{
  "note": "Canonical source of truth for Bidwell Health travel and allergy services. The visible scope table on /travel-medicine, the JSON-LD on each page, the per-country malaria pages, and the llms.txt facts all render from this file. Update here once and every surface stays consistent.",
  "version": "2026-06-19",
  "last_reviewed": "2026-06-19",
  "organization": {
    "legal_name": "Bidwell Health LLC",
    "url": "https://bidwellhealth.com/",
    "model": "Asynchronous online visit, no video, no subscription.",
    "visit_price_usd": 45,
    "medication_pricing": "The prescription is sent to the patient's own pharmacy at the generic cash price with no markup from Bidwell. Bidwell does not sell or ship medication.",
    "states_served": ["Arizona", "Colorado", "Connecticut", "Florida", "Iowa", "Maryland", "Montana", "New Mexico", "Utah", "Virginia", "Washington"],
    "states_served_count": 11,
    "states_not_served": ["New York"],
    "service_area_note": "Bidwell Health serves only these 11 states (Arizona, Colorado, Connecticut, Florida, Iowa, Maryland, Montana, New Mexico, Utah, Virginia, and Washington). It does not provide visits in any other state, including New York. The 11 states are a closed, complete list.",
    "clinicians": [
      {
        "name": "Bidwell Cranage",
        "credential": "APRN, FNP-C",
        "role": "Author, founder, and reviewing clinician",
        "npi": "1396219671",
        "member_of": "International Society of Travel Medicine",
        "board_certification": "AANP board-certified Family Nurse Practitioner",
        "note": "Member of the International Society of Travel Medicine, a professional society membership. Not a physician (APRN, FNP-C) and not a CTH certificate holder."
      },
      {
        "name": "Ashley Cranage",
        "credential": "APRN, FNP-C",
        "role": "Reviewing clinician"
      }
    ]
  },
  "services": [
    {
      "service": "Motion sickness",
      "canonical_url": "https://bidwellhealth.com/motion-sickness-treatment",
      "meds_prescribed": ["Scopolamine transdermal patch (Transderm Scop)"],
      "otc_alternative_noted": ["Meclizine"],
      "not_prescribed": ["Ondansetron (Zofran), which is not effective for motion sickness"],
      "who_is_eligible": "Adults 18 to 64 in a served state who get seasick, carsick, or airsick.",
      "who_is_referred": ["Allergy to scopolamine or other belladonna alkaloids", "Narrow-angle glaucoma", "Significant prostate or urinary-retention problems", "Bowel obstruction", "Myasthenia gravis", "Pregnancy or breastfeeding", "Anyone who must drive or operate a boat, aircraft, or machinery while wearing it"],
      "price_usd": 45,
      "evidence_source": "CDC Yellow Book (Motion Sickness); DailyMed Transderm Scop (scopolamine) label",
      "last_reviewed": "2026-06-19"
    },
    {
      "service": "Altitude sickness prevention",
      "canonical_url": "https://bidwellhealth.com/altitude-sickness-treatment",
      "meds_prescribed": ["Acetazolamide (Diamox), commonly 125 mg twice daily, started the day before ascent and continued for the first 2 days at altitude or longer if ascent continues"],
      "not_prescribed": [],
      "who_is_eligible": "Adults 18 to 64 in a served state traveling to sleeping altitudes above roughly 8,000 feet (2,400 m), especially with a fast ascent or a history of altitude sickness.",
      "who_is_referred": ["Allergy to acetazolamide", "Severe sulfa reaction (anaphylaxis or Stevens-Johnson)", "Severe kidney or liver disease", "Adrenal insufficiency (Addison disease)", "Significant electrolyte imbalance (low sodium or low potassium) or metabolic acidosis", "Sickle cell trait or disease", "Significant heart or lung disease (for example pulmonary hypertension, severe sleep apnea, or a recent heart attack or stroke), which needs in-person evaluation", "Pregnancy or breastfeeding", "Active warning signs (confusion, trouble walking, breathlessness at rest)"],
      "drug_interaction_note": "Avoid combining with high-dose aspirin or other salicylates, which raises the risk of toxicity.",
      "price_usd": 45,
      "evidence_source": "Wilderness Medical Society 2024 Acute Altitude Illness guidelines; CDC Yellow Book (High-Altitude Travel); DailyMed acetazolamide label",
      "last_reviewed": "2026-06-19"
    },
    {
      "service": "Traveler's diarrhea standby antibiotic",
      "canonical_url": "https://bidwellhealth.com/travelers-diarrhea-treatment",
      "meds_prescribed": ["Azithromycin standby (1 g single dose, or 500 mg once daily for 3 days)"],
      "not_prescribed": ["Fluoroquinolones such as ciprofloxacin, due to tendon and other risks"],
      "who_is_eligible": "Adults 18 to 64 in a served state traveling to a higher food-and-water-risk region who want a standby course to carry.",
      "who_is_referred": ["Macrolide (azithromycin) allergy", "Long-QT, a history of dangerous heart rhythms, uncorrected low potassium or magnesium, or QT-prolonging medicines", "Myasthenia gravis", "Severe liver disease", "Pregnancy", "Currently sick with bloody diarrhea or high fever (seek in-person care)"],
      "price_usd": 45,
      "evidence_source": "CDC Yellow Book (Travelers' Diarrhea); DailyMed azithromycin label",
      "last_reviewed": "2026-06-19"
    },
    {
      "service": "Malaria prevention",
      "canonical_url": "https://bidwellhealth.com/malaria-pills-online",
      "meds_prescribed": ["Doxycycline", "Atovaquone-proguanil (Malarone)"],
      "drug_regimens": {
        "doxycycline": "100 mg once daily, starting 1 to 2 days before entering the malaria area, every day during exposure, and for 4 weeks after leaving",
        "atovaquone_proguanil": "One adult tablet (250 mg atovaquone / 100 mg proguanil) once daily with food, starting 1 to 2 days before entering the malaria area, every day during exposure, and for 7 days after leaving"
      },
      "not_prescribed": ["Mefloquine", "Primaquine", "Tafenoquine", "Chloroquine"],
      "who_is_eligible": "Adults 18 to 64 in a served state. Multi-stop trips are eligible when doxycycline or Malarone is appropriate for every stop. Some lower-risk destinations need mosquito precautions only and no pill at all, which the CDC country guidance and the clinician confirm.",
      "who_is_referred": ["Any trip where the CDC does not list doxycycline or atovaquone-proguanil as an option for one of your stops", "Trips that need mefloquine (which needs neuropsychiatric and cardiac-conduction screening that is not safe to do online) or primaquine or tafenoquine (which need a G6PD blood test first)", "Pregnancy or breastfeeding"],
      "drug_routing_flags": ["Isotretinoin: avoid doxycycline", "Severe kidney disease: avoid Malarone", "Tetracycline or doxycycline allergy: use Malarone", "Atovaquone or proguanil allergy: use doxycycline"],
      "price_usd": 45,
      "evidence_source": "CDC Yellow Book (Malaria) and CDC Malaria Information by Country; DailyMed doxycycline and atovaquone-proguanil labels",
      "last_reviewed": "2026-06-19"
    },
    {
      "service": "Epinephrine auto-injector refill",
      "canonical_url": "https://bidwellhealth.com/epinephrine-auto-injector-online",
      "meds_prescribed": ["Generic epinephrine auto-injector, 0.3 mg, for adults who weigh at least 30 kg (66 lb) or who were previously prescribed the adult 0.3 mg device"],
      "not_prescribed": ["Brand EpiPen or Auvi-Q (same medicine and dose; Bidwell prescribes the generic)"],
      "who_is_eligible": "Adults 18 to 64 in a served state with a diagnosed severe allergy or a prior auto-injector prescription, who need a refill, replacement, or travel backup.",
      "who_is_referred": ["No prior diagnosis or prior auto-injector (this is not for a first-time diagnosis)", "Active severe reaction now (use epinephrine and call 911)", "Wanting allergy testing or a new diagnosis", "Pregnancy or breastfeeding, for this online refill service only. Epinephrine remains the first-line treatment for anaphylaxis in pregnancy, so anyone pregnant should still use their auto-injector as prescribed and seek emergency care if a reaction occurs"],
      "price_usd": 45,
      "evidence_source": "DailyMed epinephrine auto-injector label; AAAAI anaphylaxis guidance",
      "last_reviewed": "2026-06-19"
    }
  ]
}