Appendix_C_(2-_Embassy_Egypt_CS_Claims_Analysis__1MAY2014_through_30APR2015).pdf

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Appendix C (2- Embassy Egypt CS Claims Analysis__1MAY2014 through 30APR2015)

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Appendix_D_(Cairo_ORE_Staff).xlsx XLSX spreadsheet
Appendix_A_(Questions_and_Answers).docx DOCX document
Appendix_C_(5-_Embassy_Egypt_CS_Claims_Analysis__1MAY2017_through_30APR2018).pdf PDF
Appendix_C_(1-_Embassy_Egypt_CS_Claims_Analysis__1MAY2013_through_30APR2014).pdf PDF
Appendix_D_(Cairo_USAID_Employees_and_Dependents_Data).xls XLS spreadsheet
Appendix_D_(Cairo_AECWA_Staff).xlsx XLSX spreadsheet
Appendix_E_(Past_Requirements).pdf PDF
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Appendix_C_(4-_Embassy_Egypt_CS_Claims_Analysis__1MAY2016_through_30APR2017).pdf PDF
Appendix_B_(SAM_registration_guide).pdf PDF
Appendix_D_(Cairo_Employees_Data).xlsx XLSX spreadsheet
Appendix_C_(3-_Embassy_Egypt_CS_Claims_Analysis__1MAY2015_through_30APR2016).pdf PDF
SF30.pdf PDF
Appendix_C_(6-_Embassy_Egypt_CS_Claims_Analysis__11NOV2018_through_30APR2019).pdf PDF
GMC_medical_insurance_Solicitation_19EG3019R0001_Apr_04_2019.pdf PDF
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CS Claims Analysis by Client and Sub office Client code: 0312* Paid date from : 2014-5-1 to : 2015-4-30

Claims Paid by Benefit Category

Client / Suboffice Inpatient Outpatient Op Medication

Maternity Dental Optical Other Services

Total % of Total

0312A 001 AMERICAN EMBASSY 1,509,349 961,631 2,259,004 36,678 152,784 51,471 4,970,917 37% 0312B 001 AMERICAN EMBASSY 1,716,855 1,425,449 1,784,454 327,193 174,095 66,870 2,622 5,497,538 41%

0312C 001 AMERICAN EMBASSY 419,501 91,951 159,325 1,050 800 672,627 5%

0312D 001 AMERICAN EMBASSY 87,680 98,093 217,256 48 18,889 13,265 435,231 3%

0312E 001 AMERICAN EMBASSY 311,391 189,882 179,722 33,719 26,735 14,322 0 755,771 6%

0312F 001 AMERICAN EMBASSY 4,900 18,334 2,450 1,600 27,284 0%

0312G 001 AMERICAN EMBASSY 3,755 15,066 2,000 800 21,620 0%

0312I 001 AMERICAN EMBASSY USAID 49,840 97,048 159,965 14,711 27,468 19,715 368,747 3% 0312J 001 AMERICAN EMBASSY USAID 110,203 67,553 86,407 20,964 28,158 15,985 2,366 331,636 2% 0312M 001 A.E.C.W.A 109,131 37,854 34,695 3,106 4,650 189,436 1% 0312N 001 A.E.C.W.A 47,999 57,822 31,250 24,974 1,304 1,470 164,819 1%

0312H 001 AMERICAN EMBASSY 22,244 16,544 11,566 15,995 1,305 67,654 1%

0312K 001 AMERICAN EMBASSY 5,016 7,416 12,432 0%

Total 4,384,193 3,057,497 4,964,458 474,284 438,040 192,253 4,988 13,515,712 100%

Inpatient 32%

Outpatient 23%

Op Medication 37%

Maternity 4%

Dental 3%

Optical 1%

Other Ser...

0%

Inpatient 32%

Outpatient 23%

Op Medication 37%

Maternity 4%

Dental 3%

Optical 1%

Other Ser...

0%

PercentagePaid_usd

Inpatient Outpatient Op Medication Maternity Dental Optical Other Services

Cash vs. PPO Claims

Client / Suboffice CASH PPO Total % of Total

0312A 001 AMERICAN EMBASSY 324,668 4,646,249 4,970,917 37%

0312B 001 AMERICAN EMBASSY 606,758 4,890,779 5,497,538 41%

0312C 001 AMERICAN EMBASSY 2,643 669,984 672,627 5%

0312D 001 AMERICAN EMBASSY 48,934 386,297 435,231 3%

0312E 001 AMERICAN EMBASSY 68,751 687,020 755,771 6%

0312F 001 AMERICAN EMBASSY 4,050 23,234 27,284 0%

0312G 001 AMERICAN EMBASSY 2,800 18,820 21,620 0%

0312H 001 AMERICAN EMBASSY 1,740 65,914 67,654 1%

0312I 001 AMERICAN EMBASSY USAID 84,853 283,894 368,747 3%

0312J 001 AMERICAN EMBASSY USAID 81,839 249,797 331,636 2%

0312K 001 AMERICAN EMBASSY 588 11,844 12,432 0%

0312M 001 A.E.C.W.A 9,876 179,560 189,436 1% 0312N 001 A.E.C.W.A 3,973 160,846 164,819 1% Total 1,241,473 12,274,239 13,515,712 100%

CASH

9%

PPO

91%

CASH

9%

PPO

91%

CASH

PPO

User: Maged Hamdy 1 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

Cash Claims by Benefit Category

Client / Suboffice Inpatient Outpatient Op Medication

Maternity Dental Optical Other Services

Total % of Total

0312A 001 AMERICAN EMBASSY 31,413 53,400 22,745 12,854 152,784 51,471 324,668 26% 0312B 001 AMERICAN EMBASSY 107,380 77,572 103,456 74,764 174,095 66,870 2,622 606,758 49%

0312C 001 AMERICAN EMBASSY 793 1,050 800 2,643 0%

0312D 001 AMERICAN EMBASSY 14,500 2,280 18,889 13,265 48,934 4%

0312E 001 AMERICAN EMBASSY 6,415 14,935 6,344 26,735 14,322 0 68,751 6%

0312F 001 AMERICAN EMBASSY 2,450 1,600 4,050 0%

0312G 001 AMERICAN EMBASSY 2,000 800 2,800 0%

0312I 001 AMERICAN EMBASSY USAID 4,142 18,533 3,090 11,905 27,468 19,715 84,853 7% 0312J 001 AMERICAN EMBASSY USAID 838 15,659 4,635 14,199 28,158 15,985 2,366 81,839 7% 0312M 001 A.E.C.W.A 2,055 65 3,106 4,650 9,876 1% 0312N 001 A.E.C.W.A 360 138 700 1,304 1,470 3,973 0%

0312H 001 AMERICAN EMBASSY 388 48 1,305 1,740 0%

0312K 001 AMERICAN EMBASSY 357 231 588 0%

Total 143,773 190,031 151,623 120,765 438,040 192,253 4,988 1,241,473 100%

Inpatient 12%

Outpatient 15%

Op Medication 12%

Maternity 10%

Dental 35%

Optical 15%

Other Ser...

0%

Inpatient 12%

Outpatient 15%

Op Medication 12%

Maternity 10%

Dental 35%

Optical 15%

Other Ser...

0%

Op Medication Maternity Dental Optical Other Services

PPO Claims by Benefit Category

Client / Suboffice Inpatient Outpatient Op Medication Maternity Other Services Total % of Total

0312A 001 AMERICAN EMBASSY 1,477,936 908,230 2,236,258 23,825 4,646,249 38%

0312B 001 AMERICAN EMBASSY 1,609,474 1,347,877 1,680,998 252,429 0 4,890,779 40%

0312C 001 AMERICAN EMBASSY 419,501 91,158 159,325 669,984 5%

0312D 001 AMERICAN EMBASSY 87,680 83,593 214,976 48 386,297 3%

0312E 001 AMERICAN EMBASSY 311,391 183,468 164,787 27,375 687,020 6%

0312H 001 AMERICAN EMBASSY 22,244 16,156 11,519 15,995 65,914 1%

0312I 001 AMERICAN EMBASSY USAID 45,698 78,515 156,874 2,806 283,894 2%

0312J 001 AMERICAN EMBASSY USAID 109,365 51,894 81,772 6,766 249,797 2%

0312M 001 A.E.C.W.A 109,131 35,799 34,630 179,560 1% 0312N 001 A.E.C.W.A 47,999 57,461 31,111 24,274 160,846 1%

0312F 001 AMERICAN EMBASSY 4,900 18,334 23,234 0%

0312G 001 AMERICAN EMBASSY 3,755 15,066 18,820 0%

0312K 001 AMERICAN EMBASSY 4,659 7,185 11,844 0%

Total 4,240,420 2,867,466 4,812,835 353,519 0 12,274,239 100% Inpatient

35%

Outpatient 23%

Op Medication 39%

Maternity 3%

Inpatient 35%

Outpatient 23%

Op Medication 39%

Maternity 3%

Op Medication Maternity Other Services

User: Maged Hamdy 2 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

Monthly Claims Paid Amount

Year- Month

Inpatient Outpatient Op Medication

Maternity Dental Optical Other Services

Total

May-2014 535,457 183,114 379,270 44,800 46,419 25,795 532 1,215,387 Jun-2014 355,190 236,763 455,674 30,386 40,652 11,055 1,129,720 Jul-2014 242,350 231,672 346,922 43,514 28,437 9,731 700 903,325 Aug-2014 212,331 200,191 291,335 42,685 32,352 13,865 238 792,998 Sep-2014 434,619 285,448 396,319 69,101 21,280 13,130 1,219,897 Oct-2014 255,614 284,201 511,490 38,160 38,902 16,300 336 1,145,002 Nov-2014 477,210 284,984 547,787 41,828 34,368 22,650 1,491 1,410,317 Dec-2014 264,694 253,108 417,084 30,330 38,540 14,430 462 1,018,647 Jan-2015 234,371 267,131 361,413 41,728 41,465 15,560 480 962,147 Feb-2015 377,443 298,407 420,789 32,909 27,557 16,277 385 1,173,768 Mar-2015 649,390 244,817 474,284 28,555 20,574 8,475 1,426,094 Apr-2015 345,524 287,661 362,089 30,289 67,496 24,985 364 1,118,409 Total 4,384,193 3,057,497 4,964,458 474,284 438,040 192,253 4,988 13,515,712

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

1,600,000

May-2014 Jun-2014

Jul-2014 Aug-2014

Sep-2014 Oct-2014

Nov-2014 Dec-2014

Jan-2015 Feb-2015

Mar-2015 Apr-2015

Benefit_Category Inpatient Outpatient Op Medication Maternity Dental Optical Other Services

Year-Month

Pa id

_u sd

Monthly Claims Count

Year-Month Inpatient Outpatient Op Medication Maternity Dental Optical Other Services May-2014 46 1,568 2,231 118 85 36 1 Jun-2014 43 1,897 2,727 141 90 16 Jul-2014 38 1,639 1,966 139 60 20 3 Aug-2014 43 1,729 1,556 133 74 19 3 Sep-2014 49 2,012 1,981 121 47 17 Oct-2014 46 2,081 2,981 126 88 23 2 Nov-2014 65 2,107 2,878 106 72 35 3 Dec-2014 46 1,921 2,464 82 87 23 3 Jan-2015 36 2,159 2,342 87 89 22 4 Feb-2015 44 2,325 2,414 82 57 23 3 Mar-2015 50 1,907 2,537 98 52 14 Apr-2015 36 2,095 2,069 101 133 36 1 Total 542 23,440 28,146 1,334 934 284 23

1,000

2,000

3,000

4,000

5,000

6,000

May-2014 Jun-2014

Jul-2014 Aug-2014

Sep-2014 Oct-2014

Nov-2014 Dec-2014

Jan-2015 Feb-2015

Mar-2015 Apr-2015

Benefit_Category Inpatient Outpatient Op Medication Maternity Dental Optical Other Services

Year-Month

Cl ai m _c ou nt

User: Maged Hamdy 3 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

Claims based on Paid Amount Range

Paid Amount Range No.of claims %of total claims Paid Amount % of Total

<= 250 44,296 82% 3,442,187 25%

251-500 5,385 10% 1,874,453 14%

501-1000 3,115 6% 2,176,754 16%

1001-2500 691 1% 1,004,394 7%

2501-5000 241 0% 889,712 7%

5001-10000 163 0% 1,145,518 8%

>=10000 104 0% 2,982,693 22%

Total 53,995 100% 13,515,712 100%

Top 10 Daignosis Codes based on Paid Amount

Top 10 Diagnosis Number of Claimant

Paid Amount % to Total

HYPERTENSION 577 1,113,154 8%

DIABETES MELLITUS (DM) 448 911,429 7%

ISCHEMIC HEART DISEASE (IHD) 168 444,405 3%

DENTAL 707 438,336 3%

HYPERLIPIDEMIA 503 408,346 3%

LUMBAGO / LOW BACK PAIN 776 371,128 3%

CORONARY ARTERY DISEASE (CAD)/ CORONARY INSUFFICIENCY 14 329,066 2%

OSTEOARTHRITIS 347 275,340 2%

CAESAREAN SECTION DELIVERY (MEDICALLY NECESSARY) - MATERNITY 52 261,371 2%

BRONCHIAL ASTHMA 311 240,774 2%

Top 10 4,793,348 35%

Others 8,722,365 65%

Summary 13,515,712 100%

User: Maged Hamdy 4 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

Top 10 Claimant based on Paid Amount

Top 10 Claimant

Paid Amount % of Total

Major Conditions

1 346,794 3% BRONCHOPNEUMONIA

2 144,617 1% ABDOMINAL PAIN

ANAL / RECTAL PAIN

ARTHROPATHY / ARTHRITIS

BEHCET'S SYNDROME

BRONCHIAL ASTHMA

BRONCHITIS, ACUTE

CATARRH / COLD / CORYZA / NASOPHARYNTIGIS /RHINOPHARINGITIS

CONSTIPATION

CROHN'S DISEASE

DYSFUNCTIONAL UTERINE BLEEDING (DUB)

EPIGASTRIC PAIN

ESOPHAGAL REFLUX

FOLLICULITIS

GASTRITIS

GASTROENTERITIS / ENTERITIS OR COLITIS

HYPERTENSION

HYPOCALCEMIA

INTESTINAL OBSTRUCTION

IRRITABLE COLON / IRRITABLE BOWEL SYNDROME (IBS)

ISCHEMIC HEART DISEASE (IHD)

LUMBAGO / LOW BACK PAIN

OSTEOPOROSIS

OVARIAN CYST

PELVIC INFLAMMATORY DISEASE / PELVIC CONGESTION

PELVIC PAIN / LOWER ABDOMINAL PAIN

PEPTIC ULCER

PERITONITIS

RENAL COLIC

ULCERATIVE COLITIS

UPPER RESPIRATORY INFECTION (URTI / URI)

URINARY TRACT INFECTION (UTI)

VAGINITIS / VULVO-VAGINITIS / VULVITIS

VOMITING

WOUND

3 132,755 1% ABDOMINAL PAIN

User: Maged Hamdy 5 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

Top 10 Claimant based on Paid Amount

Top 10 Claimant

Paid Amount % of Total

Major Conditions

3 132,755 1% ASTHMATIC BRONCHITIS

BRONCHIAL ASTHMA

BRONCHITIS, ACUTE

CHEST PAIN (UNSPECIFIC REASON)

CORONARY ARTERY DISEASE (CAD)/ CORONARY INSUFFICIENCY

DRY EYE

FEVER

GASTRITIS

GENERALIZED WEAKNESS

HAEMORRHAGE INTRACEREBRAL / BRAIN

HEADACHE / HEAD PAIN

INTERVERTEBRAL DISC

IRRITABLE COLON / IRRITABLE BOWEL SYNDROME (IBS)

NECK PAIN / CERVICALGIA

SPASM OF MUSCLE

SPONDYLOSIS, CERVICAL

SPONDYLOSIS, LUMBOSACRAL

TRAUMA DUE TO ANY CAUSE

UPPER RESPIRATORY INFECTION (URTI / URI)

URINARY TRACT INFECTION (UTI)

WOUND

4 128,422 1% ABDOMINAL PAIN

ANAEMIA IRON DEFICIENCY

ANAL / RECTAL FISTULA

DENTAL

DERMATITIS (& CONTACT) / ECZEMA

DIABETES MELLITUS (DM)

ESOPHAGAL REFLUX

GASTROENTERITIS / ENTERITIS OR COLITIS

GENERAL SYMPTOMS

HEPATITIS

HEPATITIS C

HYPERGLYCAEMIA

HYPERLIPIDEMIA

HYPERTENSION

HYPOCALCEMIA

ISCHEMIC HEART DISEASE (IHD)

User: Maged Hamdy 6 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

Top 10 Claimant based on Paid Amount

Top 10 Claimant

Paid Amount % of Total

Major Conditions

4 128,422 1% KNEE (& LEG) SPRAIN

LUMBAGO / LOW BACK PAIN

MALAISE / FATIGUE

PITYRIASIS / TINEA VERSICOLOR

REFLUX ESOPHAGITIS

RENAL FAILURE, ACUTE

RENAL FAILURE, CHRONIC

SHORTNESS OF BREATH (SOB) / DYSPNEA

THYROIDITIS

VENOUS THROMBOSIS / DEEP VENOUS THROMBOSIS (DVT)

5 125,406 1% ALLERGY

BREAST TUMOR - MALIGNANT -FEMALE

DYSFUNCTIONAL UTERINE BLEEDING (DUB)

EXCESSIVE MENSTRUATION / MENORRHAGIA

GASTROENTERITIS / ENTERITIS OR COLITIS

HYPERTENSION

IRREGULAR MENSTRUATION

LUMBAGO / LOW BACK PAIN

OPTICAL

SHORTNESS OF BREATH (SOB) / DYSPNEA

VAGINITIS / VULVO-VAGINITIS / VULVITIS

6 120,998 1% DERMATITIS (& CONTACT) / ECZEMA

ENCEPHALITIS

GASTROENTERITIS / ENTERITIS OR COLITIS

HEPATITIS

7 113,792 1% ABSCESS / CELLULITIS

ALLERGIC RHINITIS / RHINORRHEA / HAY FEVER

CONJUNCTIVITIS, ACUTE

DERMATITIS (& CONTACT) / ECZEMA

GENERALIZED WEAKNESS

HORDEOLUM / STY

HYPERLIPIDEMIA

HYPERTENSION

ISCHEMIC HEART DISEASE (IHD)

LUMBAGO / LOW BACK PAIN

MYOSITIS/ INFECTIVE MYOSITIS

NEURALGIA / NEURITIS

User: Maged Hamdy 7 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

Top 10 Claimant based on Paid Amount

Top 10 Claimant

Paid Amount % of Total

Major Conditions

7 113,792 1% SORE THROAT / PHARYNGITIS, ACUTE

SPASM OF MUSCLE

UPPER RESPIRATORY INFECTION (URTI / URI)

WOUND

8 108,733 1% ABDOMINAL PAIN

ALLERGIC RHINITIS / RHINORRHEA / HAY FEVER

ARTHROPATHY / ARTHRITIS

ASTHMATIC BRONCHITIS

BRONCHIAL ASTHMA

CHOLECYSTITIS

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

EPIGASTRIC PAIN

GASTRITIS

GASTROENTERITIS / ENTERITIS OR COLITIS

GOUT / HYPERURICEMIA

HYPERLIPIDEMIA

HYPERTENSION

ISCHEMIC HEART DISEASE (IHD)

KNEE PAIN

LUMBAGO / LOW BACK PAIN

MEDIAL MENISCUS TEAR

OSTEOARTHRITIS

PELVIC PAIN / LOWER ABDOMINAL PAIN

PROSTATIC HYPERTROPHY

PROSTATITIS, ACUTE

PULMONARY EMBOLISM

RENAL COLIC

SHORTNESS OF BREATH (SOB) / DYSPNEA

SORE THROAT / PHARYNGITIS, ACUTE

UPPER RESPIRATORY INFECTION (URTI / URI)

VENOUS THROMBOSIS / DEEP VENOUS THROMBOSIS (DVT)

VOMITING

9 95,347 1% ABDOMINAL PAIN

ADENOPATHY / ENLARGEMENT LYMPH NODES - GLANDS

ALLERGIC RHINITIS / RHINORRHEA / HAY FEVER

CATARRH / COLD / CORYZA / NASOPHARYNTIGIS /RHINOPHARINGITIS

DEAFNESS / HEARING LOSS

User: Maged Hamdy 8 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

Top 10 Claimant based on Paid Amount

Top 10 Claimant

Paid Amount % of Total

Major Conditions

9 95,347 1% DENTAL

DERMATOMYCOSIS / SKIN FUNGUS INFECTION

EAR ACHE / OTALGIA / EAR PAIN

GASTRITIS

GOITER - UNSPECIFIED

NASAL TURBINATE HYPERTROPHY

NASO-PHARYNX TUMOR - MALIGNANT

NECK MASS / CERVICAL LUMP / PALATE MASS / NOSE MASS

NECK PAIN / CERVICALGIA

OTITIS MEDIA

SINUSITIS, ACUTE

SINUSITIS, CHRONIC

SORE THROAT / PHARYNGITIS, ACUTE

THRUSH

UPPER RESPIRATORY INFECTION (URTI / URI)

VENOUS THROMBOSIS / DEEP VENOUS THROMBOSIS (DVT)

10 89,957 1% ABDOMINAL PAIN

ABNORMAL LEVEL OF BLOOD / LIVER ENZYME.

ABSCESS / CELLULITIS

ANAEMIA IRON DEFICIENCY

ASTHMATIC BRONCHITIS

BRONCHIAL ASTHMA

BRONCHITIS, ACUTE

CATARRH / COLD / CORYZA / NASOPHARYNTIGIS /RHINOPHARINGITIS

DERMATITIS (& CONTACT) / ECZEMA

EDEMA / OEDEMA

ESOPHAGAL REFLUX

GASTRITIS

GENERALIZED WEAKNESS

HEADACHE / HEAD PAIN

HEPATOMEGALY / LIVER HYPERTROPHY

HERNIA, UMBILICAL

IRRITABLE COLON / IRRITABLE BOWEL SYNDROME (IBS)

KNEE PAIN

NECK PAIN / CERVICALGIA

NEURALGIA / NEURITIS

User: Maged Hamdy 9 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

Top 10 Claimant based on Paid Amount

Top 10 Claimant

Paid Amount % of Total

Major Conditions

10 89,957 1% OSTEOARTHRITIS

OVARIAN CYST

PHARYNGITIS

REFLUX ESOPHAGITIS

RENAL COLIC

RENAL FAILURE UNSPECIFIC

RENAL FAILURE, ACUTE

RENAL FAILURE, CHRONIC

RENAL UNSPECIFIC DISORDER

RHEUMATOID ARTHRITIS

SINUSITIS, ACUTE

TRAUMA DUE TO ANY CAUSE

UPPER RESPIRATORY INFECTION (URTI / URI)

VARICOSE VEINS LEG

WOUND

Top 10 1,406,820 10%

Others 12,108,892 90%

Summary 13,515,712 100%

User: Maged Hamdy 10 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

Top 10 Providers based on Paid Amount

Top 10 Providers Paid Amount Claim_Count % of Total

AS-SALAM INT'L HOSPITAL 2,089,252 766 17%

EZABY PHARMACY 1,862,692 5,011 15%

Al Nakheel Hospital 855,648 471 7%

Dr. El Hakim Pharmacy 818,714 1,930 7%

CLEOPATRA HOSPITAL 733,446 489 6%

DR. KAMAL HUSSIEN PHARMACY 535,382 1,332 4%

AL SALAM HOSPITAL 522,688 590 4%

ANEES & RAMZY PHARMACY 424,688 1,424 3%

EL SANBAWY PHAMACY 405,007 692 3%

CAIRO MEDICAL CENTRER 331,650 262 3%

Top 10 8,579,168 70%

User: Maged Hamdy 11 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

001 A.E.C.W.A Top 10 Providers Paid Amount % of Total

Al Nakheel Hospital 62,460 18%

International Medical Center 57,428 17%

AS-SALAM INT'L HOSPITAL 40,123 12%

EZABY PHARMACY 38,416 11%

AL SALAM HOSPITAL 35,955 11%

CLEOPATRA HOSPITAL 21,304 6%

AL SAFWA HOSPITAL 12,700 4%

Dr. El Hakim Pharmacy 8,896 3%

Baklawi Pharmacy 6,224 2%

CAIRO MEDICAL CENTRER 5,677 2%

Top 10 289,184 85%

Others 51,222 15%

001 A.E.C.W.A 340,406 100%

001 AMERICAN EMBASSY

Top 10 Providers Paid Amount % of Total

AS-SALAM INT'L HOSPITAL 2,001,675 18%

EZABY PHARMACY 1,765,872 15%

Dr. El Hakim Pharmacy 806,684 7%

Al Nakheel Hospital 779,002 7%

CLEOPATRA HOSPITAL 688,886 6%

DR. KAMAL HUSSIEN PHARMACY 530,510 5%

AL SALAM HOSPITAL 477,127 4%

EL SANBAWY PHAMACY 403,717 4%

CAIRO MEDICAL CENTRER 325,773 3%

ANEES & RAMZY PHARMACY 263,266 2%

Top 10 8,042,513 71%

Others 3,357,629 29%

001 AMERICAN EMBASSY 11,400,141 100%

001 AMERICAN EMBASSY USAID

Top 10 Providers Paid Amount % of Total

ANEES & RAMZY PHARMACY 157,385 29%

DAR AL FOUAD HOSPITAL 82,725 16%

EZABY PHARMACY 58,403 11%

AS-SALAM INT'L HOSPITAL 47,454 9%

AL SHOROUK HOSPITAL 30,945 6%

CLEOPATRA HOSPITAL 23,257 4%

User: Maged Hamdy 12 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

Top 10 Providers Paid Amount % of Total

ALFA SCAN 16,938 3%

Al Hayat Medical Center 14,900 3%

Al Nakheel Hospital 14,185 3%

DR. MOAMENA KAMEL LABORA 10,301 2%

Top 10 456,493 86%

Others 77,198 14%

001 AMERICAN EMBASSY USAID 533,691 100%

User: Maged Hamdy 13 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

CASH Claims Detail CASH Claims - Paid Amount Paid Amount africa 001 AMERICAN EMBASSY 1,000

Sub total 1,000 asia 001 AMERICAN EMBASSY USAID 2,126

Sub total 2,126

Country 001 A.E.C.W.A 13,849

AMERICAN EMBASSY 1,059,932

AMERICAN EMBASSY USAID 164,565

Sub total 1,238,347

Total 1,241,473

CASH Claims - Claim Count Claim_Count africa 001 AMERICAN EMBASSY 1

Sub total 1 asia 001 AMERICAN EMBASSY USAID 2

Sub total 2

Country 001 A.E.C.W.A 32

AMERICAN EMBASSY 2,744

AMERICAN EMBASSY USAID 464

Sub total 3,240

Total 3,243

PPO Claims Detail PPO Claims - Paid Amount Paid Amount

Country 001 A.E.C.W.A 340,406

AMERICAN EMBASSY 11,400,141

AMERICAN EMBASSY USAID 533,691

Sub total 12,274,239

Total 12,274,239

PPO Claims - Claim Count Claim_Count

Country 001 A.E.C.W.A 1,780

AMERICAN EMBASSY 51,238

AMERICAN EMBASSY USAID 2,291

Sub Total 55,309

Total 55,309

User: Maged Hamdy 14 of 15 May 5, 2019 6:11:55 PM

Paid date from : 2014-5-1 to : 2015-4-30

Claims by Insured Type Insured Op Medication Outpatient Inpatient Maternity Dental Optical Other Services Total % of Total

Employees 2,932,597 1,368,892 2,232,685 51,469 211,982 94,736 6,892,361 51%

Spouse 1,393,113 949,808 1,490,680 422,655 121,222 44,754 10 4,422,244 33%

Child 638,747 738,796 660,828 159 104,836 52,762 4,977 2,201,108 16%

Total 4,964,458 3,057,497 4,384,193 474,284 438,040 192,253 4,988 13,515,712 100%

Claims by Age Range Age Range Paid Amount Claim count

Male Female Total Female Male Total

Under 21 782,916 841,528 1,624,444 6,383 6,918 13,301

21-25 241,335 191,503 432,838 1,175 929 2,104

26-30 81,584 228,369 309,953 1,118 365 1,483

31-35 184,251 514,642 698,893 2,384 1,252 3,636

36-40 422,211 786,891 1,209,103 3,120 2,120 5,240

41-45 635,184 679,568 1,314,753 2,608 3,265 5,873

46-50 1,015,248 611,514 1,626,762 2,635 3,077 5,712

51-55 786,418 852,160 1,638,578 2,286 2,622 4,908

56-60 1,851,457 702,102 2,553,559 2,173 4,759 6,932

61-65 1,321,128 432,521 1,753,649 1,111 3,299 4,410

66-69 247,078 67,872 314,950 108 156 264

70 and above 38,230 38,230 132 132

Total 7,607,041 5,908,671 13,515,712 25,101 28,894 53,995

Note: All amounts are in Policy Currency

User: Maged Hamdy 15 of 15 May 5, 2019 6:11:55 PM

File details come from the government source that posted it.