Teladoc question, members vs visits – What am I missing?

I am valuing Teladoc and I'll share my thoughts in the coming days, but I have one topic that I am trying to make sense of.

If my understanding is correct, they make money in 2 ways:

1. Access fee which is basically a subscription that provides access to their platform where a patient can schedule a virtual visit with a doctor (This is often times paid by the employer)
2. Visit fee – A % of the total payment from the patient to the doctor.

Based on their reports, in 2021, they almost 78m total members. However, on the other side, they've reported 15.4m visits.

That means less than 20% of the total members are using the platform. Am I missing something?