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Published: Apr 10, 2026

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Do online doctors check PMP for Wellbutrin?

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Written by Klarity Editorial Team

Published: Apr 10, 2026

Do online doctors check PMP for Wellbutrin?
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If you’ve been struggling with binge eating disorder (BED), you’ve likely wondered whether you can access treatment from the privacy of your home. The short answer is yes—telehealth has made medication-assisted treatment for BED more accessible than ever. But understanding the regulatory landscape, what medications are available, and what to expect can feel overwhelming.

This guide breaks down everything you need to know about getting BED medication through telehealth in 2026, including which medications are available, state-by-state rules, and how to find safe, legitimate care.

Understanding Binge Eating Disorder and Medication Treatment

Binge Eating Disorder is the most common eating disorder in the United States, affecting millions of adults. Unlike bulimia, BED involves recurrent episodes of eating large amounts of food in a short period while feeling out of control—without compensatory behaviors like purging or excessive exercise.

According to DSM-5 criteria, a BED diagnosis requires:

  • Eating an unusually large amount of food within a two-hour period
  • Feeling a lack of control during these episodes
  • Experiencing these episodes at least once weekly for three months
  • Distress about the binge eating behavior
  • No regular purging behaviors (which would indicate a different eating disorder)

While psychotherapy—particularly cognitive behavioral therapy (CBT)—remains the gold standard for BED treatment, medications can play an important supporting role, especially when combined with therapy and nutritional counseling.

Medications Commonly Prescribed for BED via Telehealth

Two non-controlled medications are frequently prescribed off-label for binge eating disorder through telehealth platforms:

1. Topiramate (Topamax)

Originally FDA-approved for seizures and migraine prevention, topiramate has shown promise in reducing binge eating frequency and supporting weight management. Clinical studies suggest it may help with impulse control related to binge episodes.

Key considerations:

  • Typically started at low doses and gradually increased
  • Not recommended during pregnancy—linked to cleft palate and other fetal risks
  • Requires gradual tapering when discontinuing to avoid seizure risk
  • Common side effects include cognitive changes (‘brain fog’), tingling sensations, and taste changes
  • Usually prescribed in 90-day supplies with refills

2. Bupropion (Wellbutrin)

FDA-approved for depression and smoking cessation, bupropion has demonstrated effectiveness in reducing binge frequency in some patients. Research suggests it may help regulate appetite and reduce food cravings.

Key considerations:

  • Contraindicated in patients with current or past anorexia or bulimia due to seizure risk
  • Black box warning regarding suicidal thoughts in patients under 25—close monitoring required
  • Should not be combined with alcohol
  • Blood pressure monitoring recommended, especially if combined with other medications
  • Available in extended-release formulations for once-daily dosing

Both medications are non-controlled substances, which means they’re not subject to the strict federal telehealth prescribing rules that apply to controlled medications like Adderall or Vyvanse (the only FDA-approved medication for BED, which is a controlled stimulant rarely prescribed via telehealth due to regulatory restrictions).

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Federal Telehealth Prescribing Rules: What You Need to Know

The Ryan Haight Act and Non-Controlled Medications

A common misconception is that all telehealth prescribing requires an in-person visit. This confusion stems from the Ryan Haight Act of 2008, which established strict requirements for prescribing controlled substances (Schedule II-V drugs) via telemedicine.

Here’s the crucial distinction: The Ryan Haight Act does not apply to non-controlled medications like Topamax or Wellbutrin. These medications were never subject to federal in-person requirements for telehealth prescribing.

Current DEA Telehealth Flexibilities (Through 2026)

During the COVID-19 pandemic, the DEA temporarily waived the in-person requirement for controlled substance prescribing via telehealth. This flexibility has been extended through December 31, 2026, allowing patients to receive prescriptions for certain controlled medications without an initial in-person visit while the DEA finalizes permanent rules.

For BED patients, this means:

  • Non-controlled medications (Topamax, Wellbutrin) can be prescribed via telehealth indefinitely—no federal restrictions
  • The ongoing DEA extensions ensure telehealth infrastructure remains robust
  • Providers are increasingly comfortable with telehealth workflows due to these established policies

State-by-State Telehealth Prescribing Requirements

While federal law sets the baseline, individual states regulate medical practice, including telehealth. State requirements vary considerably regarding:

  • Whether an in-person exam is required before prescribing
  • How often patients must be seen in-person for ongoing care
  • Who can prescribe (physicians vs. nurse practitioners)
  • Prescription monitoring requirements

States with No In-Person Requirements

California, New York, Texas, Michigan, Wisconsin, Delaware, South Carolina, and Florida allow healthcare providers to prescribe non-controlled medications via telehealth without requiring an in-person visit—either initially or for ongoing care.

California has been particularly progressive, with 2025 legislation (AB 1503) explicitly defining ‘good faith exams’ to include asynchronous telehealth evaluations, further expanding prescribing flexibility.

States Requiring Periodic In-Person Visits

Alabama, Georgia, and New Hampshire allow telehealth prescribing but require periodic in-person follow-ups under certain circumstances:

  • Alabama: If you have more than four telehealth visits for the same condition within 12 months, you must be seen in-person within one year (this can be satisfied by any collaborating provider)
  • Georgia: Requires providers to attempt an annual in-person exam for ongoing telemedicine care
  • New Hampshire: Mandates an in-person exam within 12 months for patients on Schedule II-IV medications (less relevant for non-controlled BED meds, but shows the state’s approach to telehealth follow-up)

Important note: These requirements are typically flexible regarding which provider conducts the in-person visit—it doesn’t necessarily need to be your telehealth prescriber.

Prescription Monitoring Programs (PMPs)

Many states require prescribers to check the state Prescription Drug Monitoring Program database before prescribing controlled substances. Because Topamax and Wellbutrin are not controlled, most states don’t legally mandate PMP checks for these medications.

However, responsible telehealth providers may still review your medication history to:

  • Ensure you’re not receiving duplicate prescriptions
  • Check for potential drug interactions
  • Verify your treatment history for safety

This is considered best practice, even when not legally required.

Who Can Prescribe BED Medications via Telehealth?

Physicians (MDs and DOs)

All states allow licensed physicians to prescribe non-controlled medications via telehealth, provided they’re licensed in the patient’s state.

Nurse Practitioners (NPs) and Physician Assistants (PAs)

The landscape for advanced practice providers has evolved significantly in recent years:

Full Practice Authority States (34+ states plus D.C.):In states like California, New York, Michigan, Wisconsin, and New Hampshire, NPs can evaluate patients and prescribe BED medications independently, without physician oversight. Recent additions to this category include Louisiana, Kansas, and Wisconsin (2023-2025 legislation).

Collaborative/Supervisory States:In states like Texas, Florida, Alabama, and Georgia, NPs and PAs can prescribe these medications but must work under a collaborative agreement or supervisory relationship with a physician. This is a regulatory requirement that typically doesn’t affect your care quality—you might simply see both names on your prescription.

Key Insight: For non-controlled medications like those used for BED, prescriber type rarely poses a barrier. Whether you see an MD, DO, NP, or PA through a telehealth platform, they can legally prescribe these medications within their scope of practice.

Klarity Health’s network includes licensed providers across all these categories, ensuring you can access care regardless of your state’s specific regulations. The platform handles the compliance complexity behind the scenes, matching you with appropriately licensed providers for your location.

Who Is (and Isn’t) a Good Candidate for Telehealth BED Treatment?

Good Candidates for Telehealth BED Medication

Telehealth is ideal if you:

  • Meet DSM-5 criteria for Binge Eating Disorder
  • Have no contraindications to Topamax or Wellbutrin
  • Are able to participate in video or phone consultations
  • Can provide accurate medical history
  • Are willing to engage in follow-up care
  • Live in a state where your provider is licensed
  • Prefer the convenience and privacy of home-based care

Who Should Seek In-Person Evaluation

Telehealth may not be appropriate if you have:

Medical Contraindications:

  • History of anorexia or bulimia (Wellbutrin is contraindicated due to seizure risk)
  • Uncontrolled epilepsy or seizure disorders (both medications can affect seizure threshold)
  • Current pregnancy or planning pregnancy (topiramate can cause birth defects)
  • Severe, uncontrolled medical conditions requiring hands-on examination

Clinical Complexity:

  • Active suicidal ideation requiring immediate intervention
  • Severe medical instability from binge eating complications
  • Co-occurring substance use disorders requiring specialized treatment
  • Need for controlled substance treatment (like Vyvanse) that may not be available via telehealth

Preference for Comprehensive Evaluation:

  • Desire for physical examination findings
  • Preference for face-to-face initial assessment
  • Need for laboratory work or diagnostic testing before starting medication

What to Expect from a Telehealth BED Evaluation

Initial Consultation

Legitimate telehealth BED evaluations typically take 30-45 minutes and include:

  1. Identity and Location Verification: Providers verify you’re in a state where they’re licensed
  2. Comprehensive Medical History: Detailed questions about eating behaviors, mental health, medical conditions, and current medications
  3. BED Diagnostic Assessment: Discussion of binge eating frequency, triggers, associated distress, and impact on daily life
  4. Safety Screening: Questions about contraindications, pregnancy status, substance use, and suicide risk
  5. Treatment Discussion: Review of medication options, risks/benefits, alternative treatments, and expected outcomes
  6. Informed Consent: Clear explanation of off-label medication use, telehealth limitations, and treatment plan

Red flags: If a service promises a prescription before proper evaluation, rushes through the assessment in under 10 minutes, or doesn’t discuss non-medication options, consider that a warning sign.

Documentation and Privacy

Your telehealth provider will:

  • Document that you meet DSM-5 BED criteria
  • Record informed consent for telehealth and medication treatment
  • Note the clinical rationale for medication choice
  • Store records in HIPAA-compliant electronic health record systems
  • Issue prescriptions electronically to your chosen pharmacy

Many providers use standardized questionnaires like the Eating Disorder Examination Questionnaire (EDE-Q) or Binge Eating Scale (BES) to assess symptom severity and track progress over time.

Follow-Up Care

Expect regular monitoring, especially when starting medication:

  • Week 2-4: Initial check-in to assess tolerance and side effects
  • Monthly (first 3 months): Regular follow-ups to monitor response and adjust dosing
  • Quarterly thereafter: Ongoing monitoring once stable

Some states require periodic in-person visits (as noted earlier), but most allow ongoing telehealth follow-up indefinitely.

Telehealth Safety: How to Identify Legitimate Services

The telehealth boom has brought increased scrutiny—and rightfully so. High-profile cases, including federal indictments of executives from companies that inappropriately prescribed controlled substances online, have highlighted the importance of choosing reputable providers.

Signs of a Legitimate Telehealth Service

Comprehensive Evaluation Process:

  • Thorough intake questionnaires (15-30 minutes to complete)
  • Live video or phone consultations with licensed providers
  • Detailed medical and psychiatric history review
  • Discussion of alternative treatments and lifestyle modifications

Transparent Prescribing Practices:

  • Clear explanation of why specific medications are recommended
  • Discussion of off-label use when applicable
  • Honest conversation about what they can and cannot prescribe
  • No guarantees of prescriptions before evaluation

Proper Licensing and Credentials:

  • Providers licensed in your state
  • Clear display of provider credentials and license numbers
  • State medical board registration verification available

Appropriate Follow-Up:

  • Scheduled follow-up appointments
  • Access to provider between visits for concerns
  • Coordination with your other healthcare providers when needed

Pharmacy Integration:

  • Electronic prescriptions sent to legitimate pharmacies
  • No direct medication sales from the platform
  • Use of FDA-approved medications only

Red Flags to Avoid

  • Services promising prescriptions before evaluation
  • ‘Prescription guaranteed’ marketing
  • Minimal medical history questions
  • No discussion of therapy or non-medication options
  • Selling medications directly rather than using pharmacies
  • Inability to verify provider licensing
  • No established follow-up protocol
  • Pressure to start medication immediately

Klarity Health prioritizes safety through evidence-based protocols, comprehensive evaluations, and ongoing monitoring. The platform’s providers follow clinical guidelines, conduct thorough assessments, and coordinate care to ensure appropriate treatment for each patient’s unique needs.

The Role of Therapy and Comprehensive Treatment

While medication can be helpful for BED, it’s rarely sufficient as a standalone treatment. The American Psychiatric Association and other professional organizations recommend multimodal treatment approaches:

Evidence-Based Psychotherapy

Cognitive Behavioral Therapy (CBT) is considered the first-line treatment for BED, with strong research support for:

  • Reducing binge frequency
  • Improving body image
  • Addressing underlying thought patterns
  • Developing healthier coping strategies

Interpersonal Therapy (IPT) and Dialectical Behavior Therapy (DBT) also show effectiveness, particularly when emotional regulation difficulties contribute to binge eating.

Nutritional Counseling

Working with a registered dietitian who specializes in eating disorders can help:

  • Normalize eating patterns
  • Challenge food rules and restrictions
  • Develop intuitive eating skills
  • Address nutritional deficiencies

Support Groups and Peer Support

Organizations like Eating Disorders Anonymous, NEDA support groups, and online communities provide valuable peer support and reduce isolation.

Medication’s Role in Comprehensive Treatment

Medications like Topamax or Wellbutrin work best when combined with therapy and lifestyle changes. They can:

  • Reduce urges to binge
  • Support impulse control
  • Address co-occurring depression or anxiety
  • Facilitate engagement with psychotherapy

Many telehealth platforms, including Klarity Health, take an integrated approach—connecting patients not just with prescribers but also with therapists and resources for comprehensive care. This model mirrors what research shows works best: addressing BED from multiple angles simultaneously.

Insurance Coverage and Cost Considerations

Telehealth Coverage

Most insurance plans now cover telehealth visits at parity with in-person care, thanks to pandemic-era policy changes that have been extended or made permanent in many states.

When using insurance:

  • Verify your provider is in-network
  • Confirm telehealth coverage for mental health/psychiatry visits
  • Check whether prior authorization is needed
  • Understand your copay or coinsurance responsibility

Self-Pay Options

Many patients choose self-pay for telehealth BED treatment for various reasons:

  • Privacy concerns (not wanting eating disorder diagnosis in insurance records)
  • Out-of-network benefits that still provide partial reimbursement
  • High deductible plans where self-pay is more affordable
  • Faster access without insurance authorization delays

Klarity Health accepts both insurance and offers transparent self-pay pricing, making treatment accessible regardless of your coverage situation. This flexibility ensures that cost doesn’t become a barrier to getting help.

Medication Costs

Both Topamax and Wellbutrin are available as generics (topiramate and bupropion), which makes them affordable:

  • Generic topiramate: Often $10-30/month with insurance; $20-50 without
  • Generic bupropion: Usually $4-20/month with insurance; $10-40 without

GoodRx and similar discount programs can further reduce costs if you’re paying out-of-pocket.

Recent Regulatory Developments (2025-2026)

The telehealth landscape continues to evolve, with several significant developments:

Federal Level

DEA Telehealth Extension (January 2026): The DEA announced its fourth extension of COVID-era telehealth prescribing flexibilities, now lasting through December 31, 2026. While this primarily affects controlled substances, it signals continued federal support for telehealth infrastructure.

The DEA is still working on permanent rules for telehealth prescribing of controlled substances, with a final rule expected before the current extension expires.

State Level

Several states updated telehealth laws in 2025:

New Hampshire (SB 252, August 2025): Explicitly allowed telehealth prescribing of Schedule II-IV medications without an initial in-person visit, requiring only annual in-person follow-up.

California (AB 1503, 2025): Redefined ‘good faith exam’ to include asynchronous telehealth, expanding prescribing flexibility.

Delaware (SB 101, July 2025): Clarified that telemedicine is permitted for medication-assisted treatment of opioid use disorder, resolving previous legal ambiguity.

New York (May 2025): Adopted regulations requiring in-person exams before prescribing controlled substances once federal waivers expire—but this doesn’t affect non-controlled BED medications.

Advanced Practice Provider Scope Expansions

Multiple states expanded NP independence in 2023-2025:

  • Michigan joined full practice authority states
  • Wisconsin passed the APRN Modernization Act
  • Louisiana and Kansas eliminated collaboration requirements

These changes increase access to telehealth prescribers, particularly in underserved areas.

Frequently Asked Questions

Q: Do I need to have an in-person visit before getting BED medication via telehealth?

A: In most states, no. For non-controlled medications like Topamax and Wellbutrin, telehealth evaluations are sufficient to establish care and receive prescriptions. A few states (Alabama, Georgia, New Hampshire) require periodic in-person follow-ups for ongoing treatment, but not for initial prescriptions.

Q: Will my telehealth provider check a prescription monitoring database?

A: While not legally required for non-controlled medications, many providers check prescription history as a safety precaution to identify potential drug interactions or duplicate prescriptions. This is considered good clinical practice even when not mandated.

Q: Can nurse practitioners prescribe BED medications via telehealth?

A: Yes, in all states. In states with full practice authority, NPs can prescribe independently. In other states, they prescribe under collaborative agreements with physicians—this doesn’t affect your access to care.

Q: Is off-label prescribing safe and legal?

A: Yes. Off-label prescribing is legal, common, and often evidence-based. Neither Topamax nor Wellbutrin is FDA-approved specifically for BED, but clinical research supports their use. Your provider should explain the rationale and obtain informed consent.

Q: How long will I need to take medication for BED?

A: Treatment duration varies. Some patients benefit from 6-12 months of medication support while establishing new eating patterns through therapy. Others may need longer-term treatment. This should be discussed with your provider and regularly reassessed.

Q: What if I need a controlled substance like Vyvanse?

A: Vyvanse (lisdexamfetamine) is the only FDA-approved medication for BED but is a Schedule II controlled substance. While the DEA’s current flexibilities technically allow telehealth prescribing through 2026, most telehealth platforms don’t prescribe stimulants for BED due to abuse potential and regulatory scrutiny. You would likely need an in-person specialist referral.

Q: Can I continue my current therapist while using telehealth for medication?

A: Absolutely. Coordinating medication management via telehealth with ongoing in-person or virtual therapy is ideal. Inform both providers so they can collaborate on your care.

Q: What happens if I move to a different state?

A: Your provider must be licensed in your current state of residence. If you move, you’ll need to transfer care to a provider licensed in your new state. Many multi-state telehealth platforms can facilitate this transition.

Getting Started with Telehealth BED Treatment

If you’re ready to explore telehealth treatment for Binge Eating Disorder, here’s how to begin:

Step 1: Research Providers

Look for telehealth platforms with:

  • Licensed providers in your state
  • Specialization in eating disorders or mental health
  • Transparent pricing
  • Clear policies about prescribing practices
  • Positive patient reviews and professional credentials

Step 2: Prepare for Your Consultation

Before your appointment:

  • Track your symptoms: Note binge frequency, triggers, and impact on daily life for 1-2 weeks
  • List current medications: Include supplements and over-the-counter drugs
  • Document medical history: Previous diagnoses, treatments tried, and outcomes
  • Write down questions: What you want to know about treatment options
  • Identify goals: What you hope to achieve with treatment

Step 3: Be Honest During Evaluation

The more information you provide, the better your provider can help:

  • Describe your eating behaviors candidly
  • Disclose all mental health history
  • Mention any pregnancy plans or current pregnancy
  • Share concerns about medication side effects
  • Ask about alternatives if you have reservations

Step 4: Follow Through with Treatment

Medication works best when combined with:

  • Attending all follow-up appointments
  • Taking medication as prescribed
  • Engaging in recommended therapy
  • Tracking your progress
  • Communicating openly about any concerns

Why Telehealth Matters for BED Treatment Access

Binge Eating Disorder often goes untreated due to:

  • Shame and stigma making it hard to seek help in-person
  • Limited specialist availability, especially in rural areas
  • Time constraints making it difficult to attend in-person appointments
  • Financial barriers to accessing eating disorder specialists
  • Privacy concerns about being seen at an eating disorder clinic

Telehealth addresses these barriers by:

  • Providing confidential access from home
  • Connecting patients with specialists regardless of location
  • Offering flexible scheduling around work and family commitments
  • Making care more affordable through competitive pricing
  • Reducing appointment no-shows due to convenience

With Klarity Health’s nationwide network of providers, same-day and next-day appointments, and acceptance of both insurance and self-pay options, getting help for BED has never been more accessible.

The Future of Telehealth for Eating Disorders

As we move through 2026, telehealth for eating disorders continues to mature:

Expanding Research Base

New studies are examining:

  • Effectiveness of telehealth-delivered eating disorder treatment compared to in-person care
  • Optimal combination of medication, therapy, and lifestyle interventions via telehealth
  • Patient satisfaction and long-term outcomes
  • Best practices for remote monitoring and follow-up

Technology Integration

Emerging tools include:

  • Apps for tracking eating patterns and mood
  • Integration with wearable devices for comprehensive health monitoring
  • Asynchronous messaging for between-appointment support
  • AI-assisted screening tools for earlier identification

Policy Evolution

Regulatory trends suggest:

  • Continued support for telehealth access
  • More states granting advanced practice providers full authority
  • Standardization of interstate licensure for telehealth
  • Permanent extension of COVID-era flexibilities

Hybrid Models

The future likely involves combining:

  • Initial telehealth evaluation and ongoing medication management
  • Periodic in-person check-ins when clinically indicated
  • Virtual therapy supplemented by in-person group sessions
  • Remote monitoring with local laboratory work

Taking the Next Step

Binge Eating Disorder is a serious but treatable condition. You don’t have to navigate it alone, and you don’t need to wait for an in-person appointment that might be weeks or months away.

If you’re ready to explore treatment options:

The combination of medication, therapy, and lifestyle changes offers the best chance for recovery. Telehealth makes all of these components more accessible than ever before, with the regulatory framework now firmly in place to support safe, effective care.

Whether you’re struggling with frequent binge episodes, feel trapped in a cycle of dieting and bingeing, or simply want to better understand your relationship with food, reaching out for professional help is a courageous first step.

Klarity Health’s providers are available for same-day and next-day consultations, offering comprehensive evaluations, evidence-based treatment recommendations, and ongoing support throughout your recovery journey. With transparent pricing, insurance acceptance, and licensed providers across the country, getting help is more straightforward than you might think.

You deserve compassionate, expert care that fits into your life. Telehealth makes that possible.


Research Currency Statement

Verified as of: January 4, 2026

Federal Regulations:

  • DEA COVID-19 telehealth prescribing flexibilities remain in effect through December 31, 2026 (fourth extension)
  • Non-controlled medications were never subject to Ryan Haight Act in-person requirements
  • 80%+ of sources are from 2025 or updated to 2025 standards

State Verification:

  • Researched 10+ key states with information current as of late 2025
  • State board websites and 2025 legislative updates confirmed
  • Temporary COVID waivers tracked for expiration/extension status

Pending Developments:

  • Alabama and South Carolina NP scope legislation discussed but not yet enacted
  • DEA final rule on permanent telehealth prescribing expected by end of 2026
  • State-specific temporary waivers monitored for changes

Citations

  1. U.S. Department of Health and Human Services. (2026, January 2). ‘HHS and DEA Extend Telemedicine Prescribing Flexibilities Through December 31, 2026.’ https://www.hhs.gov/press-room/dea-telemedicine-extension-2026.html

  2. Sheppard Mullin Richter & Hampton LLP. (2025, August). ‘Telehealth and In-Person Visits: Tracking Federal and State Updates to Pandemic-Era Telehealth Exceptions.’ https://www.sheppardhealthlaw.com/2025/08/articles/telehealth/telehealth-and-in-person-visits-tracking-federal-and-state-updates-to-pandemic-era-telehealth-exceptions/

  3. Center for Connected Health Policy. (2025, November-December). ‘State Telehealth Laws and Reimbursement Policies: Online Prescribing.’ https://www.cchpca.org/topic/online-prescribing/

  4. Health Jobs Nationwide. (2025). ‘State-by-State Guide: Expanding Roles for PAs and NPs (Updated 2025).’ https://blog.healthjobsnationwide.com/state-by-state-guide-expanding-roles-for-pas-and-nps-updated-2025/

  5. DailyMed, National Library of Medicine. (2024). ‘Bupropion Hydrochloride Extended-Release Tablets – FDA Label.’ https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=1b69c253-4740-44b0-be63-6c20834540b6&type=display

Source:

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All professional services are provided by independent private practices via the Klarity technology platform. Klarity Health, Inc. does not provide medical services.
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