SHJ25-011 UNITED HEALTHCARE & KCJ Carceral 2025 Medicaid Contract - PARTIALLY EXECUTED

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Appendix 2 Definitions, Products and Services. This appendix sets forth definitions for our "customer" and "participating entities" as well as lists the type of benefit contracts offered to our customers. Payment Fee Information Documents Include: Fee Specifications Document, Fee Appendix(ices) Schedule Sample, and Additional Information About Your Fee Schedule. Further information about the fee schedule (such as additional fee samples) can be requested by writing to UnitedHealthcare, Market VP MN 101-D003, 9700 Health Care Lane, Minnetonka, MN 55343. Appendix 3 Professional Staff: This document provides information about the members of your professional staff. Appendix 4 Locations. This document provides information about your office, billing, and mailing locations. Please remember that, as described on page 2, this agreement applies to all of your locations even if you do not list all of your current locations or if you add a location in the future. State Regulatory In some instances, states add requirements to our agreement that are set forth in this Requirements appendix. Appendix Medicare (This appendix applies only if you are in our Medicare network.) Your Regulatory participation in our network for customers with Medicare benefit contracts is Requirements subject to additional Medicare requirements set forth in this appendix. Appendix Medicaid (This appendix applies only if you are in our Medicaid network.) Your Regulatory participation in our network for customers with Medicaid benefit contracts is Requirements subject to additional Medicaid requirements set forth in this appendix. Appendix Administrative Guide Additionally, we have provided access to our Administrative Guide and Credentialing Plan. Our Administrative Guide may be viewed by going to www.UHCProvider.com. Unless a longer period is required as set out in any Regulatory Requirements Appendix to this agreement or by applicable law, we may make changes to the Administrative Guide upon 30 days electronic or written notice to you. For services rendered to customers enrolled in certain benefit contracts that may be included under this agreement, you will be subject to additional requirements described in or made available to you through one or more additional provider manuals ("Additional Manuals"). When the agreement refers to the Administrative Guide, it is also referring to the Additional Manuals. The Additional Manuals will be made available to you on a designated website or upon request. In the event of any conflict between the "UnitedHealthcare Physician, Health Care Professional, Facility and Ancillary Provider Administrative Guide" or other UnitedHealthcare administrative protocols and payment policies, and any Additional Manual, in connection with any matter pertaining to customers enrolled in the benefit contracts to which the Additional Manual applies, that Additional Manual will govern, unless applicable statutes and regulations dictate otherwise. We may make changes to the protocols and payment policies subject to this provision in accordance with the provisions of the agreement relating to protocol and payment policy changes. The benefit contracts or names of entities under common ownership with us, names of the Additional Manuals, and name of the UHC/SMGA. REGAPX. 09.24. WTI -26-