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PARTICIPATING PROVIDER AGREEMENT <br />SCHEDULE B <br />PRODUCT PARTICIPATION <br />Provider and Contracted Providers will be subject to and bound by the Attachments set forth below, and designated <br />as a "Participating Provider" in the Products set forth below as of the date of successful completion of credentialing <br />in accordance with this Agreement. <br />List of Product Attachments and Addenda: <br />Attachment A: Medicaid <br />Attachment A-1: [Reserved] <br />Addendum A: [Reserved] <br />Addendum B: [Reserved] <br />Addendum C: [Reserved] <br />Attachment B: [Reserved] <br />Attachment C: [Reserved] <br />Attachment D: [Reserved] <br />Attachment E: [Reserved] <br />Attachment F: [Reserved] <br />Attachment G: [Reserved] <br />List of Schedules: <br />Schedule A Contracted Provider -Specific Provisions <br />Schedule B Product Participation <br />Schedule C Information For Contracted Providers <br />Schedule D-1 [Reserved] <br />Schedule D-2 [Reserved] <br />Health Plan to which Product Attachments Apply: <br />On at least 60 days' advance written notice (written or electronic), CCC and CCW may jointly notify Provider that <br />an Attachment shall no longer be a Product of CCC and shall be a Product of CCW on the date specified in the notice. <br />As of such date, the designated Attachment(s) shall terminate with respect to CCC as the Health Plan and commence <br />with respect to CCW as the Health Plan for such Product. <br />PPA WA - Kittitas County Public Health - 05.07.2025 - ICMProviderAgreement_360268 Page 23 of 24 <br />