7-Exhibit B Experience and Census.xlsx

XLSX spreadsheet 380 KB Posted Aug 30, 2025

Attached to: HEALTHCARE BENEFITS
Solicitation number: 26RFP005
Issued by: Maricopa County, Arizona

About this file

Written by GovTribe AI · Sep 1, 2025

The document is a comprehensive healthcare benefits experience report for the City of Scottsdale, covering monthly healthcare claims and enrollment data from July 2022 through June 2024. The report details healthcare benefit coverage across multiple product types including OAP (Open Access Plan) In-Network, Local Plus In-Network, High Deductible Health Plans (HDHP), and various benefit options such as family and individual plans. The data includes fixed charges, in-network costs, drug expenses, gross claims, stop-loss adjustments, pooled premiums, total subscribers, and total members across different plan categories.

The report provides granular monthly and annual healthcare utilization metrics, revealing significant variations in claims, premiums, and enrollment across different plan types. Notable observations include total gross claims ranging from approximately $2.5 million to $3.6 million monthly, with stop-loss adjustments and net claims showing dynamic financial management. The data also includes a detailed large claims report highlighting individual claims exceeding $25,000, with diagnoses ranging from cancer and cardiac conditions to neurological disorders. The comprehensive breakdown allows for precise tracking of healthcare expenditures, risk management, and potential cost containment strategies for the City of Scottsdale's employee healthcare benefits program.

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2022.2023 Exp

CITY OF SCOTTSDALE

MONTHLY HEALTHCARE DETAIL EXPERIENCE REPORT

July 2022 thru June 2023

Rating Type : RETROSPECTIVE EXPERIENCE RATED

Reported Premium: Billed Pooled Premium, ASO Fees

Reported Claims: All Claims

Note: Paid claim dollars include amounts deducted from your account and paid to vendors for cost containment services.

YTD/MONTH

PRODUCT TYPE

BENEFIT OPTION

FIXED CHARGES

IN NETWORK

COST CONTAIN

DRUG

HAF

GROSS CLAIMS

STOP LOSS

NET CLAIMS

POOLED PREMIUM

TOTAL ASO FEES

TOTAL SUBS

TOTAL MBRS

Jul-22

	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$119,428	$1,140,104	$1,232	$487,196	$12,660	$1,760,620	($9,672)	$1,750,948	$54,376	$21,973	1,134	2,768
		OAIN2-OAP IN-NETWORK PLAN CA	$3	$0	$0	$0	$11	$14	$0	$14	$49	$20	1	1
		OAIN4-OAP IN-NETWORK PLAN	$26,341	$652,084	$200	$53,719	$2,256	$734,600	($147,549)	$587,051	$9,874	$3,990	200	629
	PRODUCT TYPE Total		$145,772	$1,792,188	$1,432	$540,916	$14,927	$2,495,234	($157,221)	$2,338,013	$64,300	$25,983	1,335	3,398
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$9,558	$23,802	$0	$2,937	$1,171	$37,468	$0	$37,468	$4,986	$2,015	101	219
		LPIN3-LOCAL PLUS IN-NETWORK PLAN	$1,283	$3,059	$0	$663	$89	$5,094	$0	$5,094	$395	$160	8	21
	PRODUCT TYPE Total		$10,841	$26,860	$0	$3,601	$1,260	$42,562	$0	$42,562	$5,381	$2,175	109	240
	OAP1	HDPF1-OAP FAMILY HDHPQ	$15,635	$260,146	$1,585	$11,694	$1,517	$290,576	($9,214)	$281,363	$6,517	$2,633	131	393
		HDPF3-OAP FAMILY HDHPQ	$1,766	$3,536	$0	$1,390	$190	$6,881	$0	$6,881	$839	$339	17	50
		HDPI1-OAP INDIVIDUAL HDHPQ	$6,180	$51,121	$131	$6,069	$2,003	$65,505	$0	$65,505	$8,887	$3,591	181	181
		HDPI3-OAP INDIVIDUAL HDHPQ	$774	$4,624	$0	$21	$279	$5,699	$0	$5,699	$1,284	$519	26	26
		OAP1-OAP COPAY PLAN	$23,699	$184,114	$4,573	$62,637	$3,024	$278,047	$0	$278,047	$13,478	$5,446	274	570
		OAP3-OAP COPAY PLAN	$3,872	$95,619	$0	$16,633	$402	$116,526	($72)	$116,453	$1,777	$718	36	90
	PRODUCT TYPE Total		$51,925	$599,161	$6,289	$98,443	$7,416	$763,234	($9,286)	$753,948	$32,782	$13,247	665	1,310
	PRODUCT TYPE Total		$0	$4,123	$0	$0	$0	$4,123	$0	$4,123	$0	$748	2,111	4,955
Jul-2022 Total			$208,538	$2,528,668	$37,862	$642,959	$23,603	$3,441,631	($166,507)	$3,275,124	$102,463	$47,053	5,914	13,888
Aug-22

	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$118,253	$1,148,168	$1,158	$585,230	$12,477	$1,865,286	$0	$1,865,286	$54,996	$22,223	1,131	2,755
		OAIN2-OAP IN-NETWORK PLAN CA	$3	$0	$0	$0	$11	$14	$0	$14	$49	$20	1	1
		OAIN4-OAP IN-NETWORK PLAN	$26,685	$342,832	$0	$54,096	$2,256	$425,869	($155,084)	$270,785	$9,874	$3,990	200	624
	PRODUCT TYPE Total		$144,940	$1,491,001	$1,158	$639,325	$14,744	$2,291,169	($155,084)	$2,136,084	$64,919	$26,233	1,332	3,380
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$10,125	$32,830	$0	$4,602	$1,128	$48,686	$0	$48,686	$5,036	$2,035	102	217
		LPIN3-LOCAL PLUS IN-NETWORK PLAN	$884	$23,269	$45	$562	$89	$24,849	$0	$24,849	$395	$160	8	21
	PRODUCT TYPE Total		$11,009	$56,099	$45	$5,164	$1,218	$73,536	$0	$73,536	$5,431	$2,195	110	238
	OAP1	HDPF1-OAP FAMILY HDHPQ	$14,641	$39,438	$940	$12,230	$1,385	$68,634	$0	$68,634	$6,566	$2,653	132	395
		HDPF3-OAP FAMILY HDHPQ	$1,808	$9,037	$0	$1,470	$212	$12,528	$0	$12,528	$889	$359	18	52
		HDPI1-OAP INDIVIDUAL HDHPQ	$5,962	$18,246	$100	$1,729	$1,914	$27,950	$0	$27,950	$8,788	$3,551	179	179
		HDPI3-OAP INDIVIDUAL HDHPQ	$881	$220	$0	$83	$335	$1,519	$0	$1,519	$1,382	$559	28	28
		OAP1-OAP COPAY PLAN	$24,251	$124,685	$1,800	$81,123	$2,971	$234,830	$0	$234,830	$13,330	$5,387	272	567
		OAP3-OAP COPAY PLAN	$3,642	$31,476	$0	$18,893	$402	$54,413	$0	$54,413	$1,777	$718	36	89
	PRODUCT TYPE Total		$51,185	$223,101	$2,840	$115,528	$7,220	$399,874	$0	$399,874	$32,732	$13,227	665	1,310
	PRODUCT TYPE Total		$0	$4,775	$0	$0	$0	$4,775	$0	$4,775	$0	$752	2,108	4,933
Aug-2022 Total			$207,135	$1,894,867	$33,866	$760,017	$23,182	$2,919,068	($155,084)	$2,763,983	$103,082	$47,332	5,906	13,831
Sep-22

	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$122,865	$1,056,889	$25,876	$510,212	$12,778	$1,728,620	$0	$1,728,620	$56,134	$22,832	1,136	2,751
		OAIN2-OAP IN-NETWORK PLAN CA	$3	$0	$0	$0	$11	$14	$0	$14	$49	$20	1	1
		OAIN4-OAP IN-NETWORK PLAN	$27,148	$288,465	$2,571	$64,846	$2,279	$385,309	($20,683)	$364,626	$9,973	$4,030	202	627
	PRODUCT TYPE Total		$150,015	$1,345,354	$28,447	$575,058	$15,068	$2,113,942	($20,683)	$2,093,259	$66,156	$26,882	1,339	3,379
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$9,421	$92,417	$100	$3,600	$1,184	$106,721	$0	$106,721	$5,085	$2,055	103	216
		LPIN3-LOCAL PLUS IN-NETWORK PLAN	$881	$7,053	$0	$313	$89	$8,336	$0	$8,336	$395	$160	8	21
	PRODUCT TYPE Total		$10,302	$99,469	$100	$3,913	$1,273	$115,057	$0	$115,057	$5,480	$2,214	111	237
	OAP1	HDPF1-OAP FAMILY HDHPQ	$15,106	$44,638	$747	$19,501	$1,575	$81,567	$0	$81,567	$6,714	$2,713	135	401
		HDPF3-OAP FAMILY HDHPQ	$1,968	$4,303	$0	$235	$201	$6,707	$0	$6,707	$889	$359	18	52
		HDPI1-OAP INDIVIDUAL HDHPQ	$6,336	$7,722	$0	$3,993	$1,955	$20,006	$0	$20,006	$8,492	$3,431	172	172
		HDPI3-OAP INDIVIDUAL HDHPQ	$929	$639	$0	$339	$335	$2,242	$0	$2,242	$1,481	$599	30	30
		OAP1-OAP COPAY PLAN	$24,537	$617,388	$34,720	$42,413	$3,049	$722,107	($49,652)	$672,455	$13,330	$5,387	271	562
		OAP3-OAP COPAY PLAN	$3,839	$12,147	$1,868	$7,713	$424	$25,992	$0	$25,992	$1,827	$738	37	90
	PRODUCT TYPE Total		$52,715	$686,838	$37,336	$74,193	$7,540	$858,622	($49,652)	$808,970	$32,732	$13,227	663	1,307
Sep-2022 Total			$213,032	$2,254,282	$96,987	$653,164	$23,881	$3,241,346	($70,335)	$3,171,011	$104,368	$48,047	5,916	13,799
Oct-22

	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$114,945	$1,135,086	$20,413	$551,114	$12,633	$1,834,192	$0	$1,834,192	$54,238	$21,917	1,134	2,737
		OAIN2-OAP IN-NETWORK PLAN CA	$3	$0	$0	$0	$11	$14	$0	$14	$49	$20	1	1
		OAIN4-OAP IN-NETWORK PLAN	$27,608	$195,744	$2,319	$56,004	$2,212	$283,887	($71,806)	$212,081	$9,874	$3,990	200	620
	PRODUCT TYPE Total		$142,556	$1,330,830	$22,732	$607,118	$14,856	$2,118,092	($71,806)	$2,046,287	$64,161	$25,927	1,335	3,358
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$9,589	$160,037	$100	$6,090	$1,173	$176,988	$0	$176,988	$5,283	$2,135	107	223
		LPIN3-LOCAL PLUS IN-NETWORK PLAN	$881	$1,734	$0	$221	$89	$2,926	$0	$2,926	$395	$160	8	21
	PRODUCT TYPE Total		$10,471	$161,771	$100	$6,311	$1,262	$179,914	$0	$179,914	$5,678	$2,294	115	244
	OAP1	HDPF1-OAP FAMILY HDHPQ	$15,037	$37,369	$709	$16,344	$1,474	$70,933	$0	$70,933	$6,616	$2,673	133	401
		HDPF3-OAP FAMILY HDHPQ	$1,961	$22,094	$0	$575	$201	$24,831	$0	$24,831	$889	$359	18	53
		HDPI1-OAP INDIVIDUAL HDHPQ	$5,802	$8,257	$0	$12,828	$1,821	$28,707	$0	$28,707	$8,393	$3,392	170	170
		HDPI3-OAP INDIVIDUAL HDHPQ	$1,027	$99	$0	$2,174	$357	$3,658	$0	$3,658	$1,481	$599	30	30
		OAP1-OAP COPAY PLAN	$23,784	$122,715	$46,132	$81,906	$3,049	$277,586	($3,919)	$273,667	$13,824	$5,586	282	597
		OAP3-OAP COPAY PLAN	$3,835	$35,160	$0	$19,638	$413	$59,046	$0	$59,046	$1,827	$738	37	91
	PRODUCT TYPE Total		$51,447	$225,694	$46,841	$133,464	$7,316	$464,761	($3,919)	$460,842	$33,029	$13,347	670	1,342
Oct-2022 Total			$204,473	$1,825,825	$99,814	$746,892	$23,435	$2,900,439	($75,724)	$2,824,714	$102,867	$47,198	5,932	13,849
Nov-22

	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$121,395	$912,715	$20,294	$464,473	$12,723	$1,531,599	($4,894)	$1,526,704	$56,035	$22,910	1,135	2,738
		OAIN2-OAP IN-NETWORK PLAN CA	$3	$0	$0	$0	$11	$14	$0	$14	$49	$20	1	1
		OAIN4-OAP IN-NETWORK PLAN	$26,399	$216,957	$3,734	$68,157	$2,189	$317,437	($8,349)	$309,088	$9,825	$3,970	199	619
	PRODUCT TYPE Total		$147,797	$1,129,672	$24,028	$532,630	$14,923	$1,849,050	($13,244)	$1,835,806	$65,909	$26,900	1,335	3,358
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$9,881	$37,926	$0	$4,635	$1,218	$53,659	$0	$53,659	$5,184	$2,095	105	218
		LPIN3-LOCAL PLUS IN-NETWORK PLAN	$879	$11,760	$0	$217	$89	$12,945	$0	$12,945	$395	$160	8	21
	PRODUCT TYPE Total		$10,760	$49,686	$0	$4,851	$1,307	$66,604	$0	$66,604	$5,579	$2,254	113	239
	OAP1	HDPF1-OAP FAMILY HDHPQ	$15,034	$84,232	$1,269	$19,166	$1,474	$121,175	$0	$121,175	$6,517	$2,633	131	397
		HDPF3-OAP FAMILY HDHPQ	$1,932	$16,883	$100	$264	$201	$19,380	$0	$19,380	$938	$379	19	55
		HDPI1-OAP INDIVIDUAL HDHPQ	$5,596	$17,622	$0	$4,806	$1,877	$29,901	$0	$29,901	$8,393	$3,392	170	170
		HDPI3-OAP INDIVIDUAL HDHPQ	$1,002	$1,771	$300	$461	$313	$3,846	$0	$3,846	$1,382	$559	28	28
		OAP1-OAP COPAY PLAN	$25,171	$126,466	$36,272	$39,174	$3,418	$230,502	($855)	$229,646	$14,120	$5,706	287	604
		OAP3-OAP COPAY PLAN	$3,817	$12,820	$934	$16,901	$413	$34,886	$0	$34,886	$1,827	$738	37	91
	PRODUCT TYPE Total		$52,553	$259,794	$38,875	$80,773	$7,696	$439,691	($855)	$438,835	$33,177	$13,406	672	1,345
Nov-2022 Total			$211,110	$1,545,630	$81,592	$618,253	$23,926	$2,480,511	($14,099)	$2,466,413	$104,664	$48,254	5,918	13,819
Dec-22

	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$121,104	$987,141	$12,711	$567,242	$12,745	$1,700,943	($455)	$1,700,488	$54,501	$22,023	1,136	2,726
		OAIN2-OAP IN-NETWORK PLAN CA	$3	$0	$0	$0	$11	$14	$0	$14	$49	$20	1	1
		OAIN4-OAP IN-NETWORK PLAN	$27,749	$190,351	$1,211	$47,675	$2,178	$269,165	($5,637)	$263,528	$9,726	$3,930	197	618
	PRODUCT TYPE Total		$148,855	$1,177,492	$13,923	$614,917	$14,934	$1,970,121	($6,092)	$1,964,029	$64,276	$25,973	1,334	3,345
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$9,924	$6,494	$44	$4,809	$1,206	$22,478	$0	$22,478	$5,332	$2,155	108	224
		LPIN3-LOCAL PLUS IN-NETWORK PLAN	$957	$12,082	$0	$309	$89	$13,437	$0	$13,437	$395	$160	8	21
	PRODUCT TYPE Total		$10,881	$18,576	$44	$5,119	$1,296	$35,915	$0	$35,915	$5,727	$2,314	116	245
	OAP1	HDPF1-OAP FAMILY HDHPQ	$15,891	$136,835	$531	$22,278	$1,564	$177,098	$0	$177,098	$6,714	$2,713	135	408
		HDPF3-OAP FAMILY HDHPQ	$2,018	$8,830	$0	$389	$235	$11,472	$0	$11,472	$889	$359	18	53
		HDPI1-OAP INDIVIDUAL HDHPQ	$5,706	$13,981	$0	$6,428	$1,921	$28,037	$0	$28,037	$8,393	$3,392	170	170
		HDPI3-OAP INDIVIDUAL HDHPQ	$970	$27,508	$100	$2,173	$290	$31,041	$0	$31,041	$1,432	$579	29	29
		OAP1-OAP COPAY PLAN	$25,952	$175,608	$28,313	$66,259	$3,206	$299,337	($25,290)	$274,047	$14,219	$5,746	289	602
		OAP3-OAP COPAY PLAN	$4,218	$13,333	$6,552	$8,200	$413	$32,716	$0	$32,716	$1,827	$738	37	91
	PRODUCT TYPE Total		$54,754	$376,095	$35,495	$105,728	$7,629	$579,701	($25,290)	$554,411	$33,473	$13,526	678	1,353
Dec-2022 Total			$214,490	$1,671,672	$74,504	$725,764	$23,859	$2,710,288	($31,382)	$2,678,906	$103,476	$47,444	5,941	13,828
Jan-23

	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$119,276	$1,102,729	$15,632	$554,856	$12,600	$1,805,092	($341,947)	$1,463,145	$55,788	$20,452	1,130	2,709
		OAIN2-OAP IN-NETWORK PLAN CA	$3	$0	$0	$0	$11	$14	$0	$14	$49	$20	1	1
		OAIN4-OAP IN-NETWORK PLAN	$26,550	$136,312	$2,331	$54,456	$2,200	$221,850	($7,760)	$214,089	$9,677	$3,910	196	614
	PRODUCT TYPE Total		$145,829	$1,239,041	$17,963	$609,312	$14,811	$2,026,956	($349,708)	$1,677,248	$65,514	$24,382	1,327	3,324
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$9,818	$27,130	$600	$5,666	$1,195	$44,410	$0	$44,410	$5,283	$2,135	107	224
		LPIN3-LOCAL PLUS IN-NETWORK PLAN	$886	$76,932	$0	$136	$89	$78,043	$0	$78,043	$395	$160	8	21
	PRODUCT TYPE Total		$10,705	$104,062	$600	$5,802	$1,285	$122,453	$0	$122,453	$5,678	$2,294	115	245
	OAP1	HDPF1-OAP FAMILY HDHPQ	$15,388	$730,735	$100	$18,558	$1,519	$766,300	$0	$766,300	$6,862	$2,773	138	415
		HDPF3-OAP FAMILY HDHPQ	$2,104	$2,685	$0	$1,150	$190	$6,129	$0	$6,129	$839	$339	17	51
		HDPI1-OAP INDIVIDUAL HDHPQ	$5,705	$5,418	$300	$9,405	$1,921	$22,749	$0	$22,749	$8,442	$3,411	170	170
		HDPI3-OAP INDIVIDUAL HDHPQ	$926	$1,276	$100	$2,282	$313	$4,896	$0	$4,896	$1,432	$579	29	29
		OAP1-OAP COPAY PLAN	$25,626	$128,844	$3,250	$53,881	$3,306	$214,907	($4,217)	$210,690	$14,515	$5,865	295	607
		OAP3-OAP COPAY PLAN	$3,877	$29,310	$200	$11,000	$413	$44,800	$4,120	$48,920	$1,827	$738	37	91
	PRODUCT TYPE Total		$53,626	$898,267	$3,950	$96,276	$7,663	$1,059,781	($97)	$1,059,684	$33,917	$13,706	686	1,363
Jan-2023 Total			$210,160	$2,332,423	$50,056	$711,389	$23,759	$3,327,787	($349,805)	$2,977,982	$105,109	$45,792	5,931	13,767
Feb-23

	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$122,913	$995,288	$36,120	$648,920	$0	$1,803,241	$342,186	$2,145,427	$55,294	$20,598	1,120	2,706
		OAIN2-OAP IN-NETWORK PLAN CA	$3	$0	$0	$0	$0	$3	$0	$3	$49	$20	1	1
		OAIN4-OAP IN-NETWORK PLAN	$27,568	$757,212	$2,533	$87,795	$0	$875,108	($323,838)	$551,270	$9,775	$3,950	198	615
	PRODUCT TYPE Total		$150,484	$1,752,500	$38,653	$736,714	$0	$2,678,352	$18,348	$2,696,699	$65,119	$24,568	1,319	3,322
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$11,402	$56,133	$0	$6,373	$0	$73,908	$0	$73,908	$5,283	$2,135	107	224
		LPIN3-LOCAL PLUS IN-NETWORK PLAN	$920	$36,703	$0	$1,930	$0	$39,553	$0	$39,553	$444	$180	9	25
	PRODUCT TYPE Total		$12,321	$92,836	$0	$8,304	$0	$113,461	$0	$113,461	$5,727	$2,314	116	249
	OAP1	HDPF1-OAP FAMILY HDHPQ	$16,958	$79,353	$805	$15,077	$0	$112,193	($342,784)	($230,591)	$6,517	$2,633	131	397
		HDPF3-OAP FAMILY HDHPQ	$2,009	$3,065	$0	$418	$0	$5,492	$0	$5,492	$889	$359	18	54
		HDPI1-OAP INDIVIDUAL HDHPQ	$6,151	$11,868	$40	$6,854	$0	$24,913	$0	$24,913	$8,640	$3,491	175	175
		HDPI3-OAP INDIVIDUAL HDHPQ	$1,072	$1,488	$0	$2,273	$0	$4,832	$0	$4,832	$1,481	$599	30	30
		OAP1-OAP COPAY PLAN	$26,517	$221,409	$14,972	$75,125	$0	$338,023	($3,033)	$334,990	$14,268	$5,766	290	601
		OAP3-OAP COPAY PLAN	$4,011	$45,776	$0	$17,933	$0	$67,720	$0	$67,720	$1,827	$738	37	90
	PRODUCT TYPE Total		$56,718	$362,958	$15,817	$117,680	$0	$553,174	($345,817)	$207,357	$33,621	$13,586	681	1,347
Feb-2023 Total			$219,523	$2,288,568	$76,327	$862,699	$0	$3,447,117	($327,469)	$3,119,648	$104,467	$45,903	5,902	13,735
Mar-23

	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$102,900	$970,618	$32,551	$576,809	$24,842	$1,707,720	($19,098)	$1,688,622	$55,097	$20,730	1,117	2,692
		OAIN2-OAP IN-NETWORK PLAN CA	($4)	$0	$0	$0	$22	$18	$0	$18	$0	$0	0	0
		OAIN4-OAP IN-NETWORK PLAN	$23,822	$204,818	$4,749	$68,193	$4,423	$306,006	($54,609)	$251,397	$9,775	$3,950	198	614
	PRODUCT TYPE Total		$126,718	$1,175,436	$37,300	$645,002	$29,288	$2,013,744	($73,707)	$1,940,037	$64,872	$24,680	1,315	3,306
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$8,896	$63,860	$25	$7,992	$2,390	$83,163	$0	$83,163	$5,233	$2,115	106	223
		LPIN3-LOCAL PLUS IN-NETWORK PLAN	$904	$4,311	$0	$2,061	$212	$7,488	$0	$7,488	$444	$180	9	25
	PRODUCT TYPE Total		$9,800	$68,171	$25	$10,053	$2,603	$90,651	$0	$90,651	$5,678	$2,294	115	248
	OAP1	HDPF1-OAP FAMILY HDHPQ	$13,378	$124,009	$1,957	$9,691	$3,027	$152,062	($668)	$151,394	$6,616	$2,673	133	404
		HDPF3-OAP FAMILY HDHPQ	$1,795	$6,721	$0	$867	$380	$9,762	$0	$9,762	$889	$359	18	54
		HDPI1-OAP INDIVIDUAL HDHPQ	$5,098	$51,148	$45	$8,576	$3,910	$68,776	$0	$68,776	$8,837	$3,571	179	179
		HDPI3-OAP INDIVIDUAL HDHPQ	$899	$618	$0	$628	$715	$2,860	$0	$2,860	$1,481	$599	30	30
		OAP1-OAP COPAY PLAN	$23,743	$151,897	$10,685	$78,368	$6,445	$271,138	($3,845)	$267,293	$14,367	$5,805	292	601
		OAP3-OAP COPAY PLAN	$3,341	$19,171	$961	$20,823	$827	$45,122	$0	$45,122	$1,827	$738	37	90
	PRODUCT TYPE Total		$48,253	$353,564	$13,648	$118,952	$15,303	$549,720	($4,513)	$545,207	$34,016	$13,746	689	1,358
Mar-2023 Total			$184,771	$1,708,784	$75,917	$774,007	$47,193	$2,790,672	($78,220)	$2,712,452	$104,566	$46,160	5,900	13,706
Apr-23

	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$122,993	$1,076,603	$14,151	$552,836	$12,477	$1,779,060	($103,917)	$1,675,143	$55,294	$22,457	1,120	2,686
		OAIN2-OAP IN-NETWORK PLAN CA	$0	$0	$0	$0	($22)	($22)	$0	($22)	$0	$0	0	0
		OAIN4-OAP IN-NETWORK PLAN	$27,403	$251,676	$4,577	$93,563	$2,212	$379,431	($47,424)	$332,007	$9,677	$3,910	196	609
	PRODUCT TYPE Total		$150,397	$1,328,280	$18,727	$646,398	$14,666	$2,158,468	($151,340)	$2,007,128	$64,971	$26,367	1,316	3,295
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$11,183	$41,452	$25	$7,676	$1,184	$61,520	$0	$61,520	$5,332	$2,155	108	231
		LPIN3-LOCAL PLUS IN-NETWORK PLAN	$1,078	$3,671	$0	$295	$101	$5,144	$0	$5,144	$444	$180	9	25
	PRODUCT TYPE Total		$12,261	$45,123	$25	$7,970	$1,285	$66,664	$0	$66,664	$5,776	$2,334	117	256
	OAP1	HDPF1-OAP FAMILY HDHPQ	$16,477	$43,119	$1,020	$21,180	$1,407	$83,204	$0	$83,204	$6,517	$2,633	131	399
		HDPF3-OAP FAMILY HDHPQ	$2,190	$4,575	$0	$947	$201	$7,914	$0	$7,914	$889	$359	18	54
		HDPI1-OAP INDIVIDUAL HDHPQ	$6,368	$54,638	$0	$33,078	$2,133	$96,218	$0	$96,218	$8,985	$3,631	182	182
		HDPI3-OAP INDIVIDUAL HDHPQ	$1,148	$555	$0	$9,101	$335	$11,139	$0	$11,139	$1,432	$579	29	29
		OAP1-OAP COPAY PLAN	$26,769	$222,475	$5,484	$72,324	$3,306	$330,357	($4,638)	$325,719	$14,416	$5,825	293	599
		OAP3-OAP COPAY PLAN	$3,918	$16,887	$1,231	$6,680	$413	$29,129	$0	$29,129	$1,827	$738	37	90
	PRODUCT TYPE Total		$56,871	$342,249	$7,735	$143,310	$7,797	$557,961	($4,638)	$553,323	$34,065	$13,766	690	1,353
Apr-2023 Total			$219,529	$1,838,432	$51,425	$797,678	$23,747	$2,930,811	($155,979)	$2,774,832	$104,813	$48,129	5,913	13,692
May-23

	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$129,110	$1,328,864	$36,056	$537,215	$12,678	$2,043,923	($37,277)	$2,006,646	$55,492	$21,450	1,125	2,682
		OAIN4-OAP IN-NETWORK PLAN	$27,502	$178,777	$23,316	$97,863	$2,145	$329,602	($65,305)	$264,297	$9,627	$3,890	195	602
	PRODUCT TYPE Total		$156,612	$1,507,641	$59,372	$635,077	$14,823	$2,373,525	($102,582)	$2,270,943	$65,119	$25,341	1,320	3,284
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$11,521	$92,600	$0	$10,152	$1,229	$115,501	$0	$115,501	$5,332	$2,155	108	229
		LPIN3-LOCAL PLUS IN-NETWORK	$1,288	$6,153	$0	$1,203	$101	$8,744	$0	$8,744	$444	$180	9	25
	PRODUCT TYPE Total		$12,809	$98,753	$0	$11,354	$1,329	$124,246	$0	$124,246	$5,776	$2,334	117	254
	OAP1	HDPF1-OAP FAMILY HDHPQ	$17,254	$70,416	$3,339	$25,924	$1,452	$118,386	$0	$118,386	$6,714	$2,713	135	411
		HDPF3-OAP FAMILY HDHPQ	$2,171	$13,262	$0	$1,295	$201	$16,929	$0	$16,929	$889	$359	18	54
		HDPI1-OAP INDIVIDUAL HDHPQ	$6,713	$47,413	$0	$35,088	$2,078	$91,292	$0	$91,292	$9,084	$3,671	184	184
		HDPI3-OAP INDIVIDUAL HDHPQ	$1,033	$192	$0	$3,634	$302	$5,161	$0	$5,161	$1,432	$579	29	29
		OAP1-OAP COPAY PLAN	$27,559	$278,567	$39,701	$94,586	$3,217	$443,630	($41,257)	$402,373	$14,268	$5,766	290	589
		OAP3-OAP COPAY PLAN	$3,957	$53,461	$8	$5,225	$413	$63,063	$0	$63,063	$1,827	$738	37	89
	PRODUCT TYPE Total		$58,687	$463,312	$43,047	$165,752	$7,663	$738,461	($41,257)	$697,205	$34,213	$13,825	693	1,356
May-2023 Total			$228,108	$2,166,626	$130,398	$812,184	$23,814	$3,361,131	($143,838)	$3,217,293	$105,109	$47,168	5,928	13,655
Jun-23

	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$130,519	$1,254,338	$24,077	$625,419	$12,544	$2,046,897	($94,759)	$1,952,138	$55,492	$22,424	1,124	2,675
		OAIN4-OAP IN-NETWORK PLAN	$26,673	$163,146	$5,184	$91,327	$2,122	$288,453	($57,434)	$231,018	$9,627	$3,890	195	600
	PRODUCT TYPE Total		$157,191	$1,417,485	$29,261	$716,747	$14,666	$2,335,350	($152,194)	$2,183,156	$65,119	$26,314	1,319	3,275
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$10,753	$108,903	$0	$11,431	$1,206	$132,293	$0	$132,293	$5,431	$2,195	110	232
		LPIN3-LOCAL PLUS IN-NETWORK PLAN	$1,081	$6,009	$0	$430	$134	$7,653	$0	$7,653	$494	$200	10	26
	PRODUCT TYPE Total		$11,834	$114,912	$0	$11,860	$1,340	$139,947	$0	$139,947	$5,924	$2,394	120	258
	OAP1	HDPF1-OAP FAMILY HDHPQ	$16,768	$104,315	$5,049	$20,703	$1,608	$148,443	$0	$148,443	$6,665	$2,693	134	408
		HDPF3-OAP FAMILY HDHPQ	$2,157	$51,802	$0	$731	$201	$54,892	$0	$54,892	$889	$359	18	55
		HDPI1-OAP INDIVIDUAL HDHPQ	$7,732	$37,189	$0	$65,765	$2,078	$112,763	$0	$112,763	$9,133	$3,691	185	185
		HDPI3-OAP INDIVIDUAL HDHPQ	$1,061	$1,276	$0	$4,180	$447	$6,963	$0	$6,963	$1,481	$599	30	30
		OAP1-OAP COPAY PLAN	$27,699	$222,360	$14,139	$69,006	$3,150	$336,355	($2,281)	$334,074	$14,120	$5,706	286	586
		OAP2-OAP COPAY PLAN CA	$0	$0	$0	$0	$11	$11	$0	$11	$0	$0	0	0
		OAP3-OAP COPAY PLAN	$3,878	$14,817	$287	$21,573	$436	$40,991	$0	$40,991	$1,925	$778	39	93
	PRODUCT TYPE Total		$59,295	$431,759	$19,476	$181,958	$7,931	$700,418	($2,281)	$698,137	$34,213	$13,825	692	1,357
Jun-2023 Total			$228,320	$2,064,919	$80,146	$910,565	$23,937	$3,307,887	($154,474)	$3,153,412	$105,257	$48,181	5,921	13,623

Grand Total $2,549,188 $24,120,696 $888,895 $9,015,572 $284,337 $36,858,687 ($1,722,917) $35,135,770 $1,250,240 $566,661 71,022 165,192

&G &7This report contains proprietary and/or confidential information. Disclosure is strictly prohibited except to the extent required by law. ADVICE Reporting System &8Page &P of &N Date: 7/8/2023

&7HAF includes charges for such health advocacy programs as disease/condition management and health coaching.

Large Claims 2022

CITY OF SCOTTSDALE
CLAIMS EXCEEDING REPORT
July 2022 thru June 2023
Rating Type : POOLED STOP LOSS, RETROSPECTIVE EXPERIENCE RATED
Claims Exceeding : $25,000.00
Reported Claims: InNet, OutNet, Drug
Note: Diagnosis is based on the largest medical claim amount
	REL	GENDER	ICD CODE	ICD DESCRIPTION	ICD VERSION	DRUG CLAIMS	PAID CLAIMS	CLAIMANT TOTAL
	EE	M	Z5112	ENCOUNTER FOR ANTINEOPLASTIC IMMUNOTHERAPY	10	$164,211	$727,475	$891,686
	EE	M	I63312	CEREBRAL INFRC DUE TO THOMBOS OF LEFT MIDDLE CEREBRAL ARTERY	10	$1,733	$749,507	$751,240
	EE	F	M3213	LUNG INVOLVEMENT IN SYSTEMIC LUPUS ERYTHEMATOSUS	10	$5,130	$696,957	$702,087
	SP	F	C712	MALIGNANT NEOPLASM OF TEMPORAL LOBE	10	$19,936	$454,717	$474,653
	CH	F	I5041	ACUTE COMBINED SYSTOLIC AND DIASTOLIC (CONGESTIVE) HRT FAIL	10	$7,730	$456,238	$463,968
	EE	M	N186	END STAGE RENAL DISEASE	10	$198,491	$198,051	$396,541
	EE	F	E0500	THYROTOXICOSIS W DIFFUSE GOITER W/O THYROTOXIC CRISIS	10	$868	$332,397	$333,265
	SP	F	Z45018	ENCOUNTER FOR ADJUST AND MGMT OTH PRT CARDIAC PACEMAKER	10	$59,788	$219,371	$279,159
	CH	M	N2889	OTHER SPECIFIED DISORDERS OF KIDNEY AND URETER	10	$212,563	$65,222	$277,785
	SP	F	R0602	SHORTNESS OF BREATH	10	$261,833	$15,150	$276,984
	CH	M	G0400	ACUTE DISSEMINATED ENCEPHALITIS AND ENCEPHALOMYELITIS, UNSP	10	$2,663	$271,699	$274,362
	SP	F	H5711	OCULAR PAIN, RIGHT EYE	10	$223,757	$3,718	$227,474
	CH	F	E840	CYSTIC FIBROSIS WITH PULMONARY MANIFESTATIONS	10	$199,297	$1,350	$200,647
	EE	M	C9110	CHRONIC LYMPHOCYTIC LEUK OF B-CELL TYPE NOT ACHIEVE REMIS	10	$183,790	$16,709	$200,498
	SP	F	G7000	MYASTHENIA GRAVIS WITHOUT (ACUTE) EXACERBATION	10	$637	$185,465	$186,101
	EE	F	A4159	OTHER GRAM-NEGATIVE SEPSIS	10	$1,794	$161,240	$163,033
	EE	M	K5090	CROHN'S DISEASE, UNSPECIFIED, WITHOUT COMPLICATIONS	10	$156,238	$6,657	$162,895
	EE	M	Z1211	ENCOUNTER FOR SCREENING FOR MALIGNANT NEOPLASM OF COLON	10	$155,851	$3,068	$158,920
	EE	F	G35	MULTIPLE SCLEROSIS	10	$1,486	$154,226	$155,712
	CH	F	C9100	ACUTE LYMPHOBLASTIC LEUKEMIA NOT HAVING ACHIEVED REMISSION	10	$669	$147,962	$148,632
	EE	F	M8468XA	PATHOLOGICAL FRACTURE IN OTH DISEASE, OTH SITE, INIT FOR FX	10	$3,191	$145,070	$148,260
	EE	M	I25118	ATHSCL HEART DISEASE OF NATIVE COR ART W OTH ANG PCTRS	10	$2,460	$144,116	$146,576
	SP	M	K56600	PARTIAL INTESTINAL OBSTRUCTION, UNSPECIFIED AS TO CAUSE	10	$122,089	$21,169	$143,258
	EE	M	D120	BENIGN NEOPLASM OF CECUM	10	$132,396	$8,035	$140,431
	CH	M	N1370	VESICOURETERAL-REFLUX, UNSPECIFIED	10	$1,939	$133,825	$135,764
	EE	M	F1020	ALCOHOL DEPENDENCE, UNCOMPLICATED	10	$80	$133,119	$133,198
	EE	M	I25118	ATHSCL HEART DISEASE OF NATIVE COR ART W OTH ANG PCTRS	10	$0	$129,611	$129,611
	EE	M	K8521	ALCOHOL INDUCED ACUTE PANCREATITIS WITH UNINFECTED NECROSIS	10	$39,625	$89,817	$129,442
	EE	M	J069	ACUTE UPPER RESPIRATORY INFECTION, UNSPECIFIED	10	$126,726	$1,171	$127,897
	EE	F	Z5111	ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY	10	$1,494	$126,215	$127,709
	EE	M	N486	INDURATION PENIS PLASTICA	10	$24,175	$102,168	$126,343
	EE	M	C9210	CHRONIC MYELOID LEUK, BCR/ABL-POSITIVE, NOT ACHIEVE REMIS	10	$124,904	$1,438	$126,342
	EE	M	D333	BENIGN NEOPLASM OF CRANIAL NERVES	10	$0	$125,355	$125,355
	SP	F	K8066	CALCULUS OF GB AND BILE DUCT W AC AND CHR CHOLECYST W/O OBST	10	$123	$124,093	$124,216
	EE	M	I25118	ATHSCL HEART DISEASE OF NATIVE COR ART W OTH ANG PCTRS	10	$19,432	$104,676	$124,108
	CH	M	E230	HYPOPITUITARISM	10	$121,857	$1,457	$123,314
	EE	M	C73	MALIGNANT NEOPLASM OF THYROID GLAND	10	$73,929	$43,565	$117,494
	SP	M	A419	SEPSIS, UNSPECIFIED ORGANISM	10	$342	$114,691	$115,034
	SP	F	N186	END STAGE RENAL DISEASE	10	$1,030	$111,798	$112,827
	EE	M	C61	MALIGNANT NEOPLASM OF PROSTATE	10	$11,798	$98,532	$110,330
	EE	F	PH	PHARMACY	*	$107,283	$0	$107,283
	CH	F	Z3830	TWIN LIVEBORN INFANT, DELIVERED VAGINALLY	10	$196	$105,204	$105,400
	CH	M	Z00129	ENCNTR FOR ROUTINE CHILD HEALTH EXAM W/O ABNORMAL FINDINGS	10	$102,397	$1,463	$103,860

&G &7This report contains proprietary and/or confidential information. Disclosure is strictly prohibited except to the extent required by law. ADVICE Reporting System &8Page &P of &N Date: 7/8/2023

&7Cigna makes no warranty, express or implied, as to content and disclaims all liability arising directly or indirectly from use or reliance upon its contents by any third party even if Cigna has been advised of an intended use.

2023.2024 Exp

CITY OF SCOTTSDALE

MONTHLY HEALTHCARE DETAIL EXPERIENCE REPORT

July 2023 thru June 2024

Rating Type : RETROSPECTIVE EXPERIENCE RATED

Reported Premium: Billed Pooled Premium, ASO Fees

Reported Claims: All Claims

Note: Paid claim dollars include amounts deducted from your account and paid to vendors for cost containment services.

YTD/MONTH

PRODUCT TYPE

BENEFIT OPTION

FIXED CHARGES

IN NETWORK

COST CONTAIN

DRUG

HAF

GROSS CLAIMS

STOP LOSS

NET CLAIMS

POOLED PREMIUM

TOTAL ASO FEES

TOTAL SUBS

TOTAL MBRS

Jul-23

	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$124,355	$978,086	$33,020	$525,271	$12,644	$1,673,375	($4,546)	$1,668,829	$65,439	$20,256	1,119	2,656
		OAIN4-OAP IN-NETWORK PLAN OAIN4-OAP IN-Network ONLY	$26,751	$175,915	$15,087	$59,869	$2,078	$279,701	($27,080)	$252,621	$10,994	$3,751	189	590
	PRODUCT TYPE Total		$151,106	$1,154,001	$48,107	$585,140	$14,722	$1,953,076	($31,626)	$1,921,450	$76,433	$24,007	1,308	3,246
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$10,848	$96,984	$0	$9,272	$1,296	$118,400	$0	$118,400	$6,082	$2,075	104	214
		LPIN3-LOCAL PLUS IN-NETWORK PLAN 001	$1,131	$2,302	$0	$335	($11)	$3,756	$0	$3,756	$585	$200	11	29
	PRODUCT TYPE Total		$11,979	$99,286	$0	$9,607	$1,285	$122,156	$0	$122,156	$6,667	$2,274	115	243
	OAP1	HDPF1-OAP FAMILY HDHPQ	$16,658	$63,070	$2,653	$12,145	$1,508	$96,034	$0	$96,034	$7,719	$2,633	131	396
		HDPF3-OAP FAMILY HDHPQ 001 ONLY	$3,260	$6,511	$0	$579	$201	$10,552	$0	$10,552	$1,053	$359	18	55
		HDPI1-OAP INDIVIDUAL HDHPQ	$6,652	$21,142	$0	$40,544	$2,200	$70,539	$0	$70,539	$11,170	$3,810	192	192
		HDPI3-OAP INDIVIDUAL HDHPQ 001 ONLY	$1,090	$316	$0	$2,654	$391	$4,451	$0	$4,451	$2,105	$718	36	36
		OAP1-OAP COPAY PLAN	$25,746	$320,091	$20,059	$82,703	$3,273	$451,873	$0	$451,873	$16,725	$5,706	288	593
		OAP2-OAP COPAY PLAN CA	$0	$0	$0	$0	($11)	($11)	$0	($11)	$0	$0	0	0
		OAP3-OAP COPAY PLAN 001 ONLY	$4,017	$11,363	$985	$4,821	$413	$21,599	$0	$21,599	$2,105	$718	36	93
	PRODUCT TYPE Total		$57,423	$422,493	$23,697	$143,447	$7,975	$655,036	$0	$655,036	$40,878	$13,945	701	1,365
Jul-2023 Total			$220,508	$1,772,738	$105,378	$738,195	$23,982	$2,860,800	($31,626)	$2,829,174	$123,978	$45,749	5,967	13,650
Aug-23

OAPIN	OAIN1-OAP IN-NETWORK PLAN	$123,245	$1,148,896	$24,866	$618,020	$11,974	$1,927,002	$0	$1,927,002	$65,322	$20,409	1,117	2,637
	OAIN4-OAP IN-NETWORK PLAN 001 ONLY	$26,082	$245,069	$3,247	$65,107	$2,100	$341,605	$0	$341,605	$11,053	$3,771	189	591
PRODUCT TYPE Total		$149,327	$1,393,966	$28,113	$683,127	$14,074	$2,268,607	$0	$2,268,607	$76,375	$24,179	1,306	3,228
OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$10,266	$37,658	$0	$11,090	$1,173	$60,187	$0	$60,187	$6,316	$2,155	108	224
	LPIN3-LOCAL PLUS IN-NETWORK PLAN 001	$1,144	$3,374	$0	$234	$89	$4,841	$0	$4,841	$585	$200	10	28
PRODUCT TYPE Total		$11,410	$41,032	$0	$11,324	$1,262	$65,028	$0	$65,028	$6,901	$2,354	118	252
OAP1	HDPF1-OAP FAMILY HDHPQ	$15,833	$93,706	$802	$24,938	$1,385	$136,664	$0	$136,664	$8,012	$2,733	136	420
	HDPF3-OAP FAMILY HDHPQ 001 ONLY	$2,229	$8,359	$0	$1	$201	$10,790	$0	$10,790	$1,053	$359	18	55
	HDPI1-OAP INDIVIDUAL HDHPQ	$6,908	$30,895	$0	$67,352	$2,200	$107,355	$0	$107,355	$11,170	$3,810	191	191
	HDPI3-OAP INDIVIDUAL HDHPQ 001 ONLY	$1,322	$620	$0	$3,716	$380	$6,038	$0	$6,038	$2,281	$778	38	38
	OAP1-OAP COPAY PLAN	$26,756	$98,702	$8,728	$54,662	$3,161	$192,009	$0	$192,009	$17,076	$5,825	293	598
	OAP3-OAP COPAY PLAN 001 ONLY	$4,135	$15,382	$3,757	$4,941	$380	$28,595	$0	$28,595	$2,164	$738	37	95
PRODUCT TYPE Total		$57,183	$247,664	$13,288	$155,609	$7,707	$481,451	$0	$481,451	$41,755	$14,244	713	1,397

	PRODUCT TYPE Total		$0	$4,784	$0	$0	$0	$4,784	$0	$4,784	$0	$736	2,138	4,882
Aug-2023 Total			$217,920	$1,795,022	$73,455	$850,060	$23,044	$2,959,502	$0	$2,959,502	$125,030	$46,275	5,998	13,700
Sep-23
	PRODUCT TYPE Total		$0	$105,180	$20,529	$0	$0	$125,710	$0	$125,710	$0	$5,429	1,718	3,911
	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$119,022	$1,276,888	$38,180	$656,842	$12,622	$2,103,553	$0	$2,103,553	$65,147	$25,411	1,114	2,608
		OAIN4-OAP IN-NETWORK PLAN 001 ONLY	$26,007	$247,290	$641	$52,863	$2,223	$329,024	$0	$329,024	$11,287	$3,850	193	600
	PRODUCT TYPE Total		$145,029	$1,524,177	$38,821	$709,705	$14,845	$2,432,577	$0	$2,432,577	$76,433	$29,261	1,307	3,208
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$10,205	$99,664	$0	$10,878	$1,273	$122,021	$0	$122,021	$6,374	$2,175	109	227
		LPIN3-LOCAL PLUS IN-NETWORK PLAN 001	$1,209	$763	$0	$1,279	$112	$3,362	$0	$3,362	$585	$200	10	28
	PRODUCT TYPE Total		$11,414	$100,427	$0	$12,157	$1,385	$125,383	$0	$125,383	$6,959	$2,374	119	255
	OAP1	HDPF1-OAP FAMILY HDHPQ	$16,935	$39,878	$100	$23,001	$1,597	$81,511	$0	$81,511	$8,012	$2,733	136	414
		HDPF3-OAP FAMILY HDHPQ 001 ONLY	$2,208	$37,639	$0	$117	$201	$40,165	$0	$40,165	$1,053	$359	18	55
		HDPI1-OAP INDIVIDUAL HDHPQ	$6,946	$23,445	$200	$46,624	$2,111	$79,326	$0	$79,326	$11,053	$3,771	188	188
		HDPI3-OAP INDIVIDUAL HDHPQ 001 ONLY	$1,334	$3,184	$100	$9,514	$480	$14,613	$0	$14,613	$2,222	$758	37	37
		OAP1-OAP COPAY PLAN	$29,132	$112,744	$2,632	$85,834	$3,396	$233,737	$0	$233,737	$17,310	$5,905	297	609
		OAP3-OAP COPAY PLAN 001 ONLY	$3,978	$54,150	$552	$8,737	$413	$67,830	$0	$67,830	$2,047	$698	35	91
	PRODUCT TYPE Total		$60,532	$271,041	$3,584	$173,827	$8,199	$517,183	$0	$517,183	$41,696	$14,224	711	1,394

	PRODUCT TYPE Total		$0	$3,571	$0	$0	$0	$3,571	$0	$3,571	$0	$828	2,138	4,862
Sep-2023 Total			$216,975	$2,004,397	$62,934	$895,689	$24,429	$3,204,424	$0	$3,204,424	$125,089	$52,116	5,993	13,630
Oct-23
	PRODUCT TYPE Total		$0	$101,543	$29,466	$0	$0	$131,010	$0	$131,010	$0	$4,525	1,716	3,905
	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$120,615	$1,069,732	$31,190	$553,479	$12,365	$1,787,381	$0	$1,787,381	$65,205	$17,727	1,115	2,611
		OAIN4-OAP IN-NETWORK PLAN 001 ONLY	$26,711	$135,366	$597	$66,453	$2,133	$231,261	$0	$231,261	$11,228	$3,830	192	592
	PRODUCT TYPE Total		$147,326	$1,205,098	$31,787	$619,932	$14,499	$2,018,642	$0	$2,018,642	$76,433	$21,558	1,307	3,203
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$10,699	$47,431	$5	$11,898	$1,206	$71,240	$0	$71,240	$6,316	$2,155	108	224
		LPIN3-LOCAL PLUS IN-NETWORK PLAN 001	$1,211	($910)	$0	$1,054	$112	$1,466	$0	$1,466	$585	$200	10	28
	PRODUCT TYPE Total		$11,910	$46,521	$5	$12,952	$1,318	$72,706	$0	$72,706	$6,901	$2,354	118	252
	OAP1	HDPF1-OAP FAMILY HDHPQ	$16,854	$39,681	$340	$21,150	$1,575	$79,600	$0	$79,600	$8,012	$2,733	136	410
		HDPF3-OAP FAMILY HDHPQ 001 ONLY	$2,210	$19,331	$0	$699	$179	$22,419	$0	$22,419	$994	$339	17	52
		HDPI1-OAP INDIVIDUAL HDHPQ	$6,763	$25,029	$0	$64,246	$2,044	$98,082	$0	$98,082	$10,819	$3,691	185	185
		HDPI3-OAP INDIVIDUAL HDHPQ 001 ONLY	$1,382	$11,613	$13	$2,441	$391	$15,840	$0	$15,840	$2,222	$758	37	37
		OAP1-OAP COPAY PLAN	$27,138	$142,553	$3,908	$87,471	$3,385	$264,453	$0	$264,453	$17,310	$5,905	297	606
		OAP3-OAP COPAY PLAN 001 ONLY	$4,043	$5,872	$669	$8,507	$369	$19,459	$0	$19,459	$2,047	$698	35	93
	PRODUCT TYPE Total		$58,391	$244,079	$4,929	$184,513	$7,942	$499,854	$0	$499,854	$41,404	$14,125	707	1,383

	PRODUCT TYPE Total		$0	$4,210	$0	$0	$0	$4,210	$0	$4,210	$0	$687	2,133	4,843
Oct-2023 Total			$217,627	$1,601,451	$66,187	$817,398	$23,759	$2,726,422	$0	$2,726,422	$124,738	$43,248	5,981	13,586
Nov-23
	PRODUCT TYPE Total		$0	$97,581	$18,504	$0	$0	$116,086	$0	$116,086	$0	$5,039	1,714	3,899
	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$132,482	$1,264,454	$30,213	$641,008	$12,555	$2,080,712	($168,734)	$1,911,977	$65,381	$21,848	1,118	2,613
		OAIN4-OAP IN-NETWORK PLAN 001 ONLY	$29,260	$184,775	$439	$61,581	$2,212	$278,268	$0	$278,268	$11,287	$3,850	193	596
	PRODUCT TYPE Total		$161,741	$1,449,229	$30,652	$702,590	$14,767	$2,358,979	($168,734)	$2,190,245	$76,667	$25,698	1,311	3,209
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$11,610	$35,286	$0	$21,712	$1,262	$69,870	$0	$69,870	$6,433	$2,195	110	228
		LPIN3-LOCAL PLUS IN-NETWORK PLAN 001	$1,375	$2,767	$0	$285	$89	$4,517	$0	$4,517	$526	$180	9	24
	PRODUCT TYPE Total		$12,986	$38,053	$0	$21,997	$1,352	$74,387	$0	$74,387	$6,959	$2,374	119	252
	OAP1	HDPF1-OAP FAMILY HDHPQ	$18,640	$74,929	($340)	$21,229	$1,530	$115,989	$0	$115,989	$8,070	$2,753	137	414
		HDPF3-OAP FAMILY HDHPQ 001 ONLY	$3,303	$96,567	$0	$1,493	$212	$101,576	$0	$101,576	$1,053	$359	18	54
		HDPI1-OAP INDIVIDUAL HDHPQ	$7,472	$27,320	$0	$73,524	$1,988	$110,304	$0	$110,304	$10,702	$3,651	183	183
		HDPI3-OAP INDIVIDUAL HDHPQ 001 ONLY	$1,483	$585	$0	$3,453	$436	$5,956	$0	$5,956	$2,164	$738	37	37
		OAP1-OAP COPAY PLAN	$30,399	$117,221	$4,728	$73,287	$3,273	$228,909	$0	$228,909	$17,252	$5,885	296	603
		OAP3-OAP COPAY PLAN 001 ONLY	$4,413	$13,824	$0	$5,235	$391	$23,863	$0	$23,863	$2,047	$698	35	93
	PRODUCT TYPE Total		$65,710	$330,447	$4,388	$178,221	$7,830	$586,596	$0	$586,596	$41,287	$14,085	706	1,384

	PRODUCT TYPE Total		$0	$2,341	$0	$0	$0	$2,341	$0	$2,341	$0	$769	2,136	4,849
Nov-2023 Total			$240,437	$1,917,651	$53,545	$902,807	$23,948	$3,138,389	($168,734)	$2,969,655	$124,913	$47,965	5,986	13,593
Dec-23
	PRODUCT TYPE Total		$0	$82,294	$30,306	$0	$0	$112,600	$0	$112,600	$0	$4,826	1,713	3,885
	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$133,352	$1,071,923	$27,969	$654,822	$12,499	$1,900,566	($61,386)	$1,839,179	$65,381	$20,546	1,119	2,607
		OAIN4-OAP IN-NETWORK PLAN 001 ONLY	$29,725	$108,446	$2,126	$63,041	$2,122	$205,461	$0	$205,461	$11,170	$3,810	191	593
	PRODUCT TYPE Total		$163,077	$1,180,369	$30,096	$717,863	$14,622	$2,106,026	($61,386)	$2,044,640	$76,550	$24,356	1,310	3,200
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$11,607	$43,261	$0	$14,333	$1,229	$70,430	$0	$70,430	$6,433	$2,195	110	227
		LPIN3-LOCAL PLUS IN-NETWORK PLAN 001	$1,265	$4,897	$0	$1,079	$101	$7,341	$0	$7,341	$526	$180	9	24
	PRODUCT TYPE Total		$12,872	$48,158	$0	$15,412	$1,329	$77,771	$0	$77,771	$6,959	$2,374	119	251
	OAP1	HDPF1-OAP FAMILY HDHPQ	$18,757	$107,064	($1,190)	$37,299	$1,564	$163,493	$0	$163,493	$8,246	$2,813	140	420
		HDPF3-OAP FAMILY HDHPQ 001 ONLY	$2,496	$62,943	$0	$1,269	$201	$66,909	$0	$66,909	$1,053	$359	18	54
		HDPI1-OAP INDIVIDUAL HDHPQ	$7,181	$47,884	$0	$70,003	$2,122	$127,190	$0	$127,190	$11,053	$3,771	189	189
		HDPI3-OAP INDIVIDUAL HDHPQ 001 ONLY	$1,511	$1,329	$0	$10,340	$391	$13,570	$0	$13,570	$2,105	$718	36	36
		OAP1-OAP COPAY PLAN	$30,162	$76,969	$4,880	$56,841	$3,262	$172,114	$0	$172,114	$17,310	$5,905	297	604
		OAP3-OAP COPAY PLAN 001 ONLY	$4,512	$94,433	$55	$7,737	$391	$107,128	$0	$107,128	$2,047	$698	35	93
	PRODUCT TYPE Total		$64,619	$390,621	$3,745	$183,489	$7,931	$650,403	$0	$650,403	$41,813	$14,264	715	1,396

	PRODUCT TYPE Total		$0	$2,670	$0	$0	$0	$2,670	$0	$2,670	$0	$740	2,145	4,852
Dec-2023 Total			$240,568	$1,704,111	$64,147	$916,764	$23,881	$2,949,471	($61,386)	$2,888,085	$125,323	$46,561	6,002	13,584
Jan-24
	PRODUCT TYPE Total		$0	$101,872	$27,240	$0	$0	$129,112	$0	$129,112	$0	$4,793	1,694	3,850
	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$132,252	$1,090,248	$10,607	$571,359	$12,466	$1,816,931	($43,282)	$1,773,650	$65,030	$20,592	1,112	2,586
		OAIN4-OAP IN-NETWORK PLAN 001 ONLY	$29,159	$327,923	$1,247	$54,560	$2,055	$414,944	($34,886)	$380,058	$10,760	$3,671	185	573
	PRODUCT TYPE Total		$161,411	$1,418,170	$11,854	$625,918	$14,521	$2,231,875	($78,168)	$2,153,707	$75,790	$24,263	1,297	3,159
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$12,185	$38,711	$0	$17,565	$1,229	$69,689	$0	$69,689	$6,374	$2,175	109	227
		LPIN3-LOCAL PLUS IN-NETWORK PLAN 001	$1,199	$9,529	$0	$498	$101	$11,326	$0	$11,326	$468	$160	8	23
	PRODUCT TYPE Total		$13,384	$48,239	$0	$18,063	$1,329	$81,015	$0	$81,015	$6,842	$2,334	117	250
	OAP1	HDPF1-OAP FAMILY HDHPQ	$18,917	$81,450	($209)	$19,151	$1,575	$120,884	$0	$120,884	$8,129	$2,773	138	414
		HDPF3-OAP FAMILY HDHPQ 001 ONLY	$2,423	$52,167	$0	$611	$201	$55,402	$0	$55,402	$1,053	$359	18	54
		HDPI1-OAP INDIVIDUAL HDHPQ	$7,543	$18,846	$0	$39,670	$2,111	$68,171	$0	$68,171	$10,936	$3,731	187	187
		HDPI3-OAP INDIVIDUAL HDHPQ 001 ONLY	$1,415	$1,479	$0	$109	$402	$3,405	$0	$3,405	$2,047	$698	35	35
		OAP1-OAP COPAY PLAN	$29,976	$153,601	$11,427	$96,665	$3,385	$295,054	$0	$295,054	$17,252	$5,885	296	609
		OAP3-OAP COPAY PLAN 001 ONLY	$4,512	$51,665	$0	$6,795	$391	$63,363	$0	$63,363	$2,047	$698	35	93
	PRODUCT TYPE Total		$64,787	$359,209	$11,219	$163,001	$8,065	$606,280	$0	$606,280	$41,462	$14,145	709	1,392

	PRODUCT TYPE Total		$0	$2,917	$0	$0	$0	$2,917	$0	$2,917	$0	$735	2,123	4,804
Jan-2024 Total			$239,582	$1,930,408	$50,312	$806,982	$23,915	$3,051,199	($78,168)	$2,973,031	$124,095	$46,270	5,940	13,455
Feb-24
	PRODUCT TYPE Total		$0	$79,992	$26,737	$0	$0	$106,729	$0	$106,729	$0	$4,594	1,689	3,845
	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$131,996	$949,219	$24,563	$423,576	$12,399	$1,541,753	($43,510)	$1,498,243	$65,088	$19,035	1,113	2,593
		OAIN4-OAP IN-NETWORK PLAN 001 ONLY	$28,480	$408,005	$1,346	$43,633	$2,033	$483,497	($304,358)	$179,139	$10,760	$3,671	184	569
	PRODUCT TYPE Total		$160,476	$1,357,224	$25,909	$467,209	$14,432	$2,025,250	($347,868)	$1,677,382	$75,849	$22,706	1,297	3,162
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$11,659	$92,609	$150	$25,849	$1,240	$131,507	$0	$131,507	$6,550	$2,234	112	232
		LPIN3-LOCAL PLUS IN-NETWORK PLAN 001	$1,170	($224)	$0	$283	$67	$1,296	$0	$1,296	$468	$160	8	23
	PRODUCT TYPE Total		$12,829	$92,385	$150	$26,132	$1,307	$132,803	$0	$132,803	$7,018	$2,394	120	255
	OAP1	HDPF1-OAP FAMILY HDHPQ	$18,807	$70,411	$99	$15,953	$1,575	$106,845	$0	$106,845	$8,129	$2,773	138	414
		HDPF3-OAP FAMILY HDHPQ 001 ONLY	$2,426	$58,704	$0	$1,126	$201	$62,457	$0	$62,457	$1,053	$359	18	54
		HDPI1-OAP INDIVIDUAL HDHPQ	$7,488	$21,250	$194	$12,332	$2,089	$43,354	$0	$43,354	$10,936	$3,731	187	187
		HDPI3-OAP INDIVIDUAL HDHPQ 001 ONLY	$1,382	($307)	$0	$6,474	$346	$7,895	$0	$7,895	$1,988	$678	34	34
		OAP1-OAP COPAY PLAN	$30,397	$115,767	$3,890	$58,080	$3,351	$211,485	$0	$211,485	$17,486	$5,965	301	617
		OAP3-OAP COPAY PLAN 001 ONLY	$4,521	$9,652	$40	$8,867	$391	$23,470	$0	$23,470	$1,988	$678	34	93
	PRODUCT TYPE Total		$65,020	$275,478	$4,223	$102,832	$7,953	$455,506	$0	$455,506	$41,579	$14,184	712	1,399

	PRODUCT TYPE Total		$0	$1,954	$0	$0	$0	$1,954	$0	$1,954	$0	$709	2,129	4,820
Feb-2024 Total			$238,325	$1,807,033	$57,019	$596,174	$23,692	$2,722,242	($347,868)	$2,374,374	$124,445	$44,587	5,947	13,481
Mar-24
	PRODUCT TYPE Total		$0	$97,662	$23,689	$0	$0	$121,350	$0	$121,350	$0	$4,760	1,684	3,840
	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$115,558	$1,038,779	$27,936	$584,187	$12,198	$1,778,658	($11,807)	$1,766,850	$64,796	$20,472	1,108	2,593
		OAIN2-OAP IN-NETWORK PLAN CA	($1)	$0	$0	$0	$0	($1)	$0	($1)	$0	$0	0	0
		OAIN4-OAP IN-NETWORK PLAN 001 ONLY	$24,393	$885,247	$1,985	$66,255	$2,033	$979,912	($781,099)	$198,813	$10,760	$3,671	184	569
	PRODUCT TYPE Total		$139,950	$1,924,026	$29,921	$650,441	$14,231	$2,758,569	($792,906)	$1,965,663	$75,556	$24,143	1,292	3,162
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$10,497	$32,456	$0	$38,505	$1,251	$82,710	$0	$82,710	$6,550	$2,234	112	232
		LPIN3-LOCAL PLUS IN-NETWORK PLAN 001	$1,006	$830	$0	$124	$89	$2,050	$0	$2,050	$468	$160	8	23
	PRODUCT TYPE Total		$11,503	$33,287	$0	$38,629	$1,340	$84,760	$0	$84,760	$7,018	$2,394	120	255
	OAP1	HDPF1-OAP FAMILY HDHPQ	$16,019	$73,688	$0	$21,076	$1,508	$112,290	$0	$112,290	$8,129	$2,773	138	416
		HDPF3-OAP FAMILY HDHPQ 001 ONLY	$2,118	$22,861	$0	$1,445	$223	$26,648	$0	$26,648	$1,111	$379	19	56
		HDPI1-OAP INDIVIDUAL HDHPQ	$6,254	$73,240	$0	$94,346	$2,022	$175,862	$0	$175,862	$10,936	$3,731	187	187
		HDPI3-OAP INDIVIDUAL HDHPQ 001 ONLY	$1,119	$1,328	$0	$8,474	$357	$11,279	$0	$11,279	$1,930	$658	33	33
		OAP1-OAP COPAY PLAN	$26,935	$178,184	$8,282	$83,511	$3,306	$300,219	$0	$300,219	$17,369	$5,925	298	604
		OAP3-OAP COPAY PLAN 001 ONLY	$3,915	$16,339	$176	$6,698	$357	$27,486	$0	$27,486	$1,988	$678	34	93
	PRODUCT TYPE Total		$56,361	$365,640	$8,458	$215,550	$7,774	$653,784	$0	$653,784	$41,462	$14,145	709	1,389

	PRODUCT TYPE Total		$0	$3,230	$0	$0	$0	$3,230	$0	$3,230	$0	$734	2,121	4,810
Mar-2024 Total			$207,814	$2,423,844	$62,068	$904,621	$23,345	$3,621,692	($792,906)	$2,828,786	$124,036	$46,176	5,926	13,456
Apr-24
	PRODUCT TYPE Total		$0	$102,813	$29,293	$0	$0	$132,106	$0	$132,106	$0	$5,154	1,687	3,848
	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$131,754	$1,238,245	$25,937	$618,316	$12,443	$2,026,695	($2,857)	$2,023,838	$64,913	$23,807	1,111	2,596
		OAIN4-OAP IN-NETWORK PLAN 001 ONLY	$28,398	$190,062	$918	$51,839	$2,044	$273,260	$0	$273,260	$10,760	$3,671	184	569
	PRODUCT TYPE Total		$160,152	$1,428,307	$26,855	$670,155	$14,487	$2,299,956	($2,857)	$2,297,098	$75,673	$27,478	1,295	3,165
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$11,909	$60,141	$0	$35,555	$1,273	$108,878	$0	$108,878	$6,608	$2,254	113	233
		LPIN3-LOCAL PLUS IN-NETWORK PLAN 001	$1,168	$1,561	$0	$168	$89	$2,986	$0	$2,986	$468	$160	8	23
	PRODUCT TYPE Total		$13,077	$61,702	$0	$35,723	$1,363	$111,865	$0	$111,865	$7,076	$2,414	121	256
	OAP1	HDPF1-OAP FAMILY HDHPQ	$18,798	$120,164	$0	$28,245	$1,575	$168,782	$0	$168,782	$8,304	$2,833	141	429
		HDPF3-OAP FAMILY HDHPQ 001 ONLY	$2,537	$98,991	$0	$2,003	$212	$103,743	($71,373)	$32,370	$1,111	$379	19	56
		HDPI1-OAP INDIVIDUAL HDHPQ	$7,403	$46,837	$230	$55,741	$2,066	$112,277	$0	$112,277	$10,877	$3,711	186	186
		HDPI3-OAP INDIVIDUAL HDHPQ 001 ONLY	$1,299	$2,055	$0	$4,469	$369	$8,192	$0	$8,192	$1,988	$678	34	34
		OAP1-OAP COPAY PLAN	$30,336	$230,323	$7,652	$90,634	$3,373	$362,319	$0	$362,319	$17,719	$6,045	304	614
		OAP3-OAP COPAY PLAN 001 ONLY	$4,541	$50,076	$0	$6,952	$357	$61,926	$0	$61,926	$1,930	$658	33	92
	PRODUCT TYPE Total		$64,915	$548,445	$7,883	$188,044	$7,953	$817,239	($71,373)	$745,866	$41,930	$14,304	717	1,411

	PRODUCT TYPE Total		$0	$2,658	$0	$0	$0	$2,658	$0	$2,658	$0	$798	2,133	4,835
Apr-2024 Total			$238,143	$2,143,924	$64,030	$893,922	$23,803	$3,363,823	($74,230)	$3,289,592	$124,679	$50,148	5,953	13,515
May-24
	PRODUCT TYPE Total		$0	$104,410	$25,324	$0	$0	$129,734	$0	$129,734	$0	$4,774	1,683	3,842
	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$134,458	$1,341,704	$30,887	$665,559	$12,343	$2,184,951	($38,823)	$2,146,127	$64,328	$20,448	1,100	2,578
		OAIN4-OAP IN-NETWORK PLAN 001 ONLY	$27,939	$170,038	$937	$53,596	$1,955	$254,465	($14,595)	$239,870	$10,760	$3,671	184	572
	PRODUCT TYPE Total		$162,397	$1,511,742	$31,824	$719,155	$14,298	$2,439,416	($53,418)	$2,385,998	$75,088	$24,118	1,284	3,150
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$12,169	$67,102	$0	$16,977	$1,262	$97,510	$0	$97,510	$6,608	$2,254	113	233
		LPIN3-LOCAL PLUS IN-NETWORK PLAN 001	$1,179	$3,635	$0	$532	$89	$5,436	$0	$5,436	$468	$160	8	23
	PRODUCT TYPE Total		$13,348	$70,738	$0	$17,509	$1,352	$102,946	$0	$102,946	$7,076	$2,414	121	256
	OAP1	HDPF1-OAP FAMILY HDHPQ	$19,785	$79,440	$639	$21,076	$1,676	$122,615	$0	$122,615	$8,421	$2,873	143	432
		HDPF3-OAP FAMILY HDHPQ 001 ONLY	$2,543	$101,078	$0	$1,302	$235	$105,158	($95,622)	$9,536	$1,170	$399	20	58
		HDPI1-OAP INDIVIDUAL HDHPQ	$8,007	$40,460	$110	$57,847	$2,100	$108,523	($13,265)	$95,258	$10,760	$3,671	184	184
		HDPI3-OAP INDIVIDUAL HDHPQ 001 ONLY	$1,336	$16,156	$0	$4,516	$380	$22,388	$0	$22,388	$1,930	$658	33	33
		OAP1-OAP COPAY PLAN	$37,121	$291,010	$5,232	$63,249	$3,496	$400,108	$0	$400,108	$18,129	$6,185	311	625
		OAP3-OAP COPAY PLAN 001 ONLY	$4,500	$21,164	$135	$6,123	$369	$32,292	$0	$32,292	$1,930	$658	33	92
	PRODUCT TYPE Total		$73,293	$549,308	$6,115	$154,113	$8,255	$791,084	($108,887)	$682,196	$42,340	$14,444	724	1,424

	PRODUCT TYPE Total		$0	$2,480	$0	$0	$0	$2,480	$0	$2,480	$0	$739	2,129	4,833
May-2024 Total			$249,038	$2,238,677	$63,263	$890,777	$23,904	$3,465,660	($162,305)	$3,303,354	$124,504	$46,489	5,941	13,505
Jun-24
	PRODUCT TYPE Total		$0	$90,908	$25,336	$0	$0	$116,244	$0	$116,244	$0	$4,933	1,678	3,833
	OAPIN	OAIN1-OAP IN-NETWORK PLAN	$143,834	$1,395,116	$26,714	$546,924	$12,510	$2,125,099	($110,036)	$2,015,063	$64,796	$22,105	1,108	2,594
		OAIN4-OAP IN-NETWORK PLAN 001 ONLY	$31,296	$110,660	$1,518	$65,055	$2,011	$210,540	$0	$210,540	$10,643	$3,631	182	569
	PRODUCT TYPE Total		$175,131	$1,505,776	$28,232	$611,980	$14,521	$2,335,639	($110,036)	$2,225,603	$75,439	$25,736	1,290	3,163
	OAPINR	LPIN1-LOCAL PLUS IN-NETWORK PLAN	$12,382	$25,166	$0	$40,545	$1,184	$79,277	$0	$79,277	$6,550	$2,234	112	232
		LPIN3-LOCAL PLUS IN-NETWORK PLAN 001	$1,283	$13,952	$0	$52	$89	$15,376	$0	$15,376	$468	$160	8	23
	PRODUCT TYPE Total		$13,665	$39,118	$0	$40,597	$1,273	$94,653	$0	$94,653	$7,018	$2,394	120	255
	OAP1	HDPF1-OAP FAMILY HDHPQ	$20,757	$127,020	$461	$20,352	$1,653	$170,243	$0	$170,243	$8,538	$2,913	145	440
		HDPF3-OAP FAMILY HDHPQ 001 ONLY	$2,875	$50,842	$0	$843	$257	$54,817	($44,474)	$10,343	$1,228	$419	21	61
		HDPI1-OAP INDIVIDUAL HDHPQ	$7,758	$45,803	$0	$55,249	$2,133	$110,944	($4,901)	$106,043	$10,702	$3,651	183	183
		HDPI3-OAP INDIVIDUAL HDHPQ 001 ONLY	$1,436	$16,545	$0	$3,465	$335	$21,781	$0	$21,781	$1,871	$638	32	32
		OAP1-OAP COPAY PLAN	$33,198	$98,653	$2,872	$69,276	$3,418	$207,417	$0	$207,417	$18,187	$6,204	312	621
		OAP3-OAP COPAY PLAN 001 ONLY	$4,733	$29,695	$15	$11,227	$402	$46,073	$0	$46,073	$1,930	$658	33	92
	PRODUCT TYPE Total		$70,757	$368,559	$3,347	$160,412	$8,199	$611,274	($49,375)	$561,899	$42,456	$14,484	726	1,429

	PRODUCT TYPE Total	$0	$2,346	$0	$0	$0	$2,346	$0	$2,346	$0	$769	2,135	4,848
Jun-2024 Total		$259,552	$2,006,706	$56,915	$812,989	$23,993	$3,160,155	($159,410)	$3,000,745	$124,913	$48,315	5,949	13,528

Grand Total $2,786,489 $23,345,963 $779,253 $10,026,379 $285,695 $37,223,779 ($1,876,634) $35,347,145 $1,495,743 $563,900 71,583 162,683

&G &7This report contains proprietary and/or confidential information. Disclosure is strictly prohibited except to the extent required by law. ADVICE Reporting System &8Page &P of &N Date: 7/8/2024

&7HAF includes charges for such health advocacy programs as disease/condition management and health coaching.

Large Claims 2023

CITY OF SCOTTSDALE

CLAIMS EXCEEDING REPORT

July 2023 thru June 2024

Rating Type : POOLED STOP LOSS, RETROSPECTIVE EXPERIENCE RATED
Claims Exceeding : $25,000.00
Reported Claims: InNet, OutNet, Drug
Note: Diagnosis is based on the largest medical claim amount
	REL	GENDER	ICD CODE	ICD DESCRIPTION	ICD VERSION	DRUG CLAIMS	PAID CLAIMS	CLAIMANT TOTAL
	EE	M	D709	NEUTROPENIA, UNSPECIFIED	10	$39,225	$1,420,713	$1,459,938
	CH	F	Z5111	ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY	10	$28,699	$644,467	$673,166
	SP	F	C712	MALIGNANT NEOPLASM OF TEMPORAL LOBE	10	$3,593	$568,151	$571,744
	SP	F	C800	DISSEMINATED MALIGNANT NEOPLASM, UNSPECIFIED	10	$9,584	$526,820	$536,403
	EE	F	E849	CYSTIC FIBROSIS, UNSPECIFIED	10	$367,489	$2,248	$369,737
	CH	F	R55	SYNCOPE AND COLLAPSE	10	$325,563	$7,628	$333,191
	CH	M	G0400	ACUTE DISSEMINATED ENCEPHALITIS AND ENCEPHALOMYELITIS, UNSP	10	$21	$247,153	$247,174
	CH	M	Q7649	OTH CONGENITAL MALFORM OF SPINE, NOT ASSOCIATED W SCOLIOSIS	10	$1,994	$242,423	$244,417
	EE	M	F411	GENERALIZED ANXIETY DISORDER	10	$223,667	$8,730	$232,397
	SP	F	I442	ATRIOVENTRICULAR BLOCK, COMPLETE	10	$74,271	$135,226	$209,497
	EE	M	I214	NON-ST ELEVATION (NSTEMI) MYOCARDIAL INFARCTION	10	$7,226	$200,868	$208,094
	EE	M	Q612	POLYCYSTIC KIDNEY, ADULT TYPE	10	$6,224	$195,557	$201,781
	SP	F	N186	END STAGE RENAL DISEASE	10	$7,526	$191,501	$199,027
	EE	M	R1084	GENERALIZED ABDOMINAL PAIN	10	$180,031	$14,325	$194,356
	SP	M	K449	DIAPHRAGMATIC HERNIA WITHOUT OBSTRUCTION OR GANGRENE	10	$95,338	$88,054	$183,392
	EE	M	C61	MALIGNANT NEOPLASM OF PROSTATE	10	$179,223	$4,071	$183,294
	SP	F	Z5112	ENCOUNTER FOR ANTINEOPLASTIC IMMUNOTHERAPY	10	$229	$181,674	$181,903
	EE	M	C9110	CHRONIC LYMPHOCYTIC LEUK OF B-CELL TYPE NOT ACHIEVE REMIS	10	$179,423	$1,034	$180,457
	EE	M	Z1211	ENCOUNTER FOR SCREENING FOR MALIGNANT NEOPLASM OF COLON	10	$175,456	$4,788	$180,245
	SP	M	C61	MALIGNANT NEOPLASM OF PROSTATE	10	$639	$173,219	$173,858
	CH	M	N2889	OTHER SPECIFIED DISORDERS OF KIDNEY AND URETER	10	$167,919	$3,858	$171,777
	EE	M	M5416	RADICULOPATHY, LUMBAR REGION	10	$169,201	$717	$169,918
	EE	M	D320	BENIGN NEOPLASM OF CEREBRAL MENINGES	10	$1,739	$167,343	$169,082
	CH	F	Z3801	SINGLE LIVEBORN INFANT, DELIVERED BY CESAREAN	10	$0	$165,950	$165,950
	SP	F	C9030	SOLITARY PLASMACYTOMA NOT HAVING ACHIEVED REMISSION	10	$149,306	$7,285	$156,590
	EE	F	D320	BENIGN NEOPLASM OF CEREBRAL MENINGES	10	$0	$151,423	$151,423
	EE	F	G35	MULTIPLE SCLEROSIS	10	$1,885	$131,202	$133,086
	CH	M	R6252	SHORT STATURE (CHILD)	10	$127,161	$2,407	$129,568
	EE	M	I420	DILATED CARDIOMYOPATHY	10	$45,382	$81,901	$127,283
	SP	F	R1084	GENERALIZED ABDOMINAL PAIN	10	$89,949	$37,125	$127,074
	SP	F	S68122A	PARTIAL TRAUMATIC MCP AMPUTATION OF R MID FINGER, INIT	10	$494	$125,788	$126,282
	SP	F	D801	NONFAMILIAL HYPOGAMMAGLOBULINEMIA	10	$22,776	$102,831	$125,606
	CH	M	M041	PERIODIC FEVER SYNDROMES	10	$114,263	$10,949	$125,211
	EE	M	L4050	ARTHROPATHIC PSORIASIS, UNSPECIFIED	10	$121,077	$1,604	$122,681
	SP	M	I480	PAROXYSMAL ATRIAL FIBRILLATION	10	$17,407	$103,786	$121,194
	SP	F	M50121	CERVICAL DISC DISORDER AT C4-C5 LEVEL WITH RADICULOPATHY	10	$80,369	$38,608	$118,977
	EE	F	S2243XA	MULTIPLE FRACTURES OF RIBS, BILATERAL, INIT FOR CLOS FX	10	$32	$117,892	$117,925
	EE	F	K8590	ACUTE PANCREATITIS WITHOUT NECROSIS OR INFECTION, UNSP	10	$23,882	$88,365	$112,246
	EE	M	I25118	ATHSCL HEART DISEASE OF NATIVE COR ART W OTH ANG PCTRS	10	$17,627	$93,272	$110,899
	CH	M	E230	HYPOPITUITARISM	10	$107,925	$983	$108,908
	CH	M	Z3801	SINGLE LIVEBORN INFANT, DELIVERED BY CESAREAN	10	$52	$107,797	$107,849
	SP	M	D136	BENIGN NEOPLASM OF PANCREAS	10	$6,709	$99,723	$106,432
	SP	M	I6521	OCCLUSION AND STENOSIS OF RIGHT CAROTID ARTERY	10	$135	$104,867	$105,002
	CH	M	J159	UNSPECIFIED BACTERIAL PNEUMONIA	10	$90,469	$9,297	$99,766
	SP	M	I480	PAROXYSMAL ATRIAL FIBRILLATION	10	$8,475	$87,723	$96,197
	SP	F	R569	UNSPECIFIED CONVULSIONS	10	$74,497	$21,467	$95,964

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File details come from the government source that posted it. Updated Sep 1, 2025.