medical services, namely, doppler evaluation of the arteries of the neck, arms and legs; photo-plethysmography of the fingers and toes; pulse volume recording of the upper and lower extremities; segmental limb pressures of the arms and legs providing both a wrist/brachial index and an ankle/brachial index; provocation testing of the upper extremities to evaluate for thoracic outlet syndrome; and a full blood test workup