Page 4 - S & S Die Company 2020 Renewal Presentation

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Blue Care Network - PCP Focus Network
Group/Subgroup Disruption Report - Membership Reported as of: 8/9/2020 T, of Michigan
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PCP Focus providers for 2020 based on listing as of August 2020 A no<1pmM corp0,8hM and ntJept,11<.lont tccnsee
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Employer Group Name (ID): SANDS DIE COMPANY (00122258)
Employer Subgroup Name (ID): SANDS DIE COMPANY (0001)
Employer Group Address: 2727 LYONS AVENUE, LANS ING, Ml, 48910
Employer Group County: INGHAM

Member Count - Total: 83
Members Disrupted: 6
% of Members Disrupted: 7%

Disclaimer: This PCP Focus Disruption Analysis Report is provided by Blue Care Network of Michigan for informational purposes only and should be used only as a guide in comparing
provider networks. Due to the many variables in provider network data, matching results may be inexact and cannot be guaranteed. Given the inherent margin of error in data matching, this
report should not be used for other purposes, such as collating claims dollars or locating a participating provider from whom to obtain covered health care services. Always verify participation
status with the proposed health plan.

PCP Focus PCP Name PCP Spec PCP Address Current Member Disrupted
Network Count Member
Ind Count

Yes IA,NDRIA AMENDT PED 2414 LAKE LANSING RD LANSING Ml 48912 INGHAM 1 0
Yes LARS ANDERSEN JR FP 1005 SUS HIGHWAY 27 STE 100 SAINT JOHNS Ml 48879 CLINTON 5 0
Yes IA.MY BECK PED 1375 W GREEN ST STE 3 HASTINGS Ml 49058 BARRY 1 0
Yes UAGDISH BHAGAT INT G1071 N BALLENGER HWY STE 206 FLINT Ml 48504 GENESEE 2 0
Yes MEGAN BRZEZINSKI FP 7335 WESTSHIRE DR STE 100 LANSING Ml 48917 EATON 1 0
Yes SUSAN CALDWELL FP 13191 SCHAVEY RD STE 3 DEWITT Ml 48820 CLINTON 2 0
Yes ROBERT CAMARA FP 1225 S LATSON RD STE 350 HOWELL Ml 48843 LIVINGSTON 1 0
Yes RACHEL CHRISTENSEN PED 13750 S SEDONA PKWY STE 2 LANSING Ml 48906 CLINTON 3 0
Yes PATRICIA COLEMAN MIEZAN INT 303 S WAVERLY RD STE 3 LANSING Ml 48917 EATON 1 0
Yes ROBERT DARIOS FP 1200 E MICHIGAN AVE STE 245A LANSING Ml 48912 INGHAM 1 0
Yes UAMI DE VARONA NPF 1035 CHARLEVOIX DR STE 100 GRAND LEDGE Ml 48837 EATON 1 0
Yes iA,SHOK GUPTA INT 3937 PATIENT CARE DR LANSING Ml 48911 INGHAM 1 0
Yes COURTNEY HART PED 3937 PATIENT CARE DR STE 101 LANSING Ml 48911 INGHAM 1 0
Yes 13REGORY HOLZHEI FP 901 S OAKLAND ST SAINT JOHNS Ml 48879 CLINTON 4 0
Yes DAVID HUFF FP 9900 W M 21 STE 104 OVID Ml 48866 CLINTON 1 0
Yes SHIMIA ISAAC FP 1200 E MICHIGAN AVE STE 325 LANSING Ml 48912 INGHAM 3 0
Yes rr1MOTHY IZZO FP 1035 CHARLEVOIX DR STE 100 GRAND LEDGE Ml 48837 EATON 1 0

SANDS DIE COMPANY (00122258)
SANDS DIE COMPANY (0001) Run Date: 8/17/2020 Page 1 of 3