2-Exhibit 2 -Monthly Claims Enrollment 2023-24.xlsx
XLSX spreadsheet 13 KB Posted
- Attached to
- Medical Rx Point Solutions State and local contract opportunity
- Solicitation number
- 3581-7
- Issued by
- Maricopa County, Arizona
About this file
This is a Monthly Claims Enrollment exhibit documenting health plan claims and enrollment data for a 24-month period spanning January 2023 through December 2024 for a state or local government health plan in Arizona. The document tracks medical claims paid, pharmacy claims paid, subscriber and member enrollment figures, and per-member-per-month (PMPM) cost metrics across multiple service categories including inpatient, outpatient, office visits, and post-acute care services.
Total health plan claims paid across the 24-month period amounted to $149,822,824, consisting of $101,931,390 in medical claims and $47,891,433 in pharmacy claims, with vision, dental, and vendor payments showing zero expenditures throughout the period. Member enrollment remained relatively stable, averaging 8,933 members across 4,379 subscribers with an average family size of 2.04. Medical and pharmacy combined PMPM costs ranged from a low of $580.88 in April 2023 to a high of $868.93 in October 2024, averaging $698.83 across the entire period. The data reflects monthly variations in claims processing and utilization patterns, with inpatient PMPM costs fluctuating between $46.28 and $220.27, while outpatient PMPM costs ranged from $157.06 to $264.93, indicating seasonal or demographic shifts in healthcare utilization and costs.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 4-Exhibit 4 - Census MCCCD Nov2025 Revised.xlsx | XLSX spreadsheet | |
| 1-Exhibit 1 - HI Ballot Language.pdf | ||
| 5-3581-7 RFP Medical Rx Point Solutions.pdf | ||
| 3-Exhibit 3 - MedClaims Detail 2024Incurred MCCCD Bid Project.csv | CSV file |
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Text version
Sheet1
| Measures | Jan 2023 | Feb 2023 | Mar 2023 | Apr 2023 | May 2023 | Jun 2023 | Jul 2023 | Aug 2023 | Sep 2023 | Oct 2023 | Nov 2023 | Dec 2023 | Jan 2024 | Feb 2024 | Mar 2024 | Apr 2024 | May 2024 | Jun 2024 | Jul 2024 | Aug 2024 | Sep 2024 | Oct 2024 | Nov 2024 | Dec 2024 | Total / Average |
| Medical Claims Paid | $4,082,271.00 | $3,414,986.00 | $3,716,990.00 | $3,505,675.00 | $4,241,288.00 | $5,100,577.00 | $3,519,103.00 | $3,884,613.00 | $3,377,334.00 | $4,149,301.00 | $4,063,544.00 | $4,189,709.00 | $4,068,927.00 | $3,790,372.00 | $5,117,569.00 | $3,572,125.00 | $4,007,040.00 | $4,815,521.00 | $4,642,522.00 | $4,847,916.00 | $3,946,391.00 | $5,479,699.00 | $4,951,082.00 | $5,446,834.00 | $101,931,390.00 |
| Pharmacy Claims Paid | $2,208,154.00 | $1,801,407.00 | $1,784,241.00 | $1,661,252.00 | $1,824,175.00 | $1,698,333.00 | $1,824,808.00 | $1,993,663.00 | $1,895,515.00 | $2,124,485.00 | $2,030,047.00 | $1,780,804.00 | $1,846,968.00 | $2,031,620.00 | $1,881,808.00 | $2,058,940.00 | $2,181,044.00 | $1,982,475.00 | $2,270,456.00 | $2,157,846.00 | $2,205,224.00 | $2,337,193.00 | $2,059,808.00 | $2,251,168.00 | $47,891,433.00 |
| Vision Claims Paid | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Dental Claims Paid | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Vendor payments Paid | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Total Health Plan Claims Paid | $6,290,426.00 | $5,216,393.00 | $5,501,231.00 | $5,166,928.00 | $6,065,463.00 | $6,798,910.00 | $5,343,911.00 | $5,878,276.00 | $5,272,849.00 | $6,273,786.00 | $6,093,591.00 | $5,970,513.00 | $5,915,895.00 | $5,821,991.00 | $6,999,377.00 | $5,631,065.00 | $6,188,084.00 | $6,797,996.00 | $6,912,978.00 | $7,005,762.00 | $6,151,615.00 | $7,816,892.00 | $7,010,889.00 | $7,698,001.00 | $149,822,824.00 |
| Subscribers | 4,351 | 4,305 | 4,331 | 4,331 | 4,343 | 4,319 | 4,257 | 4,278 | 4,302 | 4,361 | 4,381 | 4,411 | 4,434 | 4,416 | 4,449 | 4,440 | 4,436 | 4,410 | 4,381 | 4,374 | 4,376 | 4,454 | 4,476 | 4,474 | 4,379 |
| Members | 8,941 | 8,851 | 8,901 | 8,895 | 8,898 | 8,847 | 8,759 | 8,799 | 8,823 | 8,918 | 8,933 | 8,978 | 9,025 | 8,998 | 9,049 | 9,033 | 9,026 | 8,973 | 8,909 | 8,898 | 8,877 | 8,996 | 9,037 | 9,027 | 8,933 |
| Member Months | 8,941 | 8,851 | 8,901 | 8,895 | 8,898 | 8,847 | 8,759 | 8,799 | 8,823 | 8,918 | 8,933 | 8,978 | 9,025 | 8,998 | 9,049 | 9,033 | 9,026 | 8,973 | 8,909 | 8,898 | 8,877 | 8,996 | 9,037 | 9,027 | 214,391 |
| Average Family Size | 2.05 | 2.06 | 2.06 | 2.05 | 2.05 | 2.05 | 2.06 | 2.06 | 2.05 | 2.04 | 2.04 | 2.04 | 2.04 | 2.04 | 2.03 | 2.03 | 2.03 | 2.03 | 2.03 | 2.03 | 2.03 | 2.02 | 2.02 | 2.02 | 2.04 |
| Inpatient PMPM | $163.08 | $105.47 | $91.87 | $82.18 | $126.95 | $220.27 | $88.83 | $85.79 | $81.33 | $138.55 | $148.53 | $143.01 | $110.95 | $68.01 | $192.42 | $46.28 | $87.97 | $153.54 | $107.36 | $173.24 | $114.68 | $191.69 | $161.91 | $176.22 | $127.59 |
| Outpatient PMPM | $157.06 | $163.62 | $183.04 | $179.72 | $215.92 | $207.18 | $176.65 | $178.24 | $172.27 | $177.03 | $172.05 | $196.05 | $175.78 | $194.63 | $247.63 | $206.12 | $201.50 | $241.29 | $235.97 | $186.68 | $174.39 | $229.64 | $219.22 | $264.93 | $198.33 |
| Office Visit PMPM | $122.68 | $104.89 | $130.03 | $110.01 | $115.74 | $133.91 | $118.00 | $159.23 | $113.14 | $134.12 | $117.54 | $112.63 | $153.89 | $145.03 | $111.20 | $129.45 | $142.38 | $129.96 | $163.17 | $170.46 | $140.84 | $168.85 | $149.97 | $146.27 | $134.34 |
| Post Acute PMPM | $13.76 | $11.85 | $12.66 | $22.21 | $18.04 | $15.17 | $18.29 | $18.22 | $16.05 | $15.57 | $16.77 | $14.98 | $10.23 | $13.58 | $14.29 | $13.60 | $12.10 | $11.87 | $14.60 | $14.45 | $14.66 | $18.95 | $16.76 | $15.98 | $15.18 |
| Medical Claims PMPM | $456.58 | $385.83 | $417.59 | $394.12 | $476.66 | $576.53 | $401.77 | $441.48 | $382.79 | $465.27 | $454.89 | $466.66 | $450.85 | $421.25 | $565.54 | $395.45 | $443.94 | $536.67 | $521.10 | $544.83 | $444.56 | $609.13 | $547.87 | $603.39 | $475.45 |
| Pharmacy Claims PMPM | $246.97 | $203.53 | $200.45 | $186.76 | $205.01 | $191.97 | $208.34 | $226.58 | $214.84 | $238.22 | $227.25 | $198.35 | $204.65 | $225.79 | $207.96 | $227.94 | $241.64 | $220.94 | $254.85 | $242.51 | $248.42 | $259.80 | $227.93 | $249.38 | $223.38 |
| Vision Claims PMPM | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Dental Claims PMPM | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Vendor payments PMPM | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Medical and Pharmacy Claims PMPM | $703.55 | $589.36 | $618.05 | $580.88 | $681.67 | $768.50 | $610.11 | $668.06 | $597.63 | $703.50 | $682.14 | $665.02 | $655.50 | $647.03 | $773.50 | $623.39 | $685.58 | $757.61 | $775.95 | $787.34 | $692.98 | $868.93 | $775.80 | $852.78 | $698.83 |
&"+,Regular"&16&K04-016EXHIBIT 6 &"-,Regular"&11 3585-7 Beneift Administration with COBRA & FSA/HSA
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