11-NISD 906022 Payments by Benefit Type.xlsx
XLSX spreadsheet 11 KB Posted
- Attached to
- Medical and Pharmacy Reinsurance
- Solicitation number
- RFP 2025-133
- Issued by
- Bexar County, Texas
About this file
The document is a confidential payment breakdown spreadsheet from UnitedHealthcare for Northside Independent School District (NISD), covering medical and pharmacy benefit payments from January 2023 to September 2025. The spreadsheet details payments by benefit type across subscriber, spouse, and dependent/other categories, encompassing various medical services such as prescription drugs, surgical procedures, mental health services, inpatient and outpatient care, and diagnostic services. The total payments across all benefit types amount to $152,685,744 during the specified period.
The payment breakdown reveals significant expenditures in key areas, with the highest payments in categories like Optum Rx ($60,477,017), Inpatient Room ($24,517,048), Miscellaneous Outpatient Services ($26,046,787), and Professional Visits - Emergency Room ($9,608,684). The document is related to a state and local contract opportunity for Medical and Pharmacy Reinsurance in Texas, specifically for Northside Independent School District. The contract opportunity indicates that the district is seeking proposals for medical and pharmacy reinsurance services, with the award to be determined solely by the district's needs.
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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 |
This document contains UnitedHealthcare's confidential and/or proprietary business information (PBI). PBI may only be used by the recipient person/entity to which it is addressed. Recipient is liable for using and protecting UnitedHealthcare's PBI from further disclosure or misuse, consistent with recipient's contractual obligations under any applicable administrative services agreement, group policy contract, non-disclosure agreement or other applicable contract or law, including but not limited to the U.S. Freedom of Information Act and state freedom of information law exemptions for 'trade secrets'. The document may also contain protected health information (PHI) and must be handled according to applicable state and federal law, including, but not limited to HIPAA. Recipients who misuse information may be subject to both civil and criminal penalties.
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