncology x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Physicians' Clinic of Iowa, P.C.-Neurology x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Physicians' Clinic of Iowa, P.C.-Orthopaedics x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Physicians' Clinic of Iowa, P.C.-Otolaryngology x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Physicians' Clinic of Iowa, P.C.-Surgical Specialists x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Physicians' Clinic of Iowa, P.C.-Urology x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Physicians' Clinic of Iowa, PC-Podiatry x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Physicians' Clinic of Iowa, PC-Rheumatology x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Pruchno Medicine x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Radiation Specialists of Eastern Iowa x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Radiology Consultants of Iowa, PLC x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Richard Louvar, MD x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Richard Pope, MD x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. St. Luke's Behavioral Health x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. St. Luke's Hospital x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. St. Luke's Living Center East x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. St. Luke's Physical Med/Rehab/Neuropsych x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. St. Luke's Respiratory & Critical Care x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. Stanley Mathew, M.D., P.L.C. x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint at Home Hospice x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-Behavioral Health-Cedar Rapids x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-Cardiology-Cedar Rapids x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-CAT Clinic -Cedar Rapids x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-Center for Liver Disease x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-Diabetes & Kidney Center x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-Family Medicine-Medical District x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-Family Medicine-Mount Vernon x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-Hospitalists-Cedar Rapids x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-Internal Medicine-Urgent Care-Hiawatha x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-Multi Specialty-Cedar Rapids x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-Multi Specialty-Cedar Rapids(STL) x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-Multispecialty-Davenport x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-Neurosurgery-Cedar Rapids x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Clinic-Pediatric Hospitalist-Cedar Rapids x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Health - St. Luke's Palliative Care x UnityPoint Health Cedar Rapids - Continuing Care Hospital at St. Luke's L.C. UnityPoint Hospice - St. Luke's Hospital x UnityPoint Health Dubuque - Finley Hospital Aesthetic Consultants of Iowa x UnityPoint Health Dubuque - Finley Hospital Blank Children's Pediatric Neurology Clinic x UnityPoint Health Dubuque - Finley Hospital Cascade ImmediateCare x UnityPoint Health Dubuque - Finley Hospital Cornerstone Family Practice x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Dubuque - Finley Hospital Cory L Dietz, MD, PC x UnityPoint Health Dubuque - Finley Hospital Dentistry x UnityPoint Health Dubuque - Finley Hospital Dubuque Endoscopy Center, LC x UnityPoint Health Dubuque - Finley Hospital Dubuque ENT Head & Neck Surgery x UnityPoint Health Dubuque - Finley Hospital Dubuque Family Practice, P.C. x UnityPoint Health Dubuque - Finley Hospital Dubuque Internal Medicine, P.C. x UnityPoint Health Dubuque - Finley Hospital Dubuque Neurology & Sleep Medicine, P.C. x UnityPoint Health Dubuque - Finley Hospital Dubuque Obstetrics & Gynecology, P.C. x UnityPoint Health Dubuque - Finley Hospital Dubuque Orthopaedic Surgeons x UnityPoint Health Dubuque - Finley Hospital Dubuque Orthopedic Surgeons x UnityPoint Health Dubuque - Finley Hospital Dubuque Pediatric Dentistry x UnityPoint Health Dubuque - Finley Hospital Dubuque Pediatrics, P.C. x UnityPoint Health Dubuque - Finley Hospital Dubuque Podiatry, P.C. x UnityPoint Health Dubuque - Finley Hospital Dubuque Radiological Associates, P.C. x UnityPoint Health Dubuque - Finley Hospital Dubuque Rheumatology x UnityPoint Health Dubuque - Finley Hospital Dubuque Surgery, P.C. x UnityPoint Health Dubuque - Finley Hospital Finley Heart and Vascular Center x UnityPoint Health Dubuque - Finley Hospital Finley Hospital x UnityPoint Health Dubuque - Finley Hospital Finley Hospital FBC x UnityPoint Health Dubuque - Finley Hospital Finley Hospital Wound Care Center x UnityPoint Health Dubuque - Finley Hospital Finley Hospital-Business Health & Occ Med x UnityPoint Health Dubuque - Finley Hospital Finley Hospital-Convenient Care x UnityPoint Health Dubuque - Finley Hospital Finley Outpatient Care Unit x UnityPoint Health Dubuque - Finley Hospital Fuerste Eye Clinic x UnityPoint Health Dubuque - Finley Hospital Great River Oral & Maxillofacial Surgery, PC x UnityPoint Health Dubuque - Finley Hospital Helen G. Nassif Community Cancer Center of Iowa x UnityPoint Health Dubuque - Finley Hospital Intranerve x UnityPoint Health Dubuque - Finley Hospital Iowa Radiology West x UnityPoint Health Dubuque - Finley Hospital Karen Lynn Maloney, M.D., LTD x UnityPoint Health Dubuque - Finley Hospital Medical Associates x UnityPoint Health Dubuque - Finley Hospital Medical Associates Clinic PC x UnityPoint Health Dubuque - Finley Hospital Mississippi Valley Anesthesiology x UnityPoint Health Dubuque - Finley Hospital Ophthalmology, P.C. x UnityPoint Health Dubuque - Finley Hospital Pathology Associates x UnityPoint Health Dubuque - Finley Hospital Pathology Associates (G213) x UnityPoint Health Dubuque - Finley Hospital Peckosh Pediatric Dentistry PC x UnityPoint Health Dubuque - Finley Hospital Plastic Surgery Aesthetics x UnityPoint Health Dubuque - Finley Hospital Radiation Oncology of Iowa, P.C. x UnityPoint Health Dubuque - Finley Hospital Radiology Consultants of Iowa, PLC x UnityPoint Health Dubuque - Finley Hospital Stanley Mathew, M.D., P.L.C. x UnityPoint Health Dubuque - Finley Hospital Steven P. Schuck, D.P.M. x UnityPoint Health Dubuque - Finley Hospital Summit Outpatient x UnityPoint Health Dubuque - Finley Hospital Trinity Medical Center-Bettendorf x UnityPoint Health Dubuque - Finley Hospital Trinity Muscatine x UnityPoint Health Dubuque - Finley Hospital TriState Family Practice, L.L.P. x UnityPoint Health Dubuque - Finley Hospital Tri-State Vein Center, P.C. x UnityPoint Health Dubuque - Finley Hospital UnityPoint Clinic-Cardiology-Cedar Rapids x UnityPoint Health Dubuque - Finley Hospital UnityPoint Clinic-Internal Medicine-Urgent Care-Hiawatha x UnityPoint Health Dubuque - Finley Hospital UnityPoint Clinic-Urology-Dubuque x UnityPoint Health Dubuque - Finley Hospital UnityPoint Health Finley Hospital Spine Care x UnityPoint Health Dubuque - Finley Hospital Virtual Radiologic Professionals, LLC (vRad) x UnityPoint Health Dubuque - Finley Hospital Wendt Regional Cancer Services x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Dubuque - Finley Hospital Westside Orthopaedics x UnityPoint Health Dubuque - Finley Hospital Women's Wellness Center x UnityPoint Health Des Moines Acute Care Inc. x UnityPoint Health Des Moines Advanced Foot & Ankle Clinic x UnityPoint Health Des Moines Albrecht Foot & Ankle, P.C. x UnityPoint Health Des Moines All About Foot Care x UnityPoint Health Des Moines Allen R. Kaufman, M.D. x UnityPoint Health Des Moines Allergy Institute, P.C. x UnityPoint Health Des Moines Allergy, Asthma & Sinus Center, P.C. x UnityPoint Health Des Moines Allergy-Asthma Associates, P.C. x UnityPoint Health Des Moines Alley Medical x UnityPoint Health Des Moines Associated Anesthesiologists, P.C. x UnityPoint Health Des Moines Associated Ophthalmologists, P.C. x UnityPoint Health Des Moines Associates in Kidney Care x UnityPoint Health Des Moines Bergman Folkers Plastic Surgery x UnityPoint Health Des Moines Berkshire Dental x UnityPoint Health Des Moines Bilgi Children's Clinic x UnityPoint Health Des Moines Blank Children's Adolescent Clinic x UnityPoint Health Des Moines Blank Children's Diagnostic Clinic x UnityPoint Health Des Moines Blank Children's Endocrinology Clinic x UnityPoint Health Des Moines Blank Children's Gastroenterology Clinic x UnityPoint Health Des Moines Blank Children's Infectious Disease x UnityPoint Health Des Moines Blank Children's Nephrology Clinic x UnityPoint Health Des Moines Blank Children's Neurology Clinic x UnityPoint Health Des Moines Blank Children's Pediatric & Adolescent Psychiatry Clinic x UnityPoint Health Des Moines Blank Children's Pediatric Cancer & Blood Disorders Clinic x UnityPoint Health Des Moines Blank Children's Pediatric Clinic x UnityPoint Health Des Moines Blank Children's Pediatric Critical Care x UnityPoint Health Des Moines Blank Children's Pediatric Development x UnityPoint Health Des Moines Blank Children's Pediatric Hospitalists x UnityPoint Health Des Moines Blank Children's Pediatric Infectious Disease x UnityPoint Health Des Moines Blank Children's Pediatric Neonatology x UnityPoint Health Des Moines Blank Children's Pediatric Neurology Clinic x UnityPoint Health Des Moines Blank Children's Pediatric Pulmonology Clinic x UnityPoint Health Des Moines Blank Children's Pediatric Surgery x UnityPoint Health Des Moines Blank Health Providers x UnityPoint Health Des Moines Blank Pediatric Emergency Physicians x UnityPoint Health Des Moines Broadlawns Medical Center – Oncology x UnityPoint Health Des Moines Broadlawns Medical Center-Geriatric Medicine and Memory Center x UnityPoint Health Des Moines Capital Orthopaedics & Sports Medicine x UnityPoint Health Des Moines Cass County Memorial Hospital RHC x UnityPoint Health Des Moines Central Iowa Foot Clinic, PC x UnityPoint Health Des Moines Central Iowa OB/GYN Specialists x UnityPoint Health Des Moines Central Iowa Pediatric Allergy & Pulmonology x UnityPoint Health Des Moines Child Psychiatry Associates, P.C. x UnityPoint Health Des Moines Children's Dental Center of Central Iowa x UnityPoint Health Des Moines Children's Eye Clinic, P.C. x UnityPoint Health Des Moines ChildServe x UnityPoint Health Des Moines City Family Clinic, P.C. x UnityPoint Health Des Moines Counseling Centers for Central Iowa x UnityPoint Health Des Moines Counseling Centers for Central Iowa - Lakeview x UnityPoint Health Des Moines Dallas Center Medical Associates, P.C. x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Des Moines David B. Blaha, D.D.S. x UnityPoint Health Des Moines David H. Stubbs, MD x UnityPoint Health Des Moines Delaware Family Medicine & Pediatrics x UnityPoint Health Des Moines Dennis P. Porto, M.D. x UnityPoint Health Des Moines Dermatology & Dermatologic Surgery Ctr x UnityPoint Health Des Moines Dermatology, P.C. x UnityPoint Health Des Moines Des Moines Anesthesiologists, P.C. x UnityPoint Health Des Moines Des Moines Children's Dentistry x UnityPoint Health Des Moines Des Moines Eye Surgeons x UnityPoint Health Des Moines Des Moines Internal Medicine x UnityPoint Health Des Moines Des Moines OB/GYN Specialists, P.C. x UnityPoint Health Des Moines Des Moines Orthopaedic Surgeons, P.C. x UnityPoint Health Des Moines Des Moines Pediatric & Adolescent Clinic x UnityPoint Health Des Moines Des Moines Pediatric Dental Center x UnityPoint Health Des Moines Des Moines University Foot & Ankle Institute x UnityPoint Health Des Moines Des Moines University Medical Clinic x UnityPoint Health Des Moines Diagnostic Clinic, P.C. x UnityPoint Health Des Moines Dirk H. Brom, M.D. x UnityPoint Health Des Moines Douglas S. Parks, M.D. x UnityPoint Health Des Moines Downtown Eye Care x UnityPoint Health Des Moines East Central Iowa Acute Care, LLP x UnityPoint Health Des Moines East Village Foot & Ankle Surgeons x UnityPoint Health Des Moines Ernesto Barrantes, M.D. x UnityPoint Health Des Moines Eye Health Physicians, P.C. x UnityPoint Health Des Moines Family Medicine of Urbandale - Mercy x UnityPoint Health Des Moines Foreman & Dick, P.C. x UnityPoint Health Des Moines Fred Brink, DO x UnityPoint Health Des Moines General Surgery Physicians x UnityPoint Health Des Moines Goshorn Psych-Services PLLC x UnityPoint Health Des Moines Greater Des Moines Dermatology x UnityPoint Health Des Moines Heartland Plastic & Recons. Surg., P.C. x UnityPoint Health Des Moines Heartland Vascular Medicine & Surgery x UnityPoint Health Des Moines Hematology & Oncology Center of Iowa x UnityPoint Health Des Moines Hooshang Soltanzadeh, M.D. x UnityPoint Health Des Moines Insight Neural Monitoring x UnityPoint Health Des Moines Internal Medicine Consultants x UnityPoint Health Des Moines Internal Medicine Residency Program x UnityPoint Health Des Moines Iowa Arthritis & Osteoporosis Center x UnityPoint Health Des Moines Iowa Dermatology Clinic, P.L.C. x UnityPoint Health Des Moines Iowa Diabetes & Endocrinology Center x UnityPoint Health Des Moines Iowa Digestive Disease Center P.C. x UnityPoint Health Des Moines Iowa Ear Center x UnityPoint Health Des Moines Iowa Ear Clinic, P.C. x UnityPoint Health Des Moines Iowa ENT Center, PLLC x UnityPoint Health Des Moines Iowa Foot Care Center x UnityPoint Health Des Moines Iowa Head & Neck, P.C. x UnityPoint Health Des Moines Iowa Health Emergency Physicians x UnityPoint Health Des Moines Iowa Kidney Physicians, P.C. x UnityPoint Health Des Moines Iowa Lutheran Hospital - CICU x UnityPoint Health Des Moines Iowa Lutheran Hospital-Department of Surgery x UnityPoint Health Des Moines Iowa Methodist Medical Center-Trauma Services x UnityPoint Health Des Moines Iowa Methodist Occupational Medicine x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Des Moines Iowa Oral & Maxillofacial Surgeons, P.C. x UnityPoint Health Des Moines Iowa Ortho x UnityPoint Health Des Moines Iowa Pathology Associates, P.C. x UnityPoint Health Des Moines Iowa Radiology West x UnityPoint Health Des Moines Iowa Retina Consultants, Inc. x UnityPoint Health Des Moines Iowa Specialty Physicians x UnityPoint Health Des Moines Iowa Spine Care PLC x UnityPoint Health Des Moines Iowa Surgery Center, P.C. x UnityPoint Health Des Moines Iowa Vein Center x UnityPoint Health Des Moines Iowa Weight Loss Specialists x UnityPoint Health Des Moines James A. Coggi, M.D., P.C. x UnityPoint Health Des Moines James Blessman, M.D. x UnityPoint Health Des Moines James L. Gallagher, M.D. x UnityPoint Health Des Moines James W. Hopkins, M.D. x UnityPoint Health Des Moines Jeffrey A. Ver Heul, MD x UnityPoint Health Des Moines Jeffrey D. Stahl, M.D. x UnityPoint Health Des Moines John E. Campbell, D.D.S. x UnityPoint Health Des Moines John Gregory Ganske, M.D. x UnityPoint Health Des Moines John H. Ghrist II, M.D. x UnityPoint Health Des Moines John Stoddard Cancer Center-Radiation Oncology x UnityPoint Health Des Moines John T. Kelley, MD x UnityPoint Health Des Moines Johnston Foot and Ankle Clinic x UnityPoint Health Des Moines Jordan Creek Family Medicine Clinic x UnityPoint Health Des Moines Kappos Family Medicine x UnityPoint Health Des Moines Katherine Hauser, M.D. x UnityPoint Health Des Moines Katzmann Breast Center x UnityPoint Health Des Moines Koch Facial Surgery x UnityPoint Health Des Moines Lance Longnecker, MD x UnityPoint Health Des Moines Leo J. Plummer, M.D., P.C. x UnityPoint Health Des Moines LifeServe Blood Center x UnityPoint Health Des Moines Lynn M. Lindaman, M.D. x UnityPoint Health Des Moines Marc Ewers, M.D. x UnityPoint Health Des Moines Mark E. Thoman, M.D. x UnityPoint Health Des Moines Marvin M. Hurd, MD x UnityPoint Health Des Moines McFarland Clinic, P.C. x UnityPoint Health Des Moines McFarland Clinic, P.C.-Reproductive Medicine x UnityPoint Health Des Moines Medical Education Consortium x UnityPoint Health Des Moines Medical Education Services x UnityPoint Health Des Moines Medical Oncology & Hematology Associates x UnityPoint Health Des Moines Melodee Woodard, M.D. x UnityPoint Health Des Moines Mercy Beaverdale Medical Clinic x UnityPoint Health Des Moines Mercy Cancer Ctr. Radiation Oncology x UnityPoint Health Des Moines Mercy Central Pediatric Clinic x UnityPoint Health Des Moines Mercy Ear, Nose & Throat Clinic x UnityPoint Health Des Moines Mercy Family Medical Center/Primary HealthCare x UnityPoint Health Des Moines Mercy Gastroenterology x UnityPoint Health Des Moines Mercy Johnston Medical Clinic x UnityPoint Health Des Moines Mercy Plastic Surgery x UnityPoint Health Des Moines Mercy Professional Practice Associates x UnityPoint Health Des Moines Mercy South Medical Clinic x UnityPoint Health Des Moines Mercy Specialty Clinics, Urology x UnityPoint Health Des Moines Mercy Surgical Affiliates x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Des Moines Mercy West Medical Clinic x UnityPoint Health Des Moines Methodist Perinatal Center x UnityPoint Health Des Moines Methodist Plaza Dental Group x UnityPoint Health Des Moines Methodist West Hospital x UnityPoint Health Des Moines Metro Anesthesia & Pain Management x UnityPoint Health Des Moines Mid-Iowa Fertility, P.C. x UnityPoint Health Des Moines Midwest Oral & Facial Surgery, PC x UnityPoint Health Des Moines Midwife Services of Iowa Health - Des Moines x UnityPoint Health Des Moines Mobile Medical Professionals x UnityPoint Health Des Moines Nephrology, P.C. x UnityPoint Health Des Moines Norma Hirsch, M.D. x UnityPoint Health Des Moines OB GYN Associates of Des Moines, PLC x UnityPoint Health Des Moines Occupational Health Center x UnityPoint Health Des Moines Ocean Dental General Dentistry x UnityPoint Health Des Moines On With Life x UnityPoint Health Des Moines Oral Surgeons, P.C. x UnityPoint Health Des Moines Orchard Place - Child Guidance Center x UnityPoint Health Des Moines Palliative Care x UnityPoint Health Des Moines Pediatric & Adult Allergy, P.C. x UnityPoint Health Des Moines Pediatric Cardiology, P.C. x UnityPoint Health Des Moines Pediatrics & Adolescent Medicine, PC x UnityPoint Health Des Moines Pediatrix Medical Group x UnityPoint Health Des Moines Penn Medical Family Care Center x UnityPoint Health Des Moines Perinatal Center of Iowa, L.L.C. x UnityPoint Health Des Moines Physicians' Eye Clinic x UnityPoint Health Des Moines Polk County Medical Examiner x UnityPoint Health Des Moines Powell Chemical Dependency Center x UnityPoint Health Des Moines Prairie City Family Clinic x UnityPoint Health Des Moines Principal Financial Group-Medical Department x UnityPoint Health Des Moines Raymond L. Webster, M.D. x UnityPoint Health Des Moines Regional Child Protection Center x UnityPoint Health Des Moines Robert Bannister, M.D., P.C. x UnityPoint Health Des Moines Robert Moratz, D.P.M. x UnityPoint Health Des Moines Robert O. Thompson, M.D. x UnityPoint Health Des Moines Roger Kunz, M.D. x UnityPoint Health Des Moines Rolando Creagh, M.D. x UnityPoint Health Des Moines Ruan Neurology x UnityPoint Health Des Moines South Ridge Foot Clinic x UnityPoint Health Des Moines Stadia Sports Medicine, P.C. x UnityPoint Health Des Moines Steven Bunge, MD x UnityPoint Health Des Moines Surgical Associates, P.C. x UnityPoint Health Des Moines Terrance O. Kurtz, D.O., P.C. x UnityPoint Health Des Moines The Foot Center, P.C. x UnityPoint Health Des Moines The Iowa Clinic x UnityPoint Health Des Moines The Iowa Clinic - Cardiac Surgery x UnityPoint Health Des Moines The Iowa Clinic - Dermatology x UnityPoint Health Des Moines The Iowa Clinic - Gynecology & Obstetrics, P.C. x UnityPoint Health Des Moines The Iowa Clinic - Neurosurgical Services x UnityPoint Health Des Moines The Iowa Clinic - OB/Gyn x UnityPoint Health Des Moines The Iowa Clinic - Surgery, P.C. x UnityPoint Health Des Moines The Iowa Clinic - Urgent Care x UnityPoint Health Des Moines The Iowa Clinic Clinical Research x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Des Moines The Iowa Clinic Endoscopy Center, LLC x UnityPoint Health Des Moines The Iowa Clinic- Radiology x UnityPoint Health Des Moines The Iowa Clinic West Lakes x UnityPoint Health Des Moines The Iowa Clinic West Lakes-Family Medicine x UnityPoint Health Des Moines The Iowa Clinic West Lakes-OB/Gyn x UnityPoint Health Des Moines The Iowa Clinic West Lakes-Vascular Surgery x UnityPoint Health Des Moines The Iowa Clinic, P.C.- Urgent Care x UnityPoint Health Des Moines The Iowa Clinic-Family Medicine x UnityPoint Health Des Moines The Iowa Clinic-General Surgery x UnityPoint Health Des Moines The Iowa Clinic-Heart & Vascular Care x UnityPoint Health Des Moines The Iowa Clinic-Indianola x UnityPoint Health Des Moines The Iowa Clinic-Internal Medicine x UnityPoint Health Des Moines The Iowa Clinic-OB/GYN x UnityPoint Health Des Moines The Iowa Clinic-Pediatrics x UnityPoint Health Des Moines The Iowa Clinic-Waukee x UnityPoint Health Des Moines Thomas A. Brown, M.D., P.C. x UnityPoint Health Des Moines Thomas G. Wilson, D.D.S. x UnityPoint Health Des Moines Thomas K. Koithan, D.O. x UnityPoint Health Des Moines Torrey Mitchell, M.D. x UnityPoint Health Des Moines Towncrest Internal Medicine x UnityPoint Health Des Moines Transplant Services x UnityPoint Health Des Moines Transplant Services-CIHC x UnityPoint Health Des Moines Trauma Clinic - The Iowa Clinic x UnityPoint Health Des Moines Trinity Medical Center Rock Island- ER Department x UnityPoint Health Des Moines Trinity Regional Medical Center x UnityPoint Health Des Moines Trinity Regional Medical Center-Hospitalists x UnityPoint Health Des Moines UnityPoint at Home x UnityPoint Health Des Moines UnityPoint at Home-Hospice x UnityPoint Health Des Moines UnityPoint Clinic-Cardiology-Lakeview x UnityPoint Health Des Moines UnityPoint Clinic-Cardiology-Methodist Plaza x UnityPoint Health Des Moines UnityPoint Clinic-Cardiology-Penn Avenue x UnityPoint Health Des Moines UnityPoint Clinic-Center for Liver Disease x UnityPoint Health Des Moines UnityPoint Clinic-Center for Liver Disease-UNMC x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Ankeny at Prairie Trail x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-East Des Moines x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Grimes x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Huxley x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Indianola x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Ingersoll x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Johnston x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Northwest Des Moines x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Norwalk x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Parks Area x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Pediatrics-Urgent Care-Southglen x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Physical Therapy-Altoona x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Pleasant Hill x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Roosevelt x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Southwest Des Moines x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Urgent Care-Ankeny x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Urgent Care-Lakeview x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Urgent Care-Merle Hay x UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-Waukee x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Des Moines UnityPoint Clinic-Family Medicine-West Des Moines x UnityPoint Health Des Moines UnityPoint Clinic-Family Med-Urgent Care-PT-Sports Med-Urbandale x UnityPoint Health Des Moines UnityPoint Clinic-Hospitalists-Des Moines x UnityPoint Health Des Moines UnityPoint Clinic-Internal Medicine- CIHC x UnityPoint Health Des Moines UnityPoint Clinic-Internal Medicine-Ankeny at Prairie Trail x UnityPoint Health Des Moines UnityPoint Clinic-Internal Medicine-Lakeview x UnityPoint Health Des Moines UnityPoint Clinic-Internal Medicine-Methodist Plaza x UnityPoint Health Des Moines UnityPoint Clinic-Internal Medicine-Penn Avenue x UnityPoint Health Des Moines UnityPoint Clinic-Internal Medicine-Waterloo x UnityPoint Health Des Moines UnityPoint Clinic-Internal Medicine-West Des Moines x UnityPoint Health Des Moines UnityPoint Clinic-Mental Health-Penn Avenue x UnityPoint Health Des Moines UnityPoint Clinic-Multi-Specialty-Methodist Plaza x UnityPoint Health Des Moines UnityPoint Clinic-OB/GYN - Lakeview x UnityPoint Health Des Moines UnityPoint Clinic-OB/GYN and Imaging-Penn Avenue x UnityPoint Health Des Moines UnityPoint Clinic-OB/GYN- Ankeny x UnityPoint Health Des Moines UnityPoint Clinic-OB/GYN-Methodist Plaza x UnityPoint Health Des Moines UnityPoint Clinic-Pediatrics-Ankeny x UnityPoint Health Des Moines UnityPoint Clinic-Pediatrics-Lakeview x UnityPoint Health Des Moines UnityPoint Clinic-Pediatrics-Methodist Plaza x UnityPoint Health Des Moines UnityPoint Clinic-Pediatrics-Walnut Creek x UnityPoint Health Des Moines UnityPoint Clinic-Pediatrics-Waukee x UnityPoint Health Des Moines UnityPoint Clinic-Physical Medicine and Rehabilitation-Methodist Plaza x UnityPoint Health Des Moines UnityPoint Clinic-Psychiatry-West Des Moines x UnityPoint Health Des Moines UnityPoint Clinic-Surgery & Neurology-Des Moines x UnityPoint Health Des Moines UnityPoint Clinic-Weight Loss-West Des Moines x UnityPoint Health Des Moines UnityPoint Health x UnityPoint Health Des Moines UnityPoint Health-Des Moines Administration x UnityPoint Health Des Moines Veterans Administration Medical Center x UnityPoint Health Des Moines Wesley Life x UnityPoint Health Des Moines West Des Moines Children's Clinic x UnityPoint Health Des Moines West Des Moines OB/GYN Associates x UnityPoint Health Des Moines Wolfe Eye Clinic, P.C. x UnityPoint Health Des Moines Women's Care Clinic x UnityPoint Health Des Moines Women's Health Services, PLLC x UnityPoint Health Des Moines Wound Healing Center x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Allen Memorial Hospital - ER DEPT x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Cedar Valley Pathologists-St. Luke's Hospital x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center East Central Iowa Acute Care, LLP x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Eastern Iowa Foot Specialist, PC x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Eastern Iowa Sleep Center, LLC x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Finley Hospital x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Foot & Ankle Specialists of Iowa x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Fox Eye Laser & Cosmetic Institute x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Gastroenterologists, P.C. x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Iowa Anesthesia x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Iowa Eye Center x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Iowa Health Emergency Physicians x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center John Wollner M.D. x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Jones Regional Medical Center x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Linn County Anesthesiologists, P.C. x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Mercy Medical Center x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center MercyCare Vernon Village x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Norma Schmoker Women's Center x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Oncology Associates x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Physicians' Clinic of Iowa, P.C. - Urology x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Physicians' Clinic of Iowa, P.C. -Hematology/Oncology x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Physicians' Clinic of Iowa, P.C.-Neurology x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Physicians' Clinic of Iowa, P.C.-Orthopaedics x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Physicians' Clinic of Iowa, P.C.-Otolaryngology x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Physicians' Clinic of Iowa, P.C.-Surgical Specialists x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Radiology Consultants of Iowa, PLC x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Regional Family Health -Manchester x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Sigma Eyehealth Centers x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center St. Luke's Behavioral Health x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center St. Luke's Family Health Center x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center St. Luke's Respiratory & Critical Care x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center St. Luke's Work Well Clinic x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Trinity Muscatine x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint at Home Hospice x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint Clinic-Cardiology-Cedar Rapids x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint Clinic-CAT Clinic -Cedar Rapids x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint Clinic-Diabetes & Kidney Center x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint Clinic-Family Medicine- Anamosa (RHC) x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint Clinic-Family Medicine-Belle Plaine x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint Clinic-Family Medicine-Medical District x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint Clinic-Family Medicine-Monticello x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint Clinic-Hospitalists-Cedar Rapids x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint Clinic-Internal Medicine-Urgent Care-Hiawatha x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint Clinic-Multi Specialty-Cedar Rapids x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint Clinic-Pediatric Cardiology x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint Health - St. Luke's Palliative Care x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center UnityPoint Hospice - St. Luke's Hospital x UnityPoint Health Anamosa - St. Luke's/Jones Regional Medical Center Xygent, Inc. x UnityPoint Health Peoria - Methodist Medical Center of Illinois A.C.P.M. Podiatry Group, Ltd x UnityPoint Health Peoria - Methodist Medical Center of Illinois Advanced Behavioral Health x UnityPoint Health Peoria - Methodist Medical Center of Illinois Advanced Pain Management Institute x UnityPoint Health Peoria - Methodist Medical Center of Illinois Affiliated Urology Specialist x UnityPoint Health Peoria - Methodist Medical Center of Illinois Affinity Womens Health Care x UnityPoint Health Peoria - Methodist Medical Center of Illinois Affinity Women's Health Care, S.C x UnityPoint Health Peoria - Methodist Medical Center of Illinois Allen Memorial Hospital - NICU x UnityPoint Health Peoria - Methodist Medical Center of Illinois Allergy & Asthma Of Illinois, SC x UnityPoint Health Peoria - Methodist Medical Center of Illinois Associates In Mental Health x UnityPoint Health Peoria - Methodist Medical Center of Illinois Associates of Sterling Podiatry x UnityPoint Health Peoria - Methodist Medical Center of Illinois Bleeding & Clotting Disorders Institute x UnityPoint Health Peoria - Methodist Medical Center of Illinois Bochantin OB/GYN Services x UnityPoint Health Peoria - Methodist Medical Center of Illinois Bond Eye Associates x UnityPoint Health Peoria - Methodist Medical Center of Illinois Boyd Obstetrics Gynecology x UnityPoint Health Peoria - Methodist Medical Center of Illinois Bruce E. Jones, M.D. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Cancer Care Associates x UnityPoint Health Peoria - Methodist Medical Center of Illinois Cardiac Consultants SC x UnityPoint Health Peoria - Methodist Medical Center of Illinois Cardiac Thoracic & Endovascular Therapies, SC x UnityPoint Health Peoria - Methodist Medical Center of Illinois Cardinal Medical Group x UnityPoint Health Peoria - Methodist Medical Center of Illinois Cardiovascular Medicine, P.C. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Central Illinois Onc Phys Ltd x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Peoria - Methodist Medical Center of Illinois Central Illinois Dermatology x UnityPoint Health Peoria - Methodist Medical Center of Illinois Central Illinois Dermatology, S.C. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Central Illinois Diabetes & Metabolism Institute x UnityPoint Health Peoria - Methodist Medical Center of Illinois Central Illinois Pulmonary x UnityPoint Health Peoria - Methodist Medical Center of Illinois Central Illinois Radiological Associate x UnityPoint Health Peoria - Methodist Medical Center of Illinois Children's Hospital of Illinois Medical Group x UnityPoint Health Peoria - Methodist Medical Center of Illinois Children's Hospital of Illinois Medical Group x UnityPoint Health Peoria - Methodist Medical Center of Illinois Comp Emergency Solutions x UnityPoint Health Peoria - Methodist Medical Center of Illinois Couri Center for Gynecology & Integrative Health x UnityPoint Health Peoria - Methodist Medical Center of Illinois Couri Center for Gynecology and Integrative Women's Health x UnityPoint Health Peoria - Methodist Medical Center of Illinois Creve Coeur Family Practice x UnityPoint Health Peoria - Methodist Medical Center of Illinois Daniel Couri, MD x UnityPoint Health Peoria - Methodist Medical Center of Illinois David Kindred Integrated Medicine x UnityPoint Health Peoria - Methodist Medical Center of Illinois Drs. Shay & Associates, Ltd. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Eagle Family Medicine x UnityPoint Health Peoria - Methodist Medical Center of Illinois Edward Luan MD, SC x UnityPoint Health Peoria - Methodist Medical Center of Illinois Elmwood Farmingtn Med Ctr x UnityPoint Health Peoria - Methodist Medical Center of Illinois Emergency Physician Staffing Solution x UnityPoint Health Peoria - Methodist Medical Center of Illinois Facial Cosmetic Reconstr x UnityPoint Health Peoria - Methodist Medical Center of Illinois Facial Plastic & Laser Surgery x UnityPoint Health Peoria - Methodist Medical Center of Illinois Facial Plastic and Laser Surgery, LLC x UnityPoint Health Peoria - Methodist Medical Center of Illinois Glen Avenue Family Practice x UnityPoint Health Peoria - Methodist Medical Center of Illinois Glen J. Sidler, M.D. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Graham Medical Group x UnityPoint Health Peoria - Methodist Medical Center of Illinois Graham Medical Group @ Canton x UnityPoint Health Peoria - Methodist Medical Center of Illinois Great Plains Orthopaedic x UnityPoint Health Peoria - Methodist Medical Center of Illinois Greater Peoria OB/GYN Corp., S.C. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Harrington Obstetrics & Gynecology x UnityPoint Health Peoria - Methodist Medical Center of Illinois Heartcare Midwest x UnityPoint Health Peoria - Methodist Medical Center of Illinois Heartland Community Clinic x UnityPoint Health Peoria - Methodist Medical Center of Illinois Heartland Community Health Clinic-Carver Clinic x UnityPoint Health Peoria - Methodist Medical Center of Illinois Heyde Eye Center Sc x UnityPoint Health Peoria - Methodist Medical Center of Illinois Human Service Center x UnityPoint Health Peoria - Methodist Medical Center of Illinois Il Neurological Institute x UnityPoint Health Peoria - Methodist Medical Center of Illinois Illini Family Medicine x UnityPoint Health Peoria - Methodist Medical Center of Illinois Illinois Cancercare x UnityPoint Health Peoria - Methodist Medical Center of Illinois Illinois CancerCare, P.C. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Illinois Cardiac Surgery Associates, S.C. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Illinois Eye Center x UnityPoint Health Peoria - Methodist Medical Center of Illinois Illinois Eye Center SC x UnityPoint Health Peoria - Methodist Medical Center of Illinois Illinois Gastroenterology Institute x UnityPoint Health Peoria - Methodist Medical Center of Illinois Illinois Lung & Critical Care Institute x UnityPoint Health Peoria - Methodist Medical Center of Illinois Illinois Neurological Institute-Physicians, LLC x UnityPoint Health Peoria - Methodist Medical Center of Illinois Illinois Plastic Surgery x UnityPoint Health Peoria - Methodist Medical Center of Illinois Illinois Retina Institute x UnityPoint Health Peoria - Methodist Medical Center of Illinois Illinois Valley Podiatry Group x UnityPoint Health Peoria - Methodist Medical Center of Illinois Institute of Physical Medicine and Rehabilitation x UnityPoint Health Peoria - Methodist Medical Center of Illinois Intensivists Icu Team x UnityPoint Health Peoria - Methodist Medical Center of Illinois Jack Gibson, MD x UnityPoint Health Peoria - Methodist Medical Center of Illinois James L. Swingler M.D. Gynecology and Obstetrics x UnityPoint Health Peoria - Methodist Medical Center of Illinois Jody L. Kelly, M.D. & Associates x UnityPoint Health Peoria - Methodist Medical Center of Illinois John J. Ayres, M.D. x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Peoria - Methodist Medical Center of Illinois Junction Medical, SC x UnityPoint Health Peoria - Methodist Medical Center of Illinois Justin Ahlman, MD x UnityPoint Health Peoria - Methodist Medical Center of Illinois Kidney Health Care, Inc. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Kindred, LLC x UnityPoint Health Peoria - Methodist Medical Center of Illinois Knight Medical and Rehab Center, LTD x UnityPoint Health Peoria - Methodist Medical Center of Illinois Koch Family Medicine Sc x UnityPoint Health Peoria - Methodist Medical Center of Illinois Lee Obstetrics & Gynecology, S.C. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Lynne M. Jalovec M.D. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Marshall Internal Medicine, S.C. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Meth Spine Pain Center x UnityPoint Health Peoria - Methodist Medical Center of Illinois Methodist Anesthesiology x UnityPoint Health Peoria - Methodist Medical Center of Illinois Methodist Center for Senior Health x UnityPoint Health Peoria - Methodist Medical Center of Illinois Methodist Diabetes Care Center-Main ST-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois Methodist Medical Center Of Illinois-Perfusionists x UnityPoint Health Peoria - Methodist Medical Center of Illinois Methodist Medical Group at East Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois Methodist Medical Group at Washington x UnityPoint Health Peoria - Methodist Medical Center of Illinois Methodist Medical Group Neurology x UnityPoint Health Peoria - Methodist Medical Center of Illinois Methodist Wound Clinic x UnityPoint Health Peoria - Methodist Medical Center of Illinois Metro Infectious Disease x UnityPoint Health Peoria - Methodist Medical Center of Illinois Metro Infectious Disease Consultants x UnityPoint Health Peoria - Methodist Medical Center of Illinois Mid Illini Surgical Associates x UnityPoint Health Peoria - Methodist Medical Center of Illinois Midwest Ear Nose & Throat x UnityPoint Health Peoria - Methodist Medical Center of Illinois Midwest Ear Nose & Throat Associates x UnityPoint Health Peoria - Methodist Medical Center of Illinois Midwest Orthopaedic Center x UnityPoint Health Peoria - Methodist Medical Center of Illinois Midwest Podiatry Group x UnityPoint Health Peoria - Methodist Medical Center of Illinois Midwest Podiatry Group, S.C. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Midwest Urological Group x UnityPoint Health Peoria - Methodist Medical Center of Illinois Millennium Pain Center x UnityPoint Health Peoria - Methodist Medical Center of Illinois Morton Dental Center x UnityPoint Health Peoria - Methodist Medical Center of Illinois Morton Internal Medicine x UnityPoint Health Peoria - Methodist Medical Center of Illinois Neonatology Associates x UnityPoint Health Peoria - Methodist Medical Center of Illinois NightHawk Radiology Services x UnityPoint Health Peoria - Methodist Medical Center of Illinois Onsite Neonatal Partners, Inc. x UnityPoint Health Peoria - Methodist Medical Center of Illinois OSF - Center for Health Pediatrics x UnityPoint Health Peoria - Methodist Medical Center of Illinois OSF Department of Neonatology x UnityPoint Health Peoria - Methodist Medical Center of Illinois OSF Family Practice x UnityPoint Health Peoria - Methodist Medical Center of Illinois OSF Medical Group x UnityPoint Health Peoria - Methodist Medical Center of Illinois OSF Medical Group - Knoxville Ave Peds x UnityPoint Health Peoria - Methodist Medical Center of Illinois OSF Medical Group Psych x UnityPoint Health Peoria - Methodist Medical Center of Illinois Osf Medical Group-Glen Park Peds/Im x UnityPoint Health Peoria - Methodist Medical Center of Illinois Osf Medical Group-Morton x UnityPoint Health Peoria - Methodist Medical Center of Illinois OSF Medical Group-Washington x UnityPoint Health Peoria - Methodist Medical Center of Illinois OSF Perinatal Associates, LLC x UnityPoint Health Peoria - Methodist Medical Center of Illinois OSF Rheumatology x UnityPoint Health Peoria - Methodist Medical Center of Illinois Pediatric Allergy & Pulmonology x UnityPoint Health Peoria - Methodist Medical Center of Illinois Pediatric Cardiology x UnityPoint Health Peoria - Methodist Medical Center of Illinois Pekin Pulmonary Clinic x UnityPoint Health Peoria - Methodist Medical Center of Illinois Peoria Ear Nose & Throat Group x UnityPoint Health Peoria - Methodist Medical Center of Illinois Peoria Ear Nose Throat x UnityPoint Health Peoria - Methodist Medical Center of Illinois Peoria Hand Surgery, LCC x UnityPoint Health Peoria - Methodist Medical Center of Illinois Peoria Podiatry Group, P.C. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Peoria Surgical Group, Ltd. x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Peoria - Methodist Medical Center of Illinois Peoria Tazewell Pathology x UnityPoint Health Peoria - Methodist Medical Center of Illinois Peoria Tazewell Pathology Group x UnityPoint Health Peoria - Methodist Medical Center of Illinois Peoria Womens Health x UnityPoint Health Peoria - Methodist Medical Center of Illinois Prairie Spine & Pain Institute x UnityPoint Health Peoria - Methodist Medical Center of Illinois Proctor First Care-Morton x UnityPoint Health Peoria - Methodist Medical Center of Illinois Proctor First Care-Peoria Heights x UnityPoint Health Peoria - Methodist Medical Center of Illinois Proctor Medical Group - Internal Medicine/Primary Care x UnityPoint Health Peoria - Methodist Medical Center of Illinois Proctor Medical Group - Associated Family Physicians x UnityPoint Health Peoria - Methodist Medical Center of Illinois Proctor Medical Group - Internal Medicine/Family Practice x UnityPoint Health Peoria - Methodist Medical Center of Illinois Proctor Medical Group Family Medicine x UnityPoint Health Peoria - Methodist Medical Center of Illinois Proctor Medical Group Internal Medicine x UnityPoint Health Peoria - Methodist Medical Center of Illinois Proctor Medical Group Internal Medicine/Primary Care x UnityPoint Health Peoria - Methodist Medical Center of Illinois Psychological Associates x UnityPoint Health Peoria - Methodist Medical Center of Illinois Psychology Specialists x UnityPoint Health Peoria - Methodist Medical Center of Illinois Psychology Specialists, Ltd x UnityPoint Health Peoria - Methodist Medical Center of Illinois RENAL CARE ASSOCIATES x UnityPoint Health Peoria - Methodist Medical Center of Illinois RenalCare Associates x UnityPoint Health Peoria - Methodist Medical Center of Illinois Reproduction Health and Fertility Center x UnityPoint Health Peoria - Methodist Medical Center of Illinois Retina Consultants of Central Illinois x UnityPoint Health Peoria - Methodist Medical Center of Illinois Ruskusky Foot and Ankle Clinic, Ltd. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Ryan D. Schmidgall, M.D., S.C. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Samaritan Family Medical Services, P.C. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Sher Institute for Reproductive Medicine x UnityPoint Health Peoria - Methodist Medical Center of Illinois Soderstrom Dermatology x UnityPoint Health Peoria - Methodist Medical Center of Illinois Specialists in Medical Imaging (SMI) x UnityPoint Health Peoria - Methodist Medical Center of Illinois Speech Language Rehab x UnityPoint Health Peoria - Methodist Medical Center of Illinois Stephen C. Thompson, M.D., SC x UnityPoint Health Peoria - Methodist Medical Center of Illinois Susan Cole, M.D. x UnityPoint Health Peoria - Methodist Medical Center of Illinois Swaminathan Dermatology Center x UnityPoint Health Peoria - Methodist Medical Center of Illinois Teverbaugh, Croland, Mueller OB/Gyn Associates, SC x UnityPoint Health Peoria - Methodist Medical Center of Illinois Trinity Medical Center Rock Island x UnityPoint Health Peoria - Methodist Medical Center of Illinois Trinity Medical Center-Bettendorf x UnityPoint Health Peoria - Methodist Medical Center of Illinois U of I Medical Service Plan x UnityPoint Health Peoria - Methodist Medical Center of Illinois U of I Medical Service Plan - Neonatology x UnityPoint Health Peoria - Methodist Medical Center of Illinois UICOMP x UnityPoint Health Peoria - Methodist Medical Center of Illinois Unity Point Clinic-MDVIP-Atrium x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic Wound Care & Hyperbaric Medicine at Methodist Atrium-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Cardiovascular Services at Methodist on Main x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Express Care at Knoxville-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine at Morton x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine- Canton x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine Main ST-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine- Metamora x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine-Chillicothe x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine-East Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine-Lacon x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine-Methodist North x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine-Pear Tree x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine-Pekin x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine-Prairie Pointe x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine-Princeville x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine-Sterling x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Family Medicine-Washington x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Hospitalist-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-In School Health-Valeska Hinton School x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Internal Medicine at Knoxville x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Internal Medicine at South Jefferson-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Internal Medicine-Dunlap x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Neurology-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Palliative Care-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Pediatric Gastroenterology-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Pediatric-Hospitalist x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Pediatrics-Methodist North x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Podiatry-Washington x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Psychiatry-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Pulmonology,Critical Care & Sleep Services at Methodist Atrium x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Rehabilitation Medicine at Methodist Atrium-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Rheumatology-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Clinic-Senior Health at Methodist Atrium-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois UnityPoint Health-Perinatology-Peoria x UnityPoint Health Peoria - Methodist Medical Center of Illinois Univ. of Illinois College Of Med Pediatrics x UnityPoint Health Peoria - Methodist Medical Center of Illinois University of Illinois College of Medicine at Peoria- Psychiatry & Behavioral Medicine x UnityPoint Health Peoria - Methodist Medical Center of Illinois Virtual Radiologic Professionals, LLC (vRad) x UnityPoint Health Peoria - Methodist Medical Center of Illinois Western Illinois Cancer Treatment Center x UnityPoint Health Peoria - Methodist Medical Center of Illinois Women's Health Institute, Ltd. x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Akron Mercy Medical Clinic x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Alegent Health, Bergan Mercy Medical Center x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Allen Memorial Hospital - ER DEPT x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Anesthesia Consultants, P.C. x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Associates for Psychiatric Services x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Biotronic Neuro Network x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Boys Town National Research Hospital x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Bruening Eye Specialists x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Cardiovascular Associates, P.C. x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Cardiovascular Associates, PC x UnityPoint Health Sioux City - St. Luke's Regional Medical Center CNOS, P.C. x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Dean & Associates x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Dermatology Associates of Siouxland, PC x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Digestive & Liver Disorders x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Dona W. Prince, DDS x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Dunes Dental 4 Kids x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Ear, Nose and Throat Consultants, PLC x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Family Health Care of Siouxland - Morningside x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Family Health Care of Siouxland - Dunes x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Family Health Care of Siouxland - Indian Hills x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Family Health Care of Siouxland - Northside x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Family Health Care of Siouxland-South Sioux City x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Foot and Ankle Clinic x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Global Infectious Disease Services x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Hospice of Siouxland x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Iowa Radiology West x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Iowa Statewide Poison Center x UnityPoint Health Sioux City - St. Luke's Regional Medical Center James Hartje, MD x UnityPoint Health Sioux City - St. Luke's Regional Medical Center James W. Roat, M.D., P.C. x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Sioux City - St. Luke's Regional Medical Center Jones Eye Clinic x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Marengo Memorial Hospital x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Medical Imaging Physicians, P.L.C. x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Mercy Cardiothoracic & Vascular Surgery x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Mercy Infectious Disease x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Mercy Internal Medicine & Pediatric Clinic x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Mercy Singing Hills Family Medicine x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Midlands Clinic, P.C. x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Neural Watch - Biotronics x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Oral Surgery Associates PC x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Pathology Medical Services of Siouxland, P.C. x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Plastic Surgery Associates of South Dakota x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Prairie Pediatrics & Adolescent Clinic, P.C. x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Renal Associates, P.C. x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Richard K. Bokemper, DDS, PC x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Russell DeGroote MD, PC x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Sioux City Allergy & Asthma Associates x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland Adult Medicine x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland Community Health Center (FQHC) x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland Dental Health Associates PC x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland Gastroenterology x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland Hospital Medicine x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland Hospitalists, PLLC x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland Medical Education Foundation x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland Mental Health x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland OB/GYN, P.C. x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland PACE x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland Palliative Care x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland Podiatry Associates x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland Regional Cancer Center x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland Urology Associates x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Siouxland Women's Healthcare, P.C. x UnityPoint Health Sioux City - St. Luke's Regional Medical Center South Sioux Mercy Medical Clinic x UnityPoint Health Sioux City - St. Luke's Regional Medical Center St. Luke's Neonatology x UnityPoint Health Sioux City - St. Luke's Regional Medical Center St. Luke's Occupational Health Services x UnityPoint Health Sioux City - St. Luke's Regional Medical Center St. Luke's Regional Medical Center-Phys x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Trinity Muscatine x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Trinity Regional Medical Center x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Trinity Regional Medical Center-Hospitalists x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Tri-State Specialists, LLP x UnityPoint Health Sioux City - St. Luke's Regional Medical Center UnityPoint Clinic-Cardiology-Methodist Plaza x UnityPoint Health Sioux City - St. Luke's Regional Medical Center UnityPoint Clinic-Family & Internal Medicine-Sunnybrook x UnityPoint Health Sioux City - St. Luke's Regional Medical Center UnityPoint Clinic-Family Medicine-Buena Vista x UnityPoint Health Sioux City - St. Luke's Regional Medical Center UnityPoint Clinic-Family Medicine-Internal Medicine-Sunnybrook x UnityPoint Health Sioux City - St. Luke's Regional Medical Center UnityPoint Clinic-Family Medicine-Sergeant Bluff x UnityPoint Health Sioux City - St. Luke's Regional Medical Center UnityPoint Clinic-Foot and Ankle-Sunnybrook x UnityPoint Health Sioux City - St. Luke's Regional Medical Center UnityPoint Clinic-General Surgery-Pierce St Physician Center x UnityPoint Health Sioux City - St. Luke's Regional Medical Center UnityPoint Clinic-Maternal Fetal Medicine-Pierce ST. Physician Center x UnityPoint Health Sioux City - St. Luke's Regional Medical Center UnityPoint Clinic-Physical Medicine & Rehab x UnityPoint Health Sioux City - St. Luke's Regional Medical Center UnityPoint Clinic-Pulmonology-Critical Care-Pierce St Physician Center x UnityPoint Health Sioux City - St. Luke's Regional Medical Center UnityPoint Health – St. Luke’s x UnityPoint Health Sioux City - St. Luke's Regional Medical Center Wadzinski Eye Clinic x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Sioux City - St. Luke's Regional Medical Center Wagner Ear, Nose & Throat x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Abbe Center for CMH x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Aesthetic Consultants of Iowa x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Affiliates of Family Practice x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Ahn Clinic x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Allen Memorial Hospital - ER DEPT x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Allen Memorial Hospital - NICU x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Allergy & Asthma Clinic x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Allergy Partners of Cedar Rapids x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Amana Family Practice Clinic, P.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Arlyn K. Robinson, DDS x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Aspen Dental x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Associates for Behavioral Healthcare x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Balster Pediatric Dentistry x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Biotronic Neuro Network x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Blank Children's Pediatric Neonatology x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Blank Children's Pediatric Neurology Clinic x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Cedar Centre Psychiatric Group x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Cedar Rapids Area Dentistry x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Cedar Rapids Dermatology x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Cedar Rapids Medical Education Foundation x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Cedar Rapids Neurologists, P.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Cedar Rapids OB GYN Specialists, P.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Cedar Rapids Oral Surgery, P.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Cedar Rapids Pediatric Dentistry PC x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Cedar Valley Hand Surgery x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Cedar Valley Medical Specialists, P.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Cedar Valley Pathologists-St. Luke's Hospital x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Corridor Christen Counseling Center, LLC x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Curtis Livengood, D.D.S. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Curtis Livengood, DDS x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Daniel E. McGrail, M.D. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Darin W. Smith, M.D., PLC x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital David S. Tearse, M.D., LLC x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Dermatology Clinic of Iowa, P.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital East Central Iowa Acute Care, LLP x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Eastern IA Physical Medicine & Rehab PC x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Eastern Iowa Anesthesia, PC x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Eastern Iowa Brain & Spine Surgery, PLLC x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Eastern Iowa Foot Specialist, PC x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Eastern Iowa Health Center (FQHC) x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital ED 10-1-11 to 10-31-11 and 2-12 to 3-1-12 x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Family Counseling Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Family Foot Care Center, P.L.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Family Medicine Specialists, P.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Family Physicians of Cedar Rapids x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Family Psychology Associates x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Finley Heart and Vascular Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Foot & Ankle Specialists of Iowa x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Forefront Dermatology x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Fox Eye Laser & Cosmetic Institute x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Gastroenterologists, P.C. x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Ghosh Center for Oncology & Hematology x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Guthrie County Hospital x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Hall Radiation Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Hawkeye Anesthesia x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Helen G. Nassif Community Cancer Center of Iowa x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Internist Associates of Iowa x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Internist Associates of Iowa #988 x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Intranerve x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Iowa Eye Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Iowa Foot & Ankle Clinic x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Iowa Health Emergency Physicians x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Iowa Retina Consultants, Inc. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital John VanderZee, M.D., P.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital John Wollner M.D. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Jones Regional Medical Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital LCA, P.L.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Linn County Anesthesiologists, P.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Linn County Anesthesiologists, P.C. - Pain Clinic x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Marengo Memorial Hospital x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Marion Foot & Ankle Specialists x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mary Nelson, MD, PC x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital McCray Oral Surgery x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Medical Associates Clinic PC x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Cardiology Clinic x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Care Blairs Ferry x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Care Center Point x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Care Community Physicians x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Care Johnson Avenue x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Care Marion x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Care Second Avenue x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Care Vernon Village x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Care--Marc Wilkinson x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Diabetes Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Employee Health Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Family Counseling x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Medical Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Pediatric Clinic x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercy Pulmonology Clinic x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital MercyCare Community Physicians x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mercycare Edgewood x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital MercyCare Marion x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital MercyCare Vernon Village x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Metropolitan Family Med & Chiropractic x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mississippi Valley Regional Blood Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Mississippi Valley Regional Blood Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Morgan & Morio Oral & Maxillofacial Surgery x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Norma Schmoker Women's Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital OB/GYN Associates, P.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Oncology Associates x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Onsite Neonatal Partners, Inc. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Ottumwa Walk-In Clinic x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Partners in Medicine, P.C. x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Pediatric Center, P.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Physical Medicine & Rehab Assoc./NE Iowa x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Physicians' Clinic of Iowa, P.C. - Urology x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Physicians' Clinic of Iowa, P.C. -Hematology/Oncology x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Physicians' Clinic of Iowa, P.C.-Neurology x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Physicians' Clinic of Iowa, P.C.-Orthopaedics x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Physicians' Clinic of Iowa, P.C.-Otolaryngology x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Physicians' Clinic of Iowa, P.C.-Surgical Specialists x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Physicians' Clinic of Iowa, P.C.-Urology x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Physicians' Clinic of Iowa, PC-Podiatry x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Physicians' Clinic of Iowa, PC-Rheumatology x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Podiatry Associates, P.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Progressive Rehabilitation Medicine, PLC x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Pruchno Medicine x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Radiation Oncology of Iowa, P.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Radiation Specialists of Eastern Iowa x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Radiology Consultants of Iowa, PLC x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Richard Louvar, MD x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Richard Pope, MD x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Robert Barry, MD x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Robin G. Brown, M.D. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Spring Park Oral & Maxillofacial Surgery Assoc. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Behavioral Health x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Child Protection Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Dental Health Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Dental Health Ctr x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Division of Neonatal Medicine x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Family Health Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Hospial Inpatient Diabetes Care, Nursing Service x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Hospital x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Hospital Dental Health Ctr x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Living Center East x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Pediatric Hospitalists x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Physical Med/Rehab/Neuropsych x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Respiratory & Critical Care x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Witwer Children's Therapy Ctr x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital St. Luke's Work Well Clinic x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Stanley Mathew, M.D., P.L.C. x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Trinity Medical Center Moline-Neonatal Medicine x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Trinity Medical Center Rock Island x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Trinity Medical Center-Bettendorf x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Trinity Medical Center-Moline x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Trinity Muscatine x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint at Home Hospice x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Behavioral Health-Cedar Rapids x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Cardiology-Cedar Rapids x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-CAT Clinic -Cedar Rapids x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Center for Liver Disease x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Diabetes & Kidney Center x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Family Medicine- Anamosa (RHC) x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Family Medicine-Bowman Woods x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Family Medicine-Corridor x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Family Medicine-Medical District x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Family Medicine-Monticello x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Family Medicine-Mount Vernon x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Family Medicine-Northridge x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Family Medicine-Urgent Care-Marion Campus x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Family Medicine-Westside x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Hospitalists-Cedar Rapids x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Internal Medicine-Urgent Care-Hiawatha x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Multi Specialty-Cedar Rapids x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Multi Specialty-Cedar Rapids(STL) x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Multispecialty-Davenport x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Neurosurgery-Cedar Rapids x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Pediatric Cardiology x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Pediatric Hospitalist-Cedar Rapids x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Pediatrics-Bettendorf x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Pediatrics-Cedar Rapids x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Pediatrics-Hiawatha Campus x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Clinic-Urgent Care United Medical Park x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Health - St. Luke's Palliative Care x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital UnityPoint Hospice - St. Luke's Hospital x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Vinton Family Medical Clinic x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Weland Clinical Laboratories x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Wendy Buresh, MD x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Wolfe Eye Clinic - Iowa City x UnityPoint Health Cedar Rapids - St. Luke's Methodist Hospital Wolfe Eye Clinic, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Advanced Radiology, S.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Allen Memorial Hospital - NICU x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Allergy & Asthma Associates of the Mississippi Valley PLLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf American Neuromonitoring Associates, PC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Andrew Abatiell MD - Western IL Anesthesiology, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Anesthesia and Pain Consultants x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Archana G., Wagle, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Area Wide Foot and Ankle Center x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Aric J Eckhardt MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Asif J Ahmed MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Atwell General Surgery x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Bettendorf Pediatric & Family Practice x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Brent S. Ohl, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Cardiac Surgery Associates, S.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Cardiac Surgery Associates, SC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Cardiovascular Medicine, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Caring Dermatology Center, PC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Centers for Headaches, Sleep, & TMJ Disorders x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Children's Hospital of Illinois Medical Group x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Clinton Occupational Health x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Davenport Eye Group x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Davenport Surgical Group x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf David Easker MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Diamond Medical Spa & Vein x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Digestive Disease Specialists x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Donald A. Normoyle, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Eastern Iowa Dermatology x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Eastern Iowa Gastroenterology, P.L.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Endocrine Associates of the Quad Cities x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf ENT Professional Services x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Eugene Collins, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Finley Hospital x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Finley Outpatient Care Unit x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Gastroenterology Associates x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Gastroenterology Consultants, SC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Gastrointestinal Clinic of Quad Cities x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf General Surgery Associates, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Genesis Health Group x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Gordon Johnson, D.O. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Great River Medical Group x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Gregory S. Duncan, D.P.M. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Hammond Henry Colona Clinic x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Hari Babu, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Healogics Specialty Physicians of Illinois, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Heartland Clinic, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Hematology & Oncology Care x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Hematology-Oncology Associates of the QC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Infinity Medical Group x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Interventions in Pain Management, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Iowa Foot & Ankle Specialist, PLLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Iowa Illinois Pain Consultants, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Iowa Plastic Surgery x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Iowa Radiology West x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Ivan Kukhar, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Jacob Shields MD - Western IL Anesthesiology, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Jeffrey F. Fullenkamp, D.O. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Jeffrey Senasu MD - Western IL Anesthesiology, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Joanne A. Michaelson, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf John C. Hendricks, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf John Deere Medical Group x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Kidney Care Quad Cities x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Laparoscopic Surgical Specialties-Dr. William Olson x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Maruti R. Kari, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Mary Francis Nuguid, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf McCray Oral Surgery x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Medical Arts Associates, Ltd. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Medical Associates x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Metro Infectious Disease Consultants x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Mississippi Valley Regional Blood Center x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Narayanswamy V. Rama Prabhu, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Obuah Osaro, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Onsite Neonatal Partners, Inc. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf ORA Orthopedics, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Orthopaedic Specialists, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Pacific Neuromonitoring Associates, PC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Pamela F. Davis, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Pediatric Cardiology x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Physicians' Clinic of Iowa, P.C.-Surgical Specialists x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Plastic Surgery Associates, LLP x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Plastic Surgery Center, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Prasan Chariya, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Pulmonary Associates x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Purighalla Neuroscience and Spine Institute x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf QC Medical Group & Weight Loss Clinic x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Quad Cities Kidney Center x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Quad Cities Nephrology Associates, PLC, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Quad Cities Pathologists x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Quad Cities Pediatrics, PC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Quad Cities Retina Consultants x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Quad City Family Physicians, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Quad City Foot & Ankle Associates x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Quad City Occupational Health, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Quad City Pulmonary Consultants, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Quality Surgery Center x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Quint Cities Radiation Oncology x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Radiation Therapy Center of The Quad Cities x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Rammohan Marla, PC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Renee D. Lass, D.O. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Rheumatology Associates,PC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Robert Milas, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Robert Young Center x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Sammy Marogil, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Sanguan Sapthavee, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Shah Medical Consulting, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Spring Park Oral & Maxillofacial Surgery Assoc. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf St. Luke's Division of Neonatal Medicine x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf State Street Women's Health Center x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Steven M. Freed, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Stewart C Garneau, MDSC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Suhas Kalghatgi, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Tarikere Kumar MD - Western IL Anesthesiology, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Thomas Ade, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Trinity Center for Wound Care & Hyperbaric Medicine x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Trinity Family Practice Clinic x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Trinity Medical Center Moline-Neonatal Medicine x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Trinity Medical Center Rock Island x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Trinity Medical Center Rock Island- ER Department x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Trinity Medical Center Rock Island-Palliative Care x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Trinity Medical Center-Bettendorf x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Trinity Medical Center-Moline x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Trinity Muscatine x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Trinity Muscatine Physician Clinics x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Trinity Rock Island - Hospitalist Program x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf True Lifestyle Medicine Clinic, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Cardiovascular Services at Methodist on Main x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-ENT-North Port x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Express Care-Bettendorf x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Express Care-John Deere Road x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Express Care-Moline x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Family Medicine-53rd ST x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Family Medicine-Bettendorf x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Family Medicine-Spring Street x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Internal Medicine-Bettendorf x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Multispecialty-Davenport x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Multi-Specialty-Rock Island x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-OB/GYN-Bettendorf x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-OB/GYN-Utica Ridge Road x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Pediatrics-Bettendorf x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Pediatrics-Moline x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Surgery-Bettendorf x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf UnityPoint Clinic-Surgery-Moline x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf University of Iowa Hospitals & Clinics x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf University of Iowa Hospitals & Clinics x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf University of Iowa Women's Health Clinic, Quad Cities x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Urological Associates, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Vascular and Thoracic Associates, Ltd. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Victor Barney, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Virdi Eye Clinic, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Virtual Radiologic Professionals, LLC (vRad) x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf Waterford Family Medicine x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center – Bettendorf William Colantoni, Jr., MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Advanced CardioVascular Consultants, S.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Advanced Radiology, S.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Allen Memorial Hospital - NICU x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline American Neuromonitoring Associates, PC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Andrew Abatiell MD - Western IL Anesthesiology, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Anis Ahmad, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Archana G., Wagle, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Aric J Eckhardt MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Arthritis Care Center PC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Asif J Ahmed MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Atwell General Surgery x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Benjamin Z. Shnurman, D.O. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Blank Children's Pediatric & Adolescent Psychiatry Clinic x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Bleeding & Clotting Disorders Institute x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Brent S. Ohl, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Brian D. Buckrop, D.P.M. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Bruce E. Jones, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Cardiac Surgery Associates, S.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Cardiac Surgery Associates, SC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Cardiovascular Medicine, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Caring Dermatology Center, PC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Cedar Valley Podiatry x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Cervetti & Associates x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Children's Hospital of Illinois Medical Group x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Children's Hospital of Illinois Medical Group x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Clinton Occupational Health x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Community Health Care, Inc. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Comprehensive Bleeding Disorder Center x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Contemporary Obstetrics and Gynecology Women’s Care Cetner, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline David Ade, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline David Easker MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline David S. Petersen, M.D. x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Digestive Disease Specialists x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Dodson Foot Clinic x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Donald A. Normoyle, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Eileen M. Wayne, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Elizabeth Temple, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Emergency Phys Mgmt Grp x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Endocrine Associates of the Quad Cities x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Eugene Collins, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Eye Surgeons Associates, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Finley Hospital x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Franklin Pediatrics, S.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Gastroenterology Associates x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Gastroenterology Consultants, SC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Gastrointestinal Clinic of Quad Cities x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Generations Women's Health x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Genesis Health Group x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Genesis HealthPlex x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Graham Medical Group @ Canton x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Hammond Henry Colona Clinic x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Hari Babu, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Healogics Specialty Physicians of Illinois, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Heartland Clinic, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Hematology & Oncology Care x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Hematology-Oncology Associates of the QC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Hybrid Medical Group & Urgent Care x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Infinity Medical Group x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Interventions in Pain Management, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Iowa Foot & Ankle Specialist, PLLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Iowa Plastic Surgery x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Iowa Radiology West x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Ivan Kukhar, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Jacob Shields MD - Western IL Anesthesiology, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Jeffrey F. Fullenkamp, D.O. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Jeffrey Senasu MD - Western IL Anesthesiology, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Joanne A. Michaelson, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline John C. Hendricks, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline John Deere Harvester Clinic x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline John Deere Medical Group x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Kevin D. Smith, DPM x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Kidney Care Quad Cities x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Laparoscopic Surgical Specialties-Dr. William Olson x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Maruti R. Kari, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Mary Francis Nuguid, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline McCaw Medical Clinic x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Medical Arts Associates, Ltd. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Medical Associates x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Medical Psychiatry Services, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Metro Infectious Disease Consultants x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Mississippi Valley Regional Blood Center x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Munawar Hussain, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Narayanswamy V. Rama Prabhu, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Navinchandra Dadhaniya, M.D. x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Neurology Associates x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline OB Hospitalist Group x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Onsite Neonatal Partners, Inc. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline ORA Orthopedics, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Orthopaedic Specialists, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline OSF Medical Group - Neurology x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline OSF St Francis Medical Center-INI Diagnostic Center x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Otolaryngology Head & Neck Surgery x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Pacific Neuromonitoring Associates, PC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Pediatric Cardiology x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Pediatric Group Associates, SC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Plastic Surgery Associates, LLP x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Plastic Surgery Center, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Prasan Chariya, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Preferred Emergency Physicians of Illinois, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Pulmonary Associates x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Purighalla Neuroscience and Spine Institute x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline QC Medical Group & Weight Loss Clinic x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Quad Cities Kidney Center x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Quad Cities Nephrology Associates, PLC, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Quad Cities Pathologists x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Quad City Foot & Ankle Associates x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Quad City Mental Health x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Quad City Occupational Health, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Quint Cities Radiation Oncology x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Radiation Therapy Center of The Quad Cities x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Rajput Medical Clinic, LTD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Rammohan Marla, PC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Reynaldo Castro, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Ricaurte & Associates x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline River Valley Family Practice, Ltd. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline River Valley Oral & Maxillofacial Surgery x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Robert Milas, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Robert Young Center x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Robert Young Center-Muscatine x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Robert Young Center-Trinity x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Rock Valley Obstetrics & Gynecology, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Ronald B. Fiscella, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Sammy Marogil, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Sanguan Sapthavee, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline SouthPark Psychology x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline St. Luke's Division of Neonatal Medicine x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Steven M. Freed, M.D. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Stewart C Garneau, MDSC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Stone Ridge Medical Group, S.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Suhas Kalghatgi, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Sujatha Govindaiah, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Surg Thor-Card x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Tarikere Kumar MD - Western IL Anesthesiology, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline The Center for Neurosciences, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Thomas Ade, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Trinity Center for Wound Care & Hyperbaric Medicine x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Trinity Center for Wound Care and Hyperbaric Medicine x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Trinity Medical Center x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Trinity Medical Center Moline-Neonatal Medicine x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Trinity Medical Center Rock Island x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Trinity Medical Center Rock Island- ER Department x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Trinity Medical Center Rock Island-Palliative Care x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Trinity Medical Center-Bettendorf x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Trinity Medical Center-Moline x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Trinity Muscatine x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Trinity Rock Island - Hospitalist Program x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Two Rivers Pediatric Dentistry x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline U of I Medical Service Plan x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Cardiovascular Services at Methodist on Main x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-ENT-Moline x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Express Care-Bettendorf x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Express Care-John Deere Road x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Express Care-Moline x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Family Medicine-Coal Valley x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Family Medicine-Geneseo x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Family Medicine-John Deere Road x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Family Medicine-Moline x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Family Medicine-Spring Street x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Internal Medicine-Bettendorf x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Internal Medicine-Moline x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Multispecialty-Davenport x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Multi-Specialty-Rock Island x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-OB/GYN-Rock Valley x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Pediatrics-Bettendorf x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Pediatrics-Moline x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Surgery-Bettendorf x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Surgery-Moline x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline UnityPoint Clinic-Surgery-Rock Island x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline University of Iowa Hospitals & Clinics x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline University of Iowa Hospitals & Clinics x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Urological Associates, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Urological Group, Ltd. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Vascular & Thoracic Associates, Ltd. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Vascular and Thoracic Associates, Ltd. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Victor Barney, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Virdi Eye Clinic, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Virtual Radiologic Professionals, LLC (vRad) x UnityPoint Health Quad Cities/Muscatine - Trinity Medical Center - Rock Island/Moline Weerapan Kuyakanon, MD x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Advanced Radiology, S.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Allen Memorial Hospital - ER DEPT x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Artic Dental, PLC x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Atwell General Surgery x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Cardiovascular Medicine, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Community Memorial Hospital x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine CompHealth Locum Tenens x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Davenport Foot & Ankle Clinic x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Eye Surgeons Associates, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Family Eye and Contact Lens Center x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Finley Hospital x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Four Seasons Counseling Clinic x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Genesis Health Group x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Gingerich Anesthesis x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Integrated Rehabilitation Center x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Iowa Anesthesia x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Iowa Health Emergency Physicians x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Laparoscopic Surgical Specialties-Dr. William Olson x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Marengo Memorial Hospital x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Mercy Specialty Clinics, Pulmonary Medicine x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Mercy Specialty Clinics, Urology x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Neurological Assoc. of Iowa City, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine ORA Orthopedics, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine PPO docs x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Purighalla Neuroscience and Spine Institute x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Quad Cities Kidney Center x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Quad Cities Pathologists x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Rammohan Marla, PC x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine River Rehabilitation Physical Therapy x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Robert Young Center x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Robert Young Center-Trinity x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Shah Medical Consulting, LLC x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine St. Luke's Regional Medical Center-Phys x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Trinity Center for Wound Care & Hyperbaric Medicine x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Trinity Medical Center Muscatine x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Trinity Medical Center Rock Island x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Trinity Medical Center Rock Island- ER Department x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Trinity Medical Center-Bettendorf x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Trinity Muscatine x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Trinity Muscatine Physician Clinics x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Trinity Muscatine Public Health x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Trinity Regional Medical Center x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Trinity Rock Island - Hospitalist Program x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Clinic-ENT-North Port x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Clinic-Express Care-North Port x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Clinic-Family Medicine-Mulberry x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Clinic-Family Medicine-North Port x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Clinic-Family Medicine-Wilton x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Clinic-Internal Medicine-Mulberry x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Clinic-Internal Medicine-Waterloo x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Clinic-OB/GYN and Imaging-Penn Avenue x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Clinic-OB/GYN-Mulberry x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Clinic-Orthopedics-North Port x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Clinic-Pediatrics-Mulberry x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Clinic-Surgery-Moline x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine UnityPoint Clinic-Surgery-Mulberry x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine University of Iowa Hospitals & Clinics x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Virdi Eye Clinic, P.C. x UnityPoint Health Quad Cities/Muscatine - Trinity Muscatine Vision Center, PC x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Allen Memorial Hospital - ER DEPT x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Allen Memorial Hospital Occupational Health x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Associated Internists x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Fort Dodge - Trinity Regional Medical Center Cedar Valley Medical Specialists, P.C. x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Community Health Center x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Community Memorial Hospital x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Covenant Clinic Pulmonology x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Des Moines Anesthesiologists, P.C. x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Family Dermatology x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Finley Hospital x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Fort Dodge Oral & Maxillofacial Surgery, P.C. x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Grundy County Memorial Hospital x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Helen G. Nassif Community Cancer Center of Iowa x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Iowa ENT & Sinus Surgery Center x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Iowa Health Emergency Physicians x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Iowa Heart Center x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Iowa Otolaryngology x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Iowa Pathology Associates, P.C. x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Jeffrey S. Foreman, O.D. x UnityPoint Health Fort Dodge - Trinity Regional Medical Center John Stoddard Cancer Center-Radiation Oncology x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Locale Anesthesia x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Marengo Memorial Hospital x UnityPoint Health Fort Dodge - Trinity Regional Medical Center McFarland Clinic, P.C. x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Medical Oncology & Hematology Associates x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Norma Schmoker Women's Center x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Northwest Foot & Ankle x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Pediatric Cardiology, P.C. x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Psychiatry Lee & Associates x UnityPoint Health Fort Dodge - Trinity Regional Medical Center R. Y. Jacobson, O.D. x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Radiology Consultants of Iowa, PLC x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Siouxland Hospitalists, PLLC x UnityPoint Health Fort Dodge - Trinity Regional Medical Center St. Luke's Regional Medical Center-Phys x UnityPoint Health Fort Dodge - Trinity Regional Medical Center The Iowa Clinic-Internal Medicine x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Trinity Muscatine x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Trinity Orthopaedics Services x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Trinity Regional Medical Center x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Trinity Regional Medical Center Palliative Medicine-Sac City x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Trinity Regional Medical Center-Hospitalists x UnityPoint Health Fort Dodge - Trinity Regional Medical Center TRMC Corporate Health x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Allergy-Fort Dodge x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Dermatology-Ft. Dodge x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Family Medicine-Kenyon Rd x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Family Medicine-Second Ave N x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Foot & Ankle-Ft. Dodge x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Gastroenterology-Ft. Dodge x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Hospitalists-Des Moines x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Internal Medicine-Waterloo x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Nephrology-Ft. Dodge x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Neurology x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-OB/Gyn-Fort Dodge x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Palliative Medicine-Ft. Dodge x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Palliative Medicine-Trinity x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Pediatrics-Ft. Dodge x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Pulmonology-Fort Dodge x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Surgery-Fort Dodge x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Clinic-Urgent Care-Sunnybrook x UnityPoint Health Fort Dodge - Trinity Regional Medical Center UnityPoint Health-Berryhill Center x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Urology Associates, P.C. x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Webster City Medical Services, P.C. x UnityPoint Health Fort Dodge - Trinity Regional Medical Center West Central Pathology x UnityPoint Health Fort Dodge - Trinity Regional Medical Center Wolfe Eye Clinic, P.C. x UnityPoint Health Peoria - Proctor Hospital A.C.P.M. Podiatry Group, Ltd x UnityPoint Health Peoria - Proctor Hospital Acpm Podiatry Grp Ltd x UnityPoint Health Peoria - Proctor Hospital Advanced Behavioral Health x UnityPoint Health Peoria - Proctor Hospital Advanced Pain Management Institute x UnityPoint Health Peoria - Proctor Hospital Affiliated Urology Specialist x UnityPoint Health Peoria - Proctor Hospital Affiliated Urology Specialists, Ltd x UnityPoint Health Peoria - Proctor Hospital Affinity Womens Health Care x UnityPoint Health Peoria - Proctor Hospital Affinity Women's Health Care, S.C x UnityPoint Health Peoria - Proctor Hospital Ahearn & Associates Medical Center x UnityPoint Health Peoria - Proctor Hospital Allergy & Asthma Of Illinois, SC x UnityPoint Health Peoria - Proctor Hospital Anesthesia Specialties Alliance x UnityPoint Health Peoria - Proctor Hospital Associated Anesthesiologists x UnityPoint Health Peoria - Proctor Hospital Associates In Mental Health x UnityPoint Health Peoria - Proctor Hospital Associates of Sterling Podiatry x UnityPoint Health Peoria - Proctor Hospital Bleeding & Clotting Disorders Institute x UnityPoint Health Peoria - Proctor Hospital Bochantin OB/GYN Services x UnityPoint Health Peoria - Proctor Hospital Bond Eye Associates x UnityPoint Health Peoria - Proctor Hospital Boyd Obstetrics Gynecology x UnityPoint Health Peoria - Proctor Hospital Cancer Care Associates x UnityPoint Health Peoria - Proctor Hospital Cardiac Consultants SC x UnityPoint Health Peoria - Proctor Hospital Cardiac Surgery Associates, S.C. x UnityPoint Health Peoria - Proctor Hospital Cardiac Thoracic & Endovascular Therapies, SC x UnityPoint Health Peoria - Proctor Hospital Cardiovascular Medicine, P.C. x UnityPoint Health Peoria - Proctor Hospital Center for Pain Management and Rehabilitation x UnityPoint Health Peoria - Proctor Hospital Center For Pain Pain Management & Rehabilitation x UnityPoint Health Peoria - Proctor Hospital Central Illinois Onc Phys Ltd x UnityPoint Health Peoria - Proctor Hospital Central Illinois Dermatology x UnityPoint Health Peoria - Proctor Hospital Central Illinois Dermatology, S.C. x UnityPoint Health Peoria - Proctor Hospital Central Illinois Pulmonary x UnityPoint Health Peoria - Proctor Hospital Central Illinois Radiological Associate x UnityPoint Health Peoria - Proctor Hospital Chauncey C. Maher Iii-Peo x UnityPoint Health Peoria - Proctor Hospital Children's Hospital of Illinois Medical Group x UnityPoint Health Peoria - Proctor Hospital Children's Hospital of Illinois Medical Group x UnityPoint Health Peoria - Proctor Hospital Clifford E. Myers M.D. x UnityPoint Health Peoria - Proctor Hospital Comp Emergency Solutions x UnityPoint Health Peoria - Proctor Hospital Couri Center for Gynecology & Integrative Health x UnityPoint Health Peoria - Proctor Hospital Couri Center for Gynecology and Integrative Women's Health x UnityPoint Health Peoria - Proctor Hospital Creve Coeur Family Practice x UnityPoint Health Peoria - Proctor Hospital Daniel Couri, MD x UnityPoint Health Peoria - Proctor Hospital David Kindred Integrated Medicine x UnityPoint Health Peoria - Proctor Hospital David M. Skillrud, M.D., Ltd. x UnityPoint Health Peoria - Proctor Hospital Dr. Stephen C. Thompson x UnityPoint Health Peoria - Proctor Hospital Drs. Shay & Associates, Ltd. x UnityPoint Health Peoria - Proctor Hospital Eagle Family Medicine x UnityPoint Health Peoria - Proctor Hospital Edward Luan MD, SC x UnityPoint Health Peoria - Proctor Hospital Elmwood Farmingtn Med Ctr x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Peoria - Proctor Hospital Emergency Physician Staffing Solution x UnityPoint Health Peoria - Proctor Hospital EPSS Peoria, LLC x UnityPoint Health Peoria - Proctor Hospital Facial Cosmetic Reconstr x UnityPoint Health Peoria - Proctor Hospital Facial Plastic & Laser Surgery x UnityPoint Health Peoria - Proctor Hospital Facial Plastic and Laser Surgery, LLC x UnityPoint Health Peoria - Proctor Hospital Facial Plastic Laser Cen x UnityPoint Health Peoria - Proctor Hospital Gary W. Hoelle, DPM x UnityPoint Health Peoria - Proctor Hospital Great Plains Orthopaedic x UnityPoint Health Peoria - Proctor Hospital Greater Peoria OB/GYN Corp., S.C. x UnityPoint Health Peoria - Proctor Hospital Heartcare Midwest x UnityPoint Health Peoria - Proctor Hospital Heartland Community Health Clinic-Carver Clinic x UnityPoint Health Peoria - Proctor Hospital Il Neurological Institute x UnityPoint Health Peoria - Proctor Hospital Illinois Cancercare x UnityPoint Health Peoria - Proctor Hospital Illinois CancerCare, P.C. x UnityPoint Health Peoria - Proctor Hospital Illinois Cardiac Surgery Associates, S.C. x UnityPoint Health Peoria - Proctor Hospital Illinois Eye Center x UnityPoint Health Peoria - Proctor Hospital Illinois Eye Center SC x UnityPoint Health Peoria - Proctor Hospital Illinois Gastroenterology Institute x UnityPoint Health Peoria - Proctor Hospital Illinois Lung & Critical Care Institute x UnityPoint Health Peoria - Proctor Hospital Illinois Neurological Institue x UnityPoint Health Peoria - Proctor Hospital Illinois Neurological Institute x UnityPoint Health Peoria - Proctor Hospital Illinois Neurological Institute-Physicians, LLC x UnityPoint Health Peoria - Proctor Hospital Illinois Plastic Surgery x UnityPoint Health Peoria - Proctor Hospital Illinois Regional Pain Institute, S.C. x UnityPoint Health Peoria - Proctor Hospital Illinois Retina Institute x UnityPoint Health Peoria - Proctor Hospital Illinois Retina Institute, S.C. x UnityPoint Health Peoria - Proctor Hospital Illinois Valley Podiatry Group x UnityPoint Health Peoria - Proctor Hospital Institute Of Phys Med x UnityPoint Health Peoria - Proctor Hospital Institute Of Phys. Med & Rehab x UnityPoint Health Peoria - Proctor Hospital Institute of Physical Medicine and Rehabilitation x UnityPoint Health Peoria - Proctor Hospital Jack Gibson, MD x UnityPoint Health Peoria - Proctor Hospital James L. Swingler M.D. Gynecology and Obstetrics x UnityPoint Health Peoria - Proctor Hospital James Swingler Md Obgyn x UnityPoint Health Peoria - Proctor Hospital Jody L. Kelly, M.D. & Associates x UnityPoint Health Peoria - Proctor Hospital John J. Ayres, M.D. x UnityPoint Health Peoria - Proctor Hospital Junction Medical, SC x UnityPoint Health Peoria - Proctor Hospital Justin Ahlman, MD x UnityPoint Health Peoria - Proctor Hospital Justin R Ahlman, MD x UnityPoint Health Peoria - Proctor Hospital Kidney Health Care, Inc. x UnityPoint Health Peoria - Proctor Hospital Kindred, LLC x UnityPoint Health Peoria - Proctor Hospital Knight Medical and Rehab Center, LTD x UnityPoint Health Peoria - Proctor Hospital Lee Obstetrics & Gynecology, S.C. x UnityPoint Health Peoria - Proctor Hospital Lee Obstetrics and Gynecology, SC x UnityPoint Health Peoria - Proctor Hospital Life Services x UnityPoint Health Peoria - Proctor Hospital Lynne M. Jalovec M.D. x UnityPoint Health Peoria - Proctor Hospital Maternal Fetal Assoc x UnityPoint Health Peoria - Proctor Hospital Meth Spine Pain Center x UnityPoint Health Peoria - Proctor Hospital Methodist Anesthesiology x UnityPoint Health Peoria - Proctor Hospital Methodist at Pekin x UnityPoint Health Peoria - Proctor Hospital Methodist Diabetes Care Center-Main ST-Peoria x UnityPoint Health Peoria - Proctor Hospital Methodist Medical Center Of Illinois-Perfusionists x UnityPoint Health Peoria - Proctor Hospital Methodist Medical Group x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Peoria - Proctor Hospital Methodist Medical Group at Knoxville x UnityPoint Health Peoria - Proctor Hospital Methodist Medical Group at Washington x UnityPoint Health Peoria - Proctor Hospital Methodist Medical Group Neurology x UnityPoint Health Peoria - Proctor Hospital Methodist Wound Clinic x UnityPoint Health Peoria - Proctor Hospital Metro Infectious Disease x UnityPoint Health Peoria - Proctor Hospital Metro Infectious Disease Consultants x UnityPoint Health Peoria - Proctor Hospital Michael E. Longevin, M.D., S.C. x UnityPoint Health Peoria - Proctor Hospital Mid Illini Surgical Associates x UnityPoint Health Peoria - Proctor Hospital Midwest Ear Nose & Throat x UnityPoint Health Peoria - Proctor Hospital Midwest Ear Nose & Throat Associates x UnityPoint Health Peoria - Proctor Hospital Midwest Orthopaedic Center x UnityPoint Health Peoria - Proctor Hospital Midwest Podiatry Group x UnityPoint Health Peoria - Proctor Hospital Midwest Podiatry Group, S.C. x UnityPoint Health Peoria - Proctor Hospital Midwest Urological Group x UnityPoint Health Peoria - Proctor Hospital Millennium Pain Center x UnityPoint Health Peoria - Proctor Hospital Morton Internal Medicine x UnityPoint Health Peoria - Proctor Hospital Morton Sleep Center x UnityPoint Health Peoria - Proctor Hospital Neurology Clinic of Peoria, S.C. x UnityPoint Health Peoria - Proctor Hospital Neurology Clinic Of Peoria, SC x UnityPoint Health Peoria - Proctor Hospital NightHawk Radiology Services x UnityPoint Health Peoria - Proctor Hospital OSF - Center for Health Pediatrics x UnityPoint Health Peoria - Proctor Hospital OSF Department of Neonatology x UnityPoint Health Peoria - Proctor Hospital OSF Family Practice x UnityPoint Health Peoria - Proctor Hospital OSF Home Care Services x UnityPoint Health Peoria - Proctor Hospital OSF Medical Group - Knoxville Ave Peds x UnityPoint Health Peoria - Proctor Hospital Osf Medical Group - Ped/Card x UnityPoint Health Peoria - Proctor Hospital OSF Medical Group-Washington x UnityPoint Health Peoria - Proctor Hospital OSF Pediatrics x UnityPoint Health Peoria - Proctor Hospital OSF Perinatal Associates, LLC x UnityPoint Health Peoria - Proctor Hospital OSF Rheumatology x UnityPoint Health Peoria - Proctor Hospital OSF St Francis Medical Center-INI Diagnostic Center x UnityPoint Health Peoria - Proctor Hospital Pediatric Cardiology x UnityPoint Health Peoria - Proctor Hospital Peoria Ear Nose & Throat Group x UnityPoint Health Peoria - Proctor Hospital Peoria Ear Nose Throat x UnityPoint Health Peoria - Proctor Hospital Peoria Family Practice, S.C. x UnityPoint Health Peoria - Proctor Hospital Peoria Hand Surgery, LCC x UnityPoint Health Peoria - Proctor Hospital Peoria Podiatry Group, P.C. x UnityPoint Health Peoria - Proctor Hospital Peoria Surgical Group, Ltd. x UnityPoint Health Peoria - Proctor Hospital Peoria Tazewell Pathology x UnityPoint Health Peoria - Proctor Hospital Peoria Tazewell Pathology Group x UnityPoint Health Peoria - Proctor Hospital Peoria Tazewell Pathology Group, S.C. x UnityPoint Health Peoria - Proctor Hospital Peoria Tazewell Pathology Grp x UnityPoint Health Peoria - Proctor Hospital Peoria Womens Health x UnityPoint Health Peoria - Proctor Hospital Peoria Women's Health x UnityPoint Health Peoria - Proctor Hospital Perfusion Solution, Inc x UnityPoint Health Peoria - Proctor Hospital Proctor Addiction Recovery Ctr x UnityPoint Health Peoria - Proctor Hospital Proctor First Care-Barring Trace x UnityPoint Health Peoria - Proctor Hospital Proctor First Care-East Peoria x UnityPoint Health Peoria - Proctor Hospital Proctor First Care-Morton x UnityPoint Health Peoria - Proctor Hospital Proctor First Care-Peoria Heights x UnityPoint Health Peoria - Proctor Hospital Proctor Health Systems x UnityPoint Health Peoria - Proctor Hospital Proctor Medical Group - Internal Medicine/Primary Care x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Peoria - Proctor Hospital Proctor Medical Group - Associated Family Physicians x UnityPoint Health Peoria - Proctor Hospital Proctor Medical Group - Behavioral Health x UnityPoint Health Peoria - Proctor Hospital Proctor Medical Group - Chillicothe Family Practice x UnityPoint Health Peoria - Proctor Hospital Proctor Medical Group - Internal Medicine/Family Practice x UnityPoint Health Peoria - Proctor Hospital Proctor Medical Group Family Medicine x UnityPoint Health Peoria - Proctor Hospital Proctor Medical Group Internal Medicine/Primary Care x UnityPoint Health Peoria - Proctor Hospital Proctor Medical Group Primary Care-N Knoxville-Peoria x UnityPoint Health Peoria - Proctor Hospital Proctor Multi Specialty Services x UnityPoint Health Peoria - Proctor Hospital Psychological Associates x UnityPoint Health Peoria - Proctor Hospital Psychology Specialists x UnityPoint Health Peoria - Proctor Hospital Psychology Specialists, Ltd x UnityPoint Health Peoria - Proctor Hospital RENAL CARE ASSOCIATES x UnityPoint Health Peoria - Proctor Hospital RenalCare Associates x UnityPoint Health Peoria - Proctor Hospital Reproduction Health and Fertility Center x UnityPoint Health Peoria - Proctor Hospital Retina Consultants of Central Illinois x UnityPoint Health Peoria - Proctor Hospital Ruskusky Foot and Ankle Clinic, Ltd. x UnityPoint Health Peoria - Proctor Hospital Ryan D. Schmidgall, M.D., S.C. x UnityPoint Health Peoria - Proctor Hospital See Comment x UnityPoint Health Peoria - Proctor Hospital Sher Institute for Reproductive Medicine x UnityPoint Health Peoria - Proctor Hospital Soderstrom Dermatology x UnityPoint Health Peoria - Proctor Hospital Specialists in Medical Imaging (SMI) x UnityPoint Health Peoria - Proctor Hospital Stephen C. Thompson, M.D., SC x UnityPoint Health Peoria - Proctor Hospital Susan B. Bishop, DMD x UnityPoint Health Peoria - Proctor Hospital Susan Cole, M.D. x UnityPoint Health Peoria - Proctor Hospital Susan J. Cole MD and Associates x UnityPoint Health Peoria - Proctor Hospital Teverbaugh, Croland, Mueller OB/Gyn Associates, SC x UnityPoint Health Peoria - Proctor Hospital Todd J. Karas, DPM, P.C. x UnityPoint Health Peoria - Proctor Hospital Trinity Medical Center Rock Island x UnityPoint Health Peoria - Proctor Hospital U of I Medical Service Plan x UnityPoint Health Peoria - Proctor Hospital U of I Medical Service Plan - Neonatology x UnityPoint Health Peoria - Proctor Hospital UICOMP x UnityPoint Health Peoria - Proctor Hospital UICOMP Psych x UnityPoint Health Peoria - Proctor Hospital Unity Point Clinic-MDVIP-Atrium x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic Wound Care & Hyperbaric Medicine at Methodist Atrium-Peoria x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Cardiovascular Services at Methodist on Main x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Express Care at Knoxville-Peoria x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Hospitalist-Peoria x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Internal Medicine at Knoxville x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Internal Medicine at South Jefferson-Peoria x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Internal Medicine-Dunlap x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Neurology-Peoria x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Palliative Care-Peoria x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Pediatric-Hospitalist x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Podiatry-Washington x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Pulmonology,Critical Care & Sleep Services at Methodist Atrium x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Rehabilitation Medicine at Methodist Atrium-Peoria x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Rheumatology-Peoria x UnityPoint Health Peoria - Proctor Hospital UnityPoint Clinic-Senior Health at Methodist Atrium-Peoria x UnityPoint Health Peoria - Proctor Hospital University of Illinois College of Medicine at Peoria- Psychiatry & Behavioral Medicine x UnityPoint Health Peoria - Proctor Hospital Valley Forge Family Physicians x UnityPoint Health Peoria - Proctor Hospital Virtual Radiologic Professionals, LLC (vRad) x UnityPoint Health Peoria - Proctor Hospital Vision Radiology x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Peoria - Proctor Hospital Western Illinois Cancer Treatment Center x UnityPoint Health Peoria - Proctor Hospital Women's Health Institute, Ltd. x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. 2727 Marshall Ct x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. 313 Price Place Ste 113 x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. 5620 Lake Mendota Dr x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. 715 Hill St Ste 132 x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. 721 American Ave #410 x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. 7974 UW Health Ct x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Access Community Health Center x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Access Community Health Center- Wingra x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Acuity Neurology, SC x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Advanced Care Dental x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Advanced Dermatology, Inc. x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Advanced Pain Management x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. AFCH Child Protection Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. AFCH Pediatric Orthopedic Surgery Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. AFCH Pediatric Plastic and Reconstructive Surgery Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. AFCH Pediatric Urology Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Agrace Hospice Care x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Alina Medical Associates x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. American Family Children’s Hospital x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. American Family Childrens Hospital x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Anderson and Shapiro x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Aspen Orthopedics x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Associated Dentists x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Associated Physicians, LLP x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Associated Podiatrists, LLP x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Belleville Family Medicine x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Belleville Family Medicine Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Carolinas Neonatology & Pediatrics x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Center for Oral and Maxillofacial Surgery, SC x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Center for Perinatal Care x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Center for Womens Health x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Child and Adolescent Psychiatry x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Childrens Dental Center x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Community Partnerships x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Counseling Resources x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. David A Besley, DDS, Inc. x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Davis Duehr Dean x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Dean Medical Center x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Dean/St Mary's Outpatient Ctr x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Dental Health Associates x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Elkhart Psychological Services x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Endodontic Specialists of Madison x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Face and Skin LLC x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Family Therapy Center x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. FHN Memorial Hospital x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. First Choice Dental x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Forward Psychology Group LLC x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Frederick J. Jaeger, DDS x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Generations Fertility Care x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Group Health Cooperative x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Gynecology Oncology Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Infectious Disease Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. JoAnn Martens DDS, LLC x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. JoAnne M Rummelhart DDS x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Jody F Schilling DDS x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Journey Mental Health Center x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Lemke Facial Surgery x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Madison Anesthesiology Consultants x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Madison Area Renal Specialists x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Madison Endodontic Assocs SC x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Madison Oral & Maxillofacial x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Madison Pediatric Dental x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Madison Plastic Surgery Assocs x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Madison Psychiatric Associates x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Madison Women’s Health, LLP x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Maple Grove Dental SC x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Medical Foundation Centennial Bldg x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Medical Foundation Centennial Building x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Melius Schurr Cardwell and Raichle x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Mental Health Solutions x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Child/Adolescent Hospital x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter DeForest Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter DeForest-Windsor x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Dermatology x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Emergency Services x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Fitchburg x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Heart & Vascular Group x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Heart & Vascular Hospital x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Hospital x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Hospital - McConnell Hall x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Hospital Administration x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Hospital Employee Hlth x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Hospital McConnell Hall x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Hospital Medicine x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Hospital NICU x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Interventional Spine Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Laboratories x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter McConnell Hall x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter McKee x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Medical Group x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Medical Imaging x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Middleton x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Monona x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Monona Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Newborn Nursery x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter NICU x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Nurse Midwife Office x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Orthopedic Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Pediatric Hospital Medicine x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Perinatal Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Psychiatry x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Psychiatry- 1E x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Rheumatology Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Specialty Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Spine Center x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Stoughton x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter West Washington x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Meriter Wisconsin Heart x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Midwest Inst of Sports Med x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. NE Family Medical Center x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Neal J. Katz, DPM x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. NewStart x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Odana Atrium Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Orthodontic Spec of Madison x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Orthopedic Associates of Sauk Prairie x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Orthopedic Surgery Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Our Lady of Hope Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Pediatriac Hematology and Oncology Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Pediatric Cardiovacular Medicine Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Pediatric Cardiovascular Medicine Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Pediatric Ear, Nose and Throat Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Pediatric Hematology and Oncology Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Pediatric Immune Deficiency Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Pediatric Nephrology Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Pediatric Pulmonary Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Pediatric Pulmonology Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Pediatric Urology Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. PO Box 764 x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Prairie Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Psychiatric Services, SC x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Regent Mental Health Group x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Research Park Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Robertson Plastic Surgery LLC x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Rogers Memorial Hospital x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Select Specialty Hospital x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Southwest Health Center Women’s Health x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Sun Prairie Psychological Svcs x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. The Psychology Center x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Thomas J Ansfield MD LLC x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Turville Bay MRI/Rad Onc Ctr x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. University Station Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Urology Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Carbone Cancer Center x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Carbonne Cancer Center x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Cardiac Surgery Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Cardiovascular Medicine x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Cardiovascular Medicine Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Department of Family Medicine x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Dept of Family Medicine x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Dept of Ortho & Rehab x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Dept of Orthopedics & Rehab x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Dept. of Pediatrics x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Dept. of Urology x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Division of PM&R x

Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW General Surgery Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Generations Fertility Clinic - MC418 x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Health x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Health - Cottage Grove Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Health AFCH - Neonatal Intensive Care Unit x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Health Allergy x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Health Arboretum Family Medicine x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. 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Updated 1/1/2016 Eligible for Eligible for Financial Financial Assistance Assistance Not Eligible under Policy under Policy for Financial Hospital Facility Provider Practice Name 1.BR.34 1.BR.34(a) Assitance UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Health Urology x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Health Urology Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Health UW Hospital & Clinics - Epilepsy Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Health Vascular Surgery Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Health West Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Health West Towne x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Health West Towne Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Heath West Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Heatlh x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Hospital & Clinics x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Hospital and Clinics x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Hospital Cardiovascular Medicine x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Infectious Disease Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Kidney Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Neuroendovascular Surgery Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Odana Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Pediatric ENT x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Pediatric Gastroenterology Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Pediatric Neurology x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Pulmonary Medicine Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Rehabilitation Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Rheumatology Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Student Health x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Urology Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Verona Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Waisman Center x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Waisman Center- Biochemical Genetics x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UW Waisman Center- Medical Genetics x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. UWHC Locum Tenens x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Waller, Ellis x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Wildwood Family Clinic x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. William S Middleton VA Hosp x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Wisconsin Dialysis x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Wisconsin Fertility Institute x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Wisconsin Sleep x UnityPoint Health Madison, Wisconsin - Meriter Hospital, Inc. Women’s Health and Integrative Medicine x

Updated 1/1/2016