11-NISD 906022 Payments by Benefit Type.xlsx
XLSX spreadsheet 11 KB Posted
- Attached to
- Medical and Pharmacy Reinsurance
- Solicitation number
- 2025-133
- Issued by
- Bexar County, Texas
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Payments by Benefit Type-Sum
| Northside ISD | 906022 | Jan 2023 to Sept 2025 | |||
| Payments by Benefit Type | |||||
| Benefit Type Code | Benefit Type Description | Subscriber Payments | Spouse Payments | Dependent/Other Payments | Total Payments |
| 97 | Optum Rx | $44,690,111 | $7,734,800 | $8,052,105 | $60,477,017 |
| 98 | Other Medical | $398,899 | $228,170 | $93,266 | $720,335 |
| 110 | Flexible Spending Account | $5,446 | $0 | $0 | $5,446 |
| 290 | Outpatient MHSA - Room and Board | $1,416 | $0 | $0 | $1,416 |
| 320 | Surgery | $4,136,115 | $648,486 | $397,009 | $5,181,610 |
| 350 | Assistant Surgical | $71,833 | $58,415 | $3,644 | $133,892 |
| 450 | Comprehensive Medical Expenses | $258,107 | $23,420 | $215,165 | $496,693 |
| 490 | Pharmacy - Health | $7,763,874 | $1,783,906 | $1,047,573 | $10,595,353 |
| 500 | Coordination of Benefits - Health | ($41,411) | ($92,573) | ($84,589) | ($218,573) |
| 510 | Convalescent Facility | $83,029 | $7,735 | $0 | $90,764 |
| 607 | Anesthesia | $1,626,395 | $251,621 | $283,180 | $2,161,196 |
| 615 | Professional Visits - Emergency Room | $5,426,972 | $1,326,445 | $2,855,267 | $9,608,684 |
| 616 | Administered Drugs - Facility | ($32,572) | $18,356 | ($733,409) | ($747,625) |
| 621 | Inpatient Room | $12,555,860 | $3,096,020 | $8,865,169 | $24,517,048 |
| 627 | Miscellaneous Outpatient Services | $15,079,952 | $2,679,549 | $8,287,286 | $26,046,787 |
| 642 | Radiation Therapy | $498,793 | $64,833 | $4,313 | $567,939 |
| 644 | Radiology Diagnostic Services | $6,085,236 | $922,289 | $854,991 | $7,862,516 |
| 658 | Mental Health/Substance Abuse Services | $1,869,379 | $235,351 | $3,080,515 | $5,185,245 |
| Total | $100,477,434 | $18,986,823 | $33,221,487 | $152,685,744 |
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