7-SCBOCC Experience Report Florida Blue Medical 202409.xlsx

XLSX spreadsheet 123 KB Posted

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Group Medical Benefits
Solicitation number
2026-10
Issued by
Seminole County, Florida

About this file

Summary of Florida Blue Medical Benefits Experience Report for Suwannee County BOCC

This document is a Florida Blue medical claims monitoring and utilization report for the Suwannee County Board of County Commissioners and associated constitutional offices (Sheriff, Tax Collector, Property Appraiser, Clerk of Courts, and Supervisor of Elections) covering the period from October 2023 through September 2024. The report provides comprehensive analysis of health plan enrollment, claims payments, utilization metrics, pharmacy performance, and high-cost claims data across multiple divisions within the county organization. Total enrollment averaged 414 contracts with 463 members throughout the measurement period, with enrollment distribution consisting primarily of employee-only coverage (389 members) and supplemental family coverage options. The report documents all medical, pharmacy, and related healthcare service claims processed under Florida Blue's managed care arrangement.

The report demonstrates significant medical cost trends during the analysis period, with total claims payments of $3,949,148.86 representing a 41.85 percent increase compared to the prior year period ($2,784,125.01), translating to annual payments per member of $8,529.36 compared to $6,176.64 previously. Inpatient facility costs increased 122.34 percent year-over-year to $1,438,754.18, driven primarily by increased admissions and average length of stay metrics. Key utilization indicators show inpatient days per 1,000 members at 311 versus 202 prior year, with pharmacy costs rising 19.57 percent to $876,889.92. The Medical Loss Ratio across the measurement period averaged 99.26 percent, indicating claims paid nearly equivalent to premiums received. High-cost claims analysis identified cardiac conditions, spinal stenosis, and malignant neoplasms as primary cost drivers, with individual claims exceeding $650,000 for complex cardiac interventions. Generic drug utilization remained strong at 86.67 percent, with formulary compliance at 97.96 percent, supporting cost management initiatives despite overall premium increases.

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S1 Monitoring by Utiliza Page1

Monitoring by Utilization and Enrollment - PAID
Company: SUWANNEE COUNTY BOCC TAX COLL

Group: 15534 Current Paid Period: From 10/2023 to 09/2024

EnrollmentPremiumCapitationFee for Service Claims
Paid Year MonthContractsMembersPremiumPCPSpecialtyTotal CapitationValue Based
ProgramsInpatientOutpatientPhysicianOtherTotal MedicalPharmacyGrand TotalMLR
202310404447$339,143.98$0.00$1,687.82$1,687.82$888.22$0.00$54,893.07$37,314.45$48,053.49$140,261.01$72,301.87$215,138.9263.44%
202311411462$326,908.39$0.00$1,667.24$1,667.24$868.26$8,026.86$34,611.05$36,449.69$17,070.34$96,157.94$85,276.14$183,969.5856.28%
202312412463$329,710.34$0.00$1,691.68$1,691.68$0.00$112,159.92$76,656.37$33,200.41$16,508.32$238,525.02$73,362.45$313,579.1595.11%
202401413464$328,475.87$0.00$1,644.35$1,644.35$0.00$12,661.08$56,278.48$26,240.05$26,719.97$121,899.58$86,843.20$210,387.1364.05%
202402412463$326,239.79$0.00$1,718.65$1,718.65$1,025.12$48,734.32$55,885.92$33,206.21$15,569.97$153,396.42$54,955.71$211,095.9064.71%
202403410461$328,578.59$0.00$1,724.93$1,724.93$1,136.43$213,550.02$40,031.04$32,365.34$36,345.15$322,291.55$64,235.97$389,388.88118.51%
202404413466$336,012.31$0.00$1,731.56$1,731.56$1,204.74$94,717.49$44,469.06$29,850.98$30,564.47$199,602.00$73,427.31$275,965.6182.13%
202405415464$328,517.43$0.00$1,778.59$1,778.59$1,223.37$52,175.47$88,339.11$39,430.69$51,120.25$231,065.52$81,075.43$315,142.9195.93%
202406414463$335,338.87$0.00$1,744.68$1,744.68$1,303.40$10,970.97$114,308.90$42,368.76$29,407.39$197,056.02$68,832.89$268,936.9980.20%
202407421470$326,641.25$0.00$1,759.19$1,759.19$1,289.68$253,382.34$55,949.87$50,444.89$30,961.77$390,738.87$53,809.25$447,596.99137.03%
202408421470$344,192.29$0.00$1,770.31$1,770.31$1,385.72$622,106.09$54,464.72$32,781.68$25,836.24$735,188.73$89,256.53$827,601.29240.45%
202409416463$328,791.07$0.00$1,725.13$1,725.13$1,589.76$10,269.62$117,406.73$47,495.08$38,346.02$213,517.45$73,513.17$290,345.5188.31%
Total4,9625,556$3,978,550.18$0.00$20,644.13$20,644.13$11,914.70$1,438,754.18$793,294.32$441,148.23$366,503.38$3,039,700.11$876,889.92$3,949,148.8699.26%
Grouping Avg414463$331,545.85$0.00$1,720.34$1,720.34$992.89$119,896.18$66,107.86$36,762.35$30,541.95$253,308.34$73,074.16$329,095.7499.26%
Monthly Avg414463$331,545.85$0.00$1,720.34$1,720.34$992.89$119,896.18$66,107.86$36,762.35$30,541.95$253,308.34$73,074.16$329,095.7499.26%

Notes:

- Grand Total includes Medical FFS, Pharmacy FFS, Incentives and Capitation.

- Grouping Avg – Average of the distinct groupings chosen by the user.

- Monthly Avg – Average of a measure over Service/Paid time period.

- Enrollment is recast to reflect retroactive adjustments.

- FFS = Fee For Service.

- MLR = Medical Loss Ratio.

&"Arial,Regular"&8 This Florida Blue report is proprietary and confidential. Report Run: 10/15/2024 1:11 PM Page 1 of 2

S2 Monitoring by Utiliza Page2

Monitoring by Utilization and Enrollment - PAID
Paid Year MonthEmployee
OnlyEmployee &
SpouseEmployee &
ChildrenFamilySpouse OnlySpouse &
ChildrenChildren OnlyTotal
ContractsTotal

Members

20231038011103000404447
20231138611104000411462
20231238711104000412463
20240138811104000413464
20240238711104000412463
20240338511104000410461
20240438711114000413466
20240539011122000415464
20240638911122000414463
20240739611122000421470
20240839611122000421470
20240939211112000416463
Total4,663132130370004,9625,556
Grouping Avg38911113000414463
Monthly Avg38911113000414463
Notes:

- Enrollment is recast to reflect retroactive adjustments.

- Grouping Avg – Average of the distinct groupings chosen by the user.

- Monthly Avg – Average of a measure over Service/Paid time period.

&"Arial,Regular"&8 This Florida Blue report is proprietary and confidential. Report Run: 10/15/2024 1:11 PM Page 2 of 2

S3 High Cost Claims Summ Page1

High Cost Claims Summary - Rolling 12
Company: SUWANNEE COUNTY BOCC TAX COLL

Group: 15534 Current Paid Period: From 10/2023 to 09/2024 Prior Paid Period: From 10/2022 to 09/2023 High Cost Claims Threshold: 50000

CURRENTInpatientOutpatientProfessionalPharmacyOther
RankDivRelationshipDiagnosis DescriptionDaysAdmitsPaid AmtVisitsPaid AmtServicesPaid Amt# of RxPaid AmtClaim CountPaid AmtTotal Paid AmtTotal Billed Amt
1023SUBSCRIBERNON-ST ELEVATION (NSTEMI) MYOCARDIAL INFARCTION; ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS; ST ELEVATION (STEMI) MYOCARDIAL INFARCTION OF UNSPECIFIED SITE192$652,305.031$610.31172$42,059.449$3,145.170$0.00$698,119.95$2,678,749.54
2011SUBSCRIBERSPINAL STENOSIS, LUMBAR REGION WITHOUT NEUROGENIC CLAUDICATION; PHARMACY RX; OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY22$154,605.006$12,845.5771$19,994.8053$16,791.490$0.00$204,236.86$1,764,929.31
3012SUBSCRIBERCHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED; HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE WITH HEART FAILURE AND STAGE 1 THROUGH STAGE 4 CHRONIC KIDNEY DISEASE, OR UNSPECIFIED CHRONIC KIDNEY DIS; CARDIAC ARREST, CAUSE UNSPECIFIED313$110,585.701$581.22152$33,606.766$17.000$0.00$144,790.68$692,352.33
4012SUBSCRIBERPHARMACY RX; CHRONIC MAXILLARY SINUSITIS; OTHER CHRONIC SINUSITIS00$0.004$10,547.7954$10,937.5867$100,939.240$0.00$122,424.61$205,626.60
5012SUBSCRIBERMALIGNANT NEOPLASM OF UPPER LOBE, RIGHT BRONCHUS OR LUNG; OTHER PERSISTENT ATRIAL FIBRILLATION; MALIGNANT NEOPLASM OF UNSPECIFIED PART OF UNSPECIFIED BRONCHUS OR LUNG73$76,299.006$19,727.7864$21,207.3325$2,261.750$0.00$119,495.86$592,069.68
6011SUBSCRIBERUNSPECIFIED FRACTURE OF SHAFT OF RIGHT FEMUR, INITIAL ENCOUNTER FOR CLOSED FRACTURE; UNSPECIFIED FRACTURE OF SHAFT OF RIGHT FEMUR, SUBSEQUENT ENCOUNTER FOR CLOSED FRACTURE WITH ROUTINE HEALING; DISPLACED TRANSVERSE FRACTURE OF SHAFT OF RIGHT FEMUR, SUBSEQUENT ENCOUNTER FOR CLOSED FRACTURE WITH ROUTINE HEALING232$105,897.079$2,535.41171$9,396.6921$308.320$0.00$118,137.49$661,723.05
7002SUBSCRIBERSECONDARY MALIGNANT NEOPLASM OF LIVER AND INTRAHEPATIC BILE DUCT; SEPSIS, UNSPECIFIED ORGANISM; PHARMACY RX72$42,761.266$9,609.0089$21,829.9524$7,997.630$0.00$82,197.84$523,379.52
8011SUBSCRIBERRADICULOPATHY, LUMBAR REGION; RADICULOPATHY, SITE UNSPECIFIED; HYDRONEPHROSIS WITH RENAL AND URETERAL CALCULOUS OBSTRUCTION00$0.001$67,098.5046$6,679.8046$182.040$0.00$73,960.34$214,276.08
9007SUBSCRIBERATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITH UNSTABLE ANGINA PECTORIS; ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY OF TRANSPLANTED HEART WITH OTHER FORMS OF ANGINA PECTORIS; PHARMACY RX11$29,304.722$25,336.4659$7,610.5080$3,246.300$0.00$65,497.98$902,993.66
10012SUBSCRIBERPHARMACY RX; PSORIASIS VULGARIS;00$0.000$0.002$101.924$53,367.730$0.00$53,469.65$66,540.71
11008SUBSCRIBERSEPSIS, UNSPECIFIED ORGANISM; MENINGITIS, UNSPECIFIED; BASAL CELL CARCINOMA OF SKIN OF OTHER PARTS OF FACE31$30,878.122$130.3229$21,106.8712$134.880$0.00$52,250.19$192,495.47
Total9316$1,202,635.9038$149,022.36909$194,531.64347$188,391.550$0.00$1,734,581.45$8,495,135.95
PRIORInpatientOutpatientProfessionalPharmacyOther
RankDivRelationshipDiagnosis DescriptionDaysAdmitsPaid AmtVisitsPaid AmtServicesPaid Amt# of RxPaid AmtClaim CountPaid AmtTotal Paid AmtTotal Billed Amt
1008SUBSCRIBERSEPSIS, UNSPECIFIED ORGANISM; ALCOHOL INDUCED ACUTE PANCREATITIS WITHOUT NECROSIS OR INFECTION; PNEUMONIA, UNSPECIFIED ORGANISM592$282,436.9010$3,435.5459$7,085.1919$382.370$0.00$293,340.00$109,444.01
2011SUBSCRIBEROTHER SPECIFIED NONINFLAMMATORY DISORDERS OF VAGINA; PHARMACY RX; CALCULUS OF KIDNEY11$32,177.0019$31,980.84137$23,845.0585$28,221.880$0.00$116,224.77$665,930.86
3010SUBSCRIBERENCOUNTER FOR ANTINEOPLASTIC RADIATION THERAPY; ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY; DYSPHONIA00$0.0049$94,950.1561$12,908.6023$137.080$0.00$107,995.83$285,283.30
4R08SUBSCRIBERUNILATERAL PRIMARY OSTEOARTHRITIS, RIGHT KNEE; UNILATERAL PRIMARY OSTEOARTHRITIS, LEFT KNEE; POLYP OF COLON00$0.0013$91,071.8474$14,933.6518$36.630$0.00$106,042.12$235,714.20
5012SUBSCRIBERPHARMACY RX; TYPE 2 DIABETES MELLITUS WITHOUT COMPLICATIONS; OTHER SPECIFIED DISORDERS OF TEETH AND SUPPORTING STRUCTURES00$0.001$640.8919$1,708.3140$91,491.350$0.00$93,840.55$130,974.17
6012SUBSCRIBERSEPSIS, UNSPECIFIED ORGANISM; IRON DEFICIENCY ANEMIA, UNSPECIFIED; MALIGNANT NEOPLASM OF UPPER-INNER QUADRANT OF LEFT FEMALE BREAST63$60,746.760$0.00128$13,014.389$274.600$0.00$74,035.74$358,174.62
7011SUBSCRIBEROTHER SPONDYLOSIS WITH RADICULOPATHY, LUMBAR REGION; BENIGN PAROXYSMAL VERTIGO, UNSPECIFIED EAR; HYPERTENSIVE EMERGENCY52$16,883.824$27,805.0073$12,194.8835$8,095.880$0.00$64,979.58$236,957.83
8002SUBSCRIBERCALCULUS OF KIDNEY; ABRASION OF RIGHT INDEX FINGER, INITIAL ENCOUNTER; ENCOUNTER FOR SCREENING FOR MALIGNANT NEOPLASM OF COLON00$0.007$57,375.7627$6,154.8117$169.160$0.00$63,699.73$358,543.22
9R07SUBSCRIBERPHARMACY RX; ENCOUNTER FOR SCREENING FOR MALIGNANT NEOPLASM OF COLON; OBSTRUCTIVE SLEEP APNEA (ADULT) (PEDIATRIC)00$0.000$0.0020$1,227.08114$53,867.320$0.00$55,094.40$98,522.55
10012SPOUSEPHARMACY RX; OTHER RHEUMATOID ARTHRITIS WITH RHEUMATOID FACTOR OF MULTIPLE SITES; CONTACT WITH AND (SUSPECTED) EXPOSURE TO COVID-1900$0.000$0.009$557.4236$53,687.080$0.00$54,244.50$72,551.84
11011SUBSCRIBERATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITH UNSTABLE ANGINA PECTORIS; OCCLUSION AND STENOSIS OF BILATERAL CAROTID ARTERIES; ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITH UNSPECIFIED ANGINA PECTORIS00$0.001$51,523.0914$1,363.8012$0.000$0.00$52,886.89$651,021.00
Total718$392,244.48104$358,783.11621$94,993.17408$236,363.350$0.00$1,082,384.11$3,203,117.60

&"Arial,Regular"&8 This Florida Blue report is proprietary and confidential. Report Run: 10/15/2024 1:11 PM Page 1 of 1

S4 High Cost Claims Summ Page1

High Cost Claims Summary - Plan YTD
Company: SUWANNEE COUNTY BOCC TAX COLL

Group: 15534 Current Paid Period: From 10/2023 to 09/2024 Prior Paid Period: From 10/2022 to 09/2023 High Cost Claims Threshold: 50000

CURRENTInpatientOutpatientProfessionalPharmacyOther
RankDivRelationshipDiagnosis DescriptionDaysAdmitsPaid AmtVisitsPaid AmtServicesPaid Amt# of RxPaid AmtClaim CountPaid AmtTotal Paid AmtTotal Billed Amt
1023SUBSCRIBERNON-ST ELEVATION (NSTEMI) MYOCARDIAL INFARCTION; ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS; ST ELEVATION (STEMI) MYOCARDIAL INFARCTION OF UNSPECIFIED SITE192$652,305.031$610.31172$42,059.449$3,145.170$0.00$698,119.95$2,678,749.54
2011SUBSCRIBERSPINAL STENOSIS, LUMBAR REGION WITHOUT NEUROGENIC CLAUDICATION; PHARMACY RX; OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY22$154,605.006$12,845.5771$19,994.8053$16,791.490$0.00$204,236.86$1,764,929.31
3012SUBSCRIBERCHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED; HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE WITH HEART FAILURE AND STAGE 1 THROUGH STAGE 4 CHRONIC KIDNEY DISEASE, OR UNSPECIFIED CHRONIC KIDNEY DIS; CARDIAC ARREST, CAUSE UNSPECIFIED313$110,585.701$581.22152$33,606.766$17.000$0.00$144,790.68$692,352.33
4012SUBSCRIBERPHARMACY RX; CHRONIC MAXILLARY SINUSITIS; OTHER CHRONIC SINUSITIS00$0.004$10,547.7954$10,937.5867$100,939.240$0.00$122,424.61$205,626.60
5012SUBSCRIBERMALIGNANT NEOPLASM OF UPPER LOBE, RIGHT BRONCHUS OR LUNG; OTHER PERSISTENT ATRIAL FIBRILLATION; MALIGNANT NEOPLASM OF UNSPECIFIED PART OF UNSPECIFIED BRONCHUS OR LUNG73$76,299.006$19,727.7864$21,207.3325$2,261.750$0.00$119,495.86$592,069.68
6011SUBSCRIBERUNSPECIFIED FRACTURE OF SHAFT OF RIGHT FEMUR, INITIAL ENCOUNTER FOR CLOSED FRACTURE; UNSPECIFIED FRACTURE OF SHAFT OF RIGHT FEMUR, SUBSEQUENT ENCOUNTER FOR CLOSED FRACTURE WITH ROUTINE HEALING; DISPLACED TRANSVERSE FRACTURE OF SHAFT OF RIGHT FEMUR, SUBSEQUENT ENCOUNTER FOR CLOSED FRACTURE WITH ROUTINE HEALING232$105,897.079$2,535.41171$9,396.6921$308.320$0.00$118,137.49$661,723.05
7002SUBSCRIBERSECONDARY MALIGNANT NEOPLASM OF LIVER AND INTRAHEPATIC BILE DUCT; SEPSIS, UNSPECIFIED ORGANISM; PHARMACY RX72$42,761.266$9,609.0089$21,829.9524$7,997.630$0.00$82,197.84$523,379.52
8011SUBSCRIBERRADICULOPATHY, LUMBAR REGION; RADICULOPATHY, SITE UNSPECIFIED; HYDRONEPHROSIS WITH RENAL AND URETERAL CALCULOUS OBSTRUCTION00$0.001$67,098.5046$6,679.8046$182.040$0.00$73,960.34$214,276.08
9007SUBSCRIBERATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITH UNSTABLE ANGINA PECTORIS; ATHEROSCLEROSIS OF NATIVE CORONARY ARTERY OF TRANSPLANTED HEART WITH OTHER FORMS OF ANGINA PECTORIS; PHARMACY RX11$29,304.722$25,336.4659$7,610.5080$3,246.300$0.00$65,497.98$902,993.66
10012SUBSCRIBERPHARMACY RX; PSORIASIS VULGARIS;00$0.000$0.002$101.924$53,367.730$0.00$53,469.65$66,540.71
11008SUBSCRIBERSEPSIS, UNSPECIFIED ORGANISM; MENINGITIS, UNSPECIFIED; BASAL CELL CARCINOMA OF SKIN OF OTHER PARTS OF FACE31$30,878.122$130.3229$21,106.8712$134.880$0.00$52,250.19$192,495.47
Total9316$1,202,635.9038$149,022.36909$194,531.64347$188,391.550$0.00$1,734,581.45$8,495,135.95
PRIORInpatientOutpatientProfessionalPharmacyOther
RankDivRelationshipDiagnosis DescriptionDaysAdmitsPaid AmtVisitsPaid AmtServicesPaid Amt# of RxPaid AmtClaim CountPaid AmtTotal Paid AmtTotal Billed Amt
1008SUBSCRIBERSEPSIS, UNSPECIFIED ORGANISM; ALCOHOL INDUCED ACUTE PANCREATITIS WITHOUT NECROSIS OR INFECTION; PNEUMONIA, UNSPECIFIED ORGANISM592$282,436.9010$3,435.5459$7,085.1919$382.370$0.00$293,340.00$109,444.01
2011SUBSCRIBEROTHER SPECIFIED NONINFLAMMATORY DISORDERS OF VAGINA; PHARMACY RX; CALCULUS OF KIDNEY11$32,177.0019$31,980.84137$23,845.0585$28,221.880$0.00$116,224.77$665,930.86
3010SUBSCRIBERENCOUNTER FOR ANTINEOPLASTIC RADIATION THERAPY; ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY; DYSPHONIA00$0.0049$94,950.1561$12,908.6023$137.080$0.00$107,995.83$285,283.30
4R08SUBSCRIBERUNILATERAL PRIMARY OSTEOARTHRITIS, RIGHT KNEE; UNILATERAL PRIMARY OSTEOARTHRITIS, LEFT KNEE; POLYP OF COLON00$0.0013$91,071.8474$14,933.6518$36.630$0.00$106,042.12$235,714.20
5012SUBSCRIBERPHARMACY RX; TYPE 2 DIABETES MELLITUS WITHOUT COMPLICATIONS; OTHER SPECIFIED DISORDERS OF TEETH AND SUPPORTING STRUCTURES00$0.001$640.8919$1,708.3140$91,491.350$0.00$93,840.55$130,974.17
6012SUBSCRIBERSEPSIS, UNSPECIFIED ORGANISM; IRON DEFICIENCY ANEMIA, UNSPECIFIED; MALIGNANT NEOPLASM OF UPPER-INNER QUADRANT OF LEFT FEMALE BREAST63$60,746.760$0.00128$13,014.389$274.600$0.00$74,035.74$358,174.62
7011SUBSCRIBEROTHER SPONDYLOSIS WITH RADICULOPATHY, LUMBAR REGION; BENIGN PAROXYSMAL VERTIGO, UNSPECIFIED EAR; HYPERTENSIVE EMERGENCY52$16,883.824$27,805.0073$12,194.8835$8,095.880$0.00$64,979.58$236,957.83
8002SUBSCRIBERCALCULUS OF KIDNEY; ABRASION OF RIGHT INDEX FINGER, INITIAL ENCOUNTER; ENCOUNTER FOR SCREENING FOR MALIGNANT NEOPLASM OF COLON00$0.007$57,375.7627$6,154.8117$169.160$0.00$63,699.73$358,543.22
9R07SUBSCRIBERPHARMACY RX; ENCOUNTER FOR SCREENING FOR MALIGNANT NEOPLASM OF COLON; OBSTRUCTIVE SLEEP APNEA (ADULT) (PEDIATRIC)00$0.000$0.0020$1,227.08114$53,867.320$0.00$55,094.40$98,522.55
10012SPOUSEPHARMACY RX; OTHER RHEUMATOID ARTHRITIS WITH RHEUMATOID FACTOR OF MULTIPLE SITES; CONTACT WITH AND (SUSPECTED) EXPOSURE TO COVID-1900$0.000$0.009$557.4236$53,687.080$0.00$54,244.50$72,551.84
11011SUBSCRIBERATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITH UNSTABLE ANGINA PECTORIS; OCCLUSION AND STENOSIS OF BILATERAL CAROTID ARTERIES; ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITH UNSPECIFIED ANGINA PECTORIS00$0.001$51,523.0914$1,363.8012$0.000$0.00$52,886.89$651,021.00
Total718$392,244.48104$358,783.11621$94,993.17408$236,363.350$0.00$1,082,384.11$3,203,117.60

&"Arial,Regular"&8 This Florida Blue report is proprietary and confidential. Report Run: 10/15/2024 1:11 PM Page 1 of 1

S5 Monitoring by Utiliza Page1

Monitoring by Utilization and Enrollment - By Division
Company: SUWANNEE COUNTY BOCC TAX COLL

Group: 15534 Current Paid Period: From 10/2023 to 09/2024

EnrollmentPremiumCapitationFee for Service Claims
Paid Year MonthDiv NumContractsMembersPremiumPCPSpecialtyTotal CapitationValue Based
ProgramsInpatientOutpatientPhysicianOtherTotal MedicalPharmacyGrand TotalMLR
20231000155$3,962.70$0.00$7.35$7.35$4.99$0.00$0.00$163.69$56.18$219.87$32.98$265.196.69%
0021111$8,859.18$0.00$74.58$74.58$34.93$0.00$249.00$232.10$461.49$942.59$3,495.79$4,547.8951.34%
00433$1,610.76$0.00$13.56$13.56$4.99$0.00$0.00$100.69$156.09$256.78$3,408.00$3,683.33228.67%
0051212$9,510.48$0.00$19.11$19.11$24.95$0.00$1,749.52$1,868.83$373.06$3,991.41$100.78$4,136.2543.49%
0061617$13,747.88$0.00$115.26$115.26$34.93$0.00$820.00$3,752.87$1,272.91$5,845.78$259.36$6,255.3345.50%
0073335$27,606.10$0.00$57.33$57.33$39.92$0.00$1,634.48$2,726.44$1,674.39$6,035.31$9,794.52$15,927.0857.69%
0084751$44,830.92$0.00$379.68$379.68$154.69$0.00$3,916.32$4,716.02$8,593.89$17,226.23$9,562.95$27,323.5560.95%
0101111$9,664.56$0.00$81.36$81.36$34.93$0.00$2,041.00$930.48$554.15$3,525.63$244.97$3,886.8940.22%
0116471$54,718.90$0.00$104.37$104.37$79.84$0.00$19,941.29$6,913.28$24,870.01$51,724.58$9,595.13$61,503.92112.40%
0129394$81,284.72$0.00$671.22$671.22$364.27$0.00$5,641.81$4,927.18$2,482.25$13,051.24$10,992.28$25,079.0130.85%
01788$4,756.64$0.00$3.76$3.76$4.99$0.00$243.94$1,017.96$669.68$1,931.58$823.44$2,763.7758.10%
01812$1,300.56$0.00$0.94$0.94$0.00$0.00$1,419.21$303.02$558.07$2,280.30$2,704.36$4,985.60383.34%
0191717$10,107.86$0.00$41.87$41.87$4.99$0.00$109.25$750.39$338.32$1,197.96$15,236.51$16,481.33163.05%
020517$6,795.72$0.00$7.99$7.99$9.98$0.00$0.00$79.80$477.73$557.53($465.56)$109.941.62%
0235151$32,673.58$0.00$25.38$25.38$54.89$0.00$16,526.29$6,865.28$3,039.46$26,431.03$94.45$26,605.7581.43%
024924$11,265.70$0.00$10.81$10.81$14.97$0.00$600.96$1.87$1,290.19$1,893.02$482.30$2,401.1021.31%
C2311$594.58$0.00$0.47$0.47$0.00$0.00$0.00$141.61$69.71$211.32$3,196.99$3,408.78573.31%
R0777$7,812.18$0.00$10.29$10.29$4.99$0.00$0.00$402.92$191.52$594.44$434.29$1,044.0113.36%
R0866$4,832.28$0.00$40.68$40.68$4.99$0.00$0.00$1,287.54$924.39$2,211.93$81.29$2,338.8948.40%
R1111$792.54$0.00$1.47$1.47$0.00$0.00$0.00$0.00$0.00$0.00$540.40$541.8768.37%
R1233$2,416.14$0.00$20.34$20.34$9.98$0.00$0.00$132.48$0.00$132.48$1,686.64$1,849.4476.55%
Total404447$339,143.98$0.00$1,687.82$1,687.82$888.22$0.00$54,893.07$37,314.45$48,053.49$140,261.01$72,301.87$215,138.9263.44%
Avg1921$16,149.71$0.00$80.37$80.37$42.30$0.00$2,613.96$1,776.88$2,288.26$6,679.10$3,442.95$10,244.7163.44%
20231100144$3,962.70$0.00$7.35$7.35$4.99$0.00$0.00$72.06$73.98$146.04$965.24$1,123.6228.35%
0021111$8,859.18$0.00$74.58$74.58$34.93$0.00$1,430.00$323.81$1,415.36$3,169.17($344.13)$2,934.5533.12%
00433$1,610.76$0.00$40.68$40.68$4.99$0.00$0.00$0.00$0.00$0.00$5,373.42$5,419.09336.43%
0051212$9,510.48$0.00$16.17$16.17$24.95$0.00$2,117.00$1,649.31$672.75$4,439.06$3,795.86$8,276.0487.02%
0061617$13,747.88$0.00$115.26$115.26$34.93$0.00$439.95$580.21$292.40$1,312.56$133.13$1,595.8811.61%
0073537$28,436.38$0.00$54.39$54.39$34.93$0.00$5,846.00$5,979.93$1,057.84$12,883.77$14,562.50$27,535.5996.83%
0084953$41,839.56$0.00$352.56$352.56$144.71$0.00$3,109.00$2,434.54$2,795.62$8,339.16$5,626.97$14,463.4034.57%
0101111$9,664.56$0.00$67.80$67.80$34.93$0.00$0.00$448.06$390.57$838.63$1,404.86$2,346.2224.28%
0116572$53,964.10$0.00$102.90$102.90$84.83$0.00$3,218.83$7,974.65$2,984.70$14,178.18$10,540.79$24,906.7046.15%
01296105$76,567.52$0.00$664.44$664.44$334.33$8,026.86$6,593.97$7,135.82$2,540.64$24,297.29$26,717.24$52,013.3067.93%
01788$4,756.64$0.00$3.76$3.76$4.99$0.00$7.06$80.43$88.36$175.85$321.47$506.0710.64%
01812$1,300.56$0.00$0.94$0.94$0.00$0.00$0.00$0.00$0.00$0.00$566.77$567.7143.65%
0191515$10,107.86$0.00$50.86$50.86$9.98$0.00$0.00$405.73$637.99$1,043.72$3,007.67$4,112.2340.68%
020517$6,795.72$0.00$7.99$7.99$9.98$0.00$8,334.96$1,995.39$1,150.54$11,480.89$1,530.08$13,028.94191.72%
0235353$30,323.58$0.00$22.56$22.56$64.87$0.00$2,082.67$6,303.54$1,604.66$9,990.87$2,509.13$12,587.4341.51%
024924$11,265.70$0.00$11.75$11.75$14.97$0.00$0.00$6.68$375.57$382.25$995.27$1,404.2412.46%
C2311$606.47$0.00$0.47$0.47$0.00$0.00$0.00$0.00$0.00$0.00$3,196.99$3,197.46527.22%
R0777$5,547.78$0.00$10.29$10.29$9.98$0.00$1,018.61$329.80$741.56$2,089.97$2,543.31$4,653.5583.88%
R0866$4,832.28$0.00$40.68$40.68$4.99$0.00$413.00$194.31$164.88$772.19$180.78$998.6420.67%
R1111$792.54$0.00$1.47$1.47$0.00$0.00$0.00$485.02$0.00$485.02$556.95$1,043.44131.66%
R1233$2,416.14$0.00$20.34$20.34$9.98$0.00$0.00$50.40$82.92$133.32$1,091.84$1,255.4851.96%
Total411462$326,908.39$0.00$1,667.24$1,667.24$868.26$8,026.86$34,611.05$36,449.69$17,070.34$96,157.94$85,276.14$183,969.5856.28%
Avg2022$15,567.07$0.00$79.39$79.39$41.35$382.23$1,648.15$1,735.70$812.87$4,578.95$4,060.77$8,760.4656.28%
20231200144$2,377.62$0.00$7.35$7.35$0.00$0.00$0.00$215.72$62.14$277.86$6,281.03$6,566.24276.17%
0021111$8,859.18$0.00$74.58$74.58$0.00$0.00$2,860.00$167.76$497.92$3,525.68$5,674.42$9,274.68104.69%
00433$5,560.96$0.00$20.34$20.34$0.00$0.00$0.00$50.96$0.00$50.96$2,358.90$2,430.2043.70%
0051313$9,510.48$0.00$17.64$17.64$0.00$0.00$0.00$1,215.60$49.05$1,264.65$198.41$1,480.7015.57%
0061516$12,942.50$0.00$115.26$115.26$0.00$0.00$0.00$438.75$241.39$680.14$172.17$967.577.48%
0073537$28,436.38$0.00$54.39$54.39$0.00$0.00$1,384.21$1,859.25$502.44$3,745.90$7,460.22$11,260.5139.60%
0084954$42,701.36$0.00$366.12$366.12$0.00$0.00$18,919.14$8,689.09$2,890.71$30,498.94$9,509.81$40,374.8794.55%
0101111$7,248.42$0.00$74.58$74.58$0.00$0.00$6,623.00$4,319.66$697.11$11,639.77$440.11$12,154.46167.68%
0116875$55,549.18$0.00$107.31$107.31$0.00$34,440.00$29,000.37$5,774.65$2,911.83$72,126.85$11,528.71$83,762.87150.79%
01293101$78,348.18$0.00$711.90$711.90$0.00$42,156.43$7,014.02$6,724.99$2,855.66$58,751.10$17,210.58$76,673.5897.86%
01788$4,756.64$0.00$3.76$3.76$0.00$35,563.49$0.00$228.29$1,544.56$37,336.34$706.99$38,047.09799.87%
01812$1,300.56$0.00$0.94$0.94$0.00$0.00$0.00$0.00$195.70$195.70$0.00$196.6415.12%
0191515$7,729.54$0.00$20.55$20.55$0.00$0.00$847.25$220.74$1,053.29$2,121.28$2,271.93$4,413.7657.10%
020517$6,809.22$0.00$7.99$7.99$0.00$0.00$251.00$627.60$484.87$1,363.47$568.91$1,940.3728.50%
0235454$32,107.32$0.00$24.44$24.44$0.00$0.00$5,877.13$1,631.22$1,786.15$9,294.50$2,273.18$11,592.1236.10%
024924$11,265.70$0.00$11.28$11.28$0.00$0.00$2,909.25$637.20$304.05$3,850.50$424.63$4,286.4138.05%
C2311$618.36$0.00$0.47$0.47$0.00$0.00$0.00$0.00$84.57$84.57$3,294.55$3,379.59546.54%
R0777$5,547.78$0.00$10.29$10.29$0.00$0.00$0.00$193.56$113.93$307.49$351.11$668.8912.06%
R0866$4,832.28$0.00$40.68$40.68$0.00$0.00$0.00$0.00$232.95$232.95$59.68$333.316.90%
R1111$792.54$0.00$1.47$1.47$0.00$0.00$971.00$288.70$0.00$1,259.70$567.49$1,828.66230.73%
R1233$2,416.14$0.00$20.34$20.34$0.00$0.00$0.00($83.33)$0.00($83.33)$2,009.62$1,946.6380.57%
Total412463$329,710.34$0.00$1,691.68$1,691.68$0.00$112,159.92$76,656.37$33,200.41$16,508.32$238,525.02$73,362.45$313,579.1595.11%
Avg2022$15,700.49$0.00$80.56$80.56$0.00$5,340.95$3,650.30$1,580.97$786.11$11,358.33$3,493.45$14,932.3495.11%
20240100144$3,170.16$0.00$2.66$2.66$0.00$0.00$0.00$0.00$0.00$0.00$1,756.32$1,758.9855.49%
0021010$8,053.80$0.00$74.58$74.58$0.00$0.00$0.00$754.55$406.49$1,161.04$8,320.85$9,556.47118.66%
00433$2,416.14$0.00$20.34$20.34$0.00$0.00$0.00$50.85$75.63$126.48$6,830.38$6,977.20288.77%
0051313$11,095.56$0.00$19.67$19.67$0.00$0.00$2,286.25$1,613.33$622.70$4,522.28$1,690.65$6,232.6056.17%
0061415$12,942.50$0.00$101.70$101.70$0.00$0.00$0.00$472.99$0.00$472.99$29.24$603.934.67%
0073739$29,228.92$0.00$53.20$53.20$0.00$0.00$4,301.52$909.63$1,583.02$6,794.17$10,671.41$17,518.7859.94%
0085055$40,285.22$0.00$372.90$372.90$0.00$0.00$19,502.41$5,616.28$5,868.77$30,987.46$11,174.47$42,534.83105.58%
0101111$8,859.18$0.00$74.58$74.58$0.00$0.00$1,430.00$214.93($52.14)$1,592.79$887.61$2,554.9828.84%
0116774$57,926.80$0.00$106.54$106.54$0.00($14,370.10)$8,528.06$3,204.67$5,141.23$2,503.86$12,317.01$14,927.4125.77%
01294102$75,752.32$0.00$664.44$664.44$0.00$27,031.18$14,178.03$10,882.31$8,870.63$60,962.15$26,390.68$88,017.27116.19%
01788$4,756.64$0.00$3.20$3.20$0.00$0.00($7.06)$3.58$597.84$594.36$271.02$868.5818.26%
01812$1,300.56$0.00$0.80$0.80$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.800.06%
0191414$8,324.12$0.00$39.05$39.05$0.00$0.00$246.27$519.77$1,310.01$2,076.05$1,618.44$3,733.5444.85%
020517$6,795.72$0.00$6.80$6.80$0.00$0.00$1,329.00$667.57$0.00$1,996.57$56.73$2,060.1030.31%
0235555$32,107.32$0.00$21.67$21.67$0.00$0.00$0.00$593.16$1,145.84$1,739.00$0.00$1,760.675.48%
024924$11,265.70$0.00$9.60$9.60$0.00$0.00$244.00($476.10)$553.86$321.76$465.83$797.197.08%
C2311$606.47$0.00$0.40$0.40$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.400.07%
R0777$5,547.78$0.00$9.80$9.80$0.00$0.00$0.00$135.84$149.79$285.63$1,992.43$2,287.8641.24%
R0866$4,832.28$0.00$40.68$40.68$0.00$0.00$4,240.00$853.82$446.30$5,540.12$99.59$5,680.39117.55%
R1111$792.54$0.00$1.40$1.40$0.00$0.00$0.00$222.87$0.00$222.87$310.58$534.8567.49%
R1233$2,416.14$0.00$20.34$20.34$0.00$0.00$0.00$0.00$0.00$0.00$1,959.96$1,980.3081.96%
Total413464$328,475.87$0.00$1,644.35$1,644.35$0.00$12,661.08$56,278.48$26,240.05$26,719.97$121,899.58$86,843.20$210,387.1364.05%
Avg2022$15,641.71$0.00$78.30$78.30$0.00$602.91$2,679.93$1,249.53$1,272.38$5,804.74$4,135.39$10,018.4364.05%
20240200144$3,170.16$0.00$5.60$5.60$5.96$0.00$0.00$0.00$86.61$86.61$1,864.12$1,962.2961.90%
0021010$8,053.80$0.00$64.42$64.42$41.72$0.00$1,163.91$756.85$540.60$2,461.36$5,460.18$8,027.6899.68%
00433$2,416.14$0.00$21.36$21.36$11.92$0.00$0.00$0.00$80.93$80.93$6,333.08$6,447.29266.84%
0051313$10,303.02$0.00$18.20$18.20$29.80$0.00$157.25$616.78$71.41$845.44$2,557.91$3,451.3533.50%
0061415$11,331.74$0.00$100.02$100.02$35.76$0.00$0.00$581.25$214.23$795.48$59.81$991.078.75%
0073537$28,436.38$0.00$51.80$51.80$29.80$0.00$98.88$726.52$1,346.25$2,171.65$8,375.32$10,628.5737.38%
0085055$42,701.36$0.00$391.60$391.60$178.80$0.00$20,485.79$5,211.95$3,786.32$29,484.06$4,632.43$34,686.8981.23%
0101111$8,859.18$0.00$78.32$78.32$47.68$0.00$746.00$607.43$449.23$1,802.66$1,122.48$3,051.1434.44%
0116673$57,134.26$0.00$99.40$99.40$119.20$71,457.07$6,605.72$2,024.01$2,042.87$82,129.67$10,600.04$92,948.31162.68%
01296104$74,890.52$0.00$733.19$733.19$369.52($22,722.75)$17,452.80$16,554.91$5,476.22$16,761.18$6,835.33$24,699.2232.98%
01788$4,756.64$0.00$3.20$3.20$5.96$0.00$3,520.41$2,132.15$230.31$5,882.87$865.91$6,757.94142.07%
01812$1,300.56$0.00$0.80$0.80$0.00$0.00$0.00$0.00$0.00$0.00$2.50$3.300.25%
0191414$8,324.12$0.00$36.06$36.06$11.92$0.00$0.00$840.94$999.43$1,840.37$1,662.43$3,550.7842.66%
020517$6,795.72$0.00$6.80$6.80$5.96$0.00$0.00$232.16$0.00$232.16$0.00$244.923.60%
0235353$31,512.74$0.00$21.20$21.20$83.44$0.00$4,057.16$1,022.23$99.74$5,179.13$0.00$5,283.7716.77%
024924$11,265.70$0.00$9.60$9.60$17.88$0.00$0.00$896.48$53.80$950.28$14.21$991.978.81%
C2311$606.47$0.00$0.40$0.40$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.400.07%
R0799$6,340.32$0.00$11.20$11.20$5.96$0.00$0.00$208.11$1.80$209.91$515.03$742.1011.70%
R0866$4,832.28$0.00$42.72$42.72$11.92$0.00$0.00$379.15$52.00$431.15$53.72$539.5111.16%
R1111$792.54$0.00$1.40$1.40$0.00$0.00$1,598.00$125.68$0.00$1,723.68$574.14$2,299.22290.11%
R1233$2,416.14$0.00$21.36$21.36$11.92$0.00$0.00$289.61$38.22$327.83$3,427.07$3,788.18156.79%
Total412463$326,239.79$0.00$1,718.65$1,718.65$1,025.12$48,734.32$55,885.92$33,206.21$15,569.97$153,396.42$54,955.71$211,095.9064.71%
Avg2022$15,535.23$0.00$81.84$81.84$48.82$2,320.68$2,661.23$1,581.25$741.43$7,304.59$2,616.94$10,052.1964.71%
20240300144$3,170.16$0.00$5.72$5.72$6.21$0.00$0.00$90.06($62.14)$27.92$4,147.33$4,187.18132.08%
0021010$8,053.80$0.00$69.80$69.80$37.26$0.00$0.00$208.48$248.44$456.92$961.52$1,525.5018.94%
00433$2,416.14$0.00$20.94$20.94$12.42$0.00$1,430.00$552.84$64.61$2,047.45$3,630.20$5,711.01236.37%
0051212$9,510.48$0.00$18.59$18.59$24.84$0.00$0.00$1,511.89$112.28$1,624.17$1,926.53$3,594.1337.79%
0061415$12,137.12$0.00$104.70$104.70$37.26$0.00$464.37$1,055.81$527.91$2,048.09$14.47$2,204.5218.16%
0073638$27,643.84$0.00$51.51$51.51$31.05$0.00$4,688.04$772.74$309.10$5,769.88$15,856.82$21,709.2678.53%
0085055$43,506.74$0.00$390.88$390.88$217.35$0.00$1,660.44$4,289.11$3,400.99$9,350.54$9,905.58$19,864.3545.66%
0101111$8,859.18$0.00$76.78$76.78$49.68$0.00$0.00$225.64$181.62$407.26$1,161.28$1,695.0019.13%
0116572$53,171.56$0.00$100.10$100.10$136.62$0.00$9,537.01$3,923.75$2,164.68$15,625.44$8,615.58$24,477.7446.04%
01296104$79,779.22$0.00$732.87$732.87$422.28$198,737.12$18,140.67$18,154.56$26,620.09$261,652.44$13,111.27$275,918.86345.85%
01788$4,756.64$0.00$3.20$3.20$6.21$0.00$0.00$503.74$104.00$607.74($148.74)$468.419.85%
01812$1,300.56$0.00$0.80$0.80$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.800.06%
0191414$8,324.12$0.00$32.92$32.92$6.21$0.00$0.00$72.98$541.30$614.28$1,662.43$2,315.8427.82%
020517$6,795.72$0.00$6.80$6.80$12.42$0.00$0.00$235.47$175.50$410.97$31.88$462.076.80%
0235252$32,107.32$0.00$20.80$20.80$86.94$14,812.90$3,659.31$252.65$1,178.69$19,903.55$750.84$20,762.1364.66%
024924$11,265.70$0.00$9.60$9.60$18.63$0.00$0.00$0.00$294.59$294.59$14.21$337.032.99%
C2311$606.47$0.00$0.40$0.40$0.00$0.00$0.00$0.00$0.00$0.00$1.64$2.040.34%
R0799$7,132.86$0.00$14.27$14.27$6.21$0.00$0.00$138.69$88.18$226.87$1,518.95$1,766.3024.76%
R0866$4,832.28$0.00$41.88$41.88$12.42$0.00$0.00$54.98$136.16$191.14$10.22$255.665.29%
R1111$792.54$0.00$1.43$1.43$0.00$0.00$451.20$159.06$259.15$869.41$489.52$1,360.36171.65%
R1233$2,416.14$0.00$20.94$20.94$12.42$0.00$0.00$162.89$0.00$162.89$574.44$770.6931.90%
Total410461$328,578.59$0.00$1,724.93$1,724.93$1,136.43$213,550.02$40,031.04$32,365.34$36,345.15$322,291.55$64,235.97$389,388.88118.51%
Avg2022$15,646.60$0.00$82.14$82.14$54.12$10,169.05$1,906.24$1,541.21$1,730.72$15,347.22$3,058.86$18,542.33118.51%
20240400144$3,170.16$0.00$5.72$5.72$6.21$0.00$0.00$0.00$1.60$1.60$64.87$78.402.47%
0021010$8,053.80$0.00$69.80$69.80$31.05$0.00$400.00$1,023.62$657.91$2,081.53$4,663.79$6,846.1785.01%
00433$2,416.14$0.00$20.94$20.94$12.42$0.00$0.00$0.00$445.44$445.44$3,634.55$4,113.35170.24%
0051111$8,717.94$0.00$14.30$14.30$18.63$6,789.51$3,534.00$136.60$586.99$11,047.10$2,078.89$13,158.92150.94%
0061516$12,137.12$0.00$111.68$111.68$37.26$0.00$2,245.34$3,147.24$811.51$6,204.09$344.13$6,697.1655.18%
0073537$31,606.54$0.00$58.57$58.57$37.26$0.00$1,317.04$1,782.74$1,000.99$4,100.77($4,192.48)$4.120.01%
0085156$44,312.12$0.00$397.86$397.86$242.19$0.00$2,755.20$3,603.89$3,417.99$9,777.08$16,403.37$26,820.5060.53%
0101111$8,859.18$0.00$76.78$76.78$49.68$0.00$1,550.64$1,748.20$840.78$4,139.62$1,234.60$5,500.6862.09%
0116978$57,831.74$0.00$110.11$110.11$117.99$6,830.85$25,247.67$4,412.87$8,570.92$45,062.31$12,122.33$57,412.7499.28%
01295103$78,973.84$0.00$741.48$741.48$496.80$0.00$957.57$6,615.47$4,394.07$11,967.11$28,004.49$41,209.8852.18%
01788$4,756.64$0.00$3.20$3.20$6.21$0.00$1,059.81$670.40$681.61$2,411.82$183.83$2,605.0654.77%
01812$1,300.56$0.00$0.80$0.80$0.00$0.00$0.00$0.00$10.60$10.60$0.00$11.400.88%
0191414$8,324.12$0.00$5.60$5.60$6.21$0.00$0.00$272.76$210.69$483.45$1,725.51$2,220.7726.68%
020517$6,795.72$0.00$6.80$6.80$18.63$0.00$0.00$109.88$215.47$325.35$0.00$350.785.16%
0235252$30,918.16$0.00$20.80$20.80$80.73$81,097.13$1,429.60$6,105.95$8,395.35$97,028.03$2,089.03$99,218.59320.91%
024924$11,265.70$0.00$9.60$9.60$12.42$0.00$1,541.19($482.53)$216.75$1,275.41$14.21$1,311.6411.64%
C2311$606.47$0.00$0.40$0.40$0.00$0.00$0.00$150.46$0.00$150.46$2,442.03$2,592.89427.54%
R0799$7,925.40$0.00$12.87$12.87$6.21$0.00$2,431.00$180.39$53.80$2,665.19$1,251.82$3,936.0949.66%
R0866$4,832.28$0.00$41.88$41.88$12.42$0.00$0.00$365.47$52.00$417.47$296.29$768.0615.89%
R1111$792.54$0.00$1.43$1.43$0.00$0.00$0.00$7.57$0.00$7.57$489.52$498.5262.90%
R1233$2,416.14$0.00$20.94$20.94$12.42$0.00$0.00$0.00$0.00$0.00$576.53$609.8925.24%
Total413466$336,012.31$0.00$1,731.56$1,731.56$1,204.74$94,717.49$44,469.06$29,850.98$30,564.47$199,602.00$73,427.31$275,965.6182.13%
Avg2022$16,000.59$0.00$82.46$82.46$57.37$4,510.36$2,117.57$1,421.48$1,455.45$9,504.86$3,496.54$13,141.2282.13%
20240500144$3,170.16$0.00$5.72$5.72$6.21$0.00$0.00$0.00$0.00$0.00$37.72$49.651.57%
0021010$8,053.80$0.00$69.80$69.80$31.05$0.00$2,884.50$3,009.47$1,848.40$7,742.37$4,700.79$12,544.01155.75%
00433$2,416.14$0.00$20.94$20.94$12.42$0.00$0.00$0.00$19.61$19.61$6,325.39$6,378.36263.99%
0051111$8,717.94$0.00$15.73$15.73$12.42$12,876.99$9,937.09$1,390.66$7,829.68$32,034.42($3.02)$32,059.55367.74%
0061617$13,747.88$0.00$118.66$118.66$37.26$0.00$9,569.41$2,653.76$208.78$12,431.95$20.38$12,608.2591.71%
0073537$27,643.84$0.00$51.48$51.48$37.26$0.00$10,392.00$1,168.51$1,763.62$13,324.13$2,771.24$16,184.1158.55%
0085458$44,312.12$0.00$397.86$397.86$254.61$30,878.12$6,736.18$3,775.20$22,305.80$63,695.30$14,817.49$79,165.26178.65%
0101111$8,859.18$0.00$76.78$76.78$49.68$0.00$0.00$322.51$82.44$404.95$1,296.90$1,828.3120.64%
0116978$58,624.28$0.00$112.97$112.97$130.41$0.00$7,132.00$4,154.60$4,162.86$15,449.46$11,960.79$27,653.6347.17%
01294102$75,752.32$0.00$786.33$786.33$478.17$8,420.36$17,464.50$5,621.98$7,356.98$38,863.82$29,986.37$70,114.6992.56%
01788$4,756.64$0.00$3.20$3.20$12.42$0.00$148.80$146.79$559.89$855.48$161.79$1,032.8921.71%
01812$1,300.56$0.00$0.80$0.80$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.800.06%
0191515$8,918.70$0.00$5.60$5.60$6.21$0.00$570.09$0.00$1,180.48$1,750.57$2,676.41$4,438.7949.77%
020514$6,063.46$0.00$6.40$6.40$18.63$0.00$0.00$0.00$0.00$0.00$0.00$25.030.41%
0235050$29,134.42$0.00$19.20$19.20$86.94$0.00$19,325.11$16,509.51$3,067.01$38,901.63($830.46)$38,177.31131.04%
024924$11,265.70$0.00$9.60$9.60$12.42$0.00$2,492.43$324.25$127.99$2,944.67$17.83$2,984.5226.49%
C2311$606.47$0.00$0.40$0.40$0.00$0.00$0.00$0.00$154.96$154.96$1.80$157.1625.91%
R0799$7,132.86$0.00$12.87$12.87$12.42$0.00$1,687.00$109.13$167.08$1,963.21$3,287.09$5,275.5973.96%
R0866$4,832.28$0.00$41.88$41.88$12.42$0.00$0.00$56.05$122.00$178.05$3.84$236.194.89%
R1111$792.54$0.00$1.43$1.43$0.00$0.00$0.00$137.87$0.00$137.87$779.20$918.50115.89%
R1233$2,416.14$0.00$20.94$20.94$12.42$0.00$0.00$50.40$162.67$213.07$3,063.88$3,310.31137.01%
Total415464$328,517.43$0.00$1,778.59$1,778.59$1,223.37$52,175.47$88,339.11$39,430.69$51,120.25$231,065.52$81,075.43$315,142.9195.93%
Avg2022$15,643.69$0.00$84.69$84.69$58.26$2,484.55$4,206.62$1,877.65$2,434.30$11,003.12$3,860.73$15,006.8195.93%
20240600144$3,170.16$0.00$5.72$5.72$6.86$0.00$0.00$0.00$0.00$0.00$2,695.19$2,707.7785.41%
0021010$8,053.80$0.00$69.80$69.80$34.30$19,451.09$6,666.00$8,317.09$6,883.33$41,317.51$5,557.40$46,979.01583.31%
00433$2,416.14$0.00$20.94$20.94$6.86$0.00$0.00$0.00$0.00$0.00$0.00$27.801.15%
0051111$8,717.94$0.00$15.73$15.73$13.72$0.00$0.00$56.12$6,659.14$6,715.26$4,006.65$10,751.36123.32%
0061617$14,553.26$0.00$118.66$118.66$41.16$0.00$1,793.32$884.14$529.32$3,206.78$1,969.56$5,336.1636.67%
0073537$28,436.38$0.00$52.91$52.91$41.16$0.00$1,232.15$1,709.11$2,980.54$5,921.80$6,314.15$12,330.0243.36%
0085559$46,728.26$0.00$411.82$411.82$253.82$0.00$726.37$3,374.75$2,454.94$6,556.06$9,232.97$16,454.6735.21%
0101111$8,859.18$0.00$76.78$76.78$48.02$0.00$0.00$390.88$524.00$914.88$1,358.33$2,398.0127.07%
0116776$59,416.82$0.00$108.68$108.68$157.78$0.00$74,903.91$5,590.13$2,720.45$83,214.49$10,886.79$94,367.74158.82%
01294102$78,168.46$0.00$742.52$742.52$528.22($8,480.12)$22,956.56$15,067.15$4,915.33$34,458.92$11,354.98$47,084.6460.23%
01788$4,756.64$0.00$3.20$3.20$13.72$0.00$140.33$977.91$479.71$1,597.95$1,046.67$2,661.5455.95%
01812$1,300.56$0.00$0.80$0.80$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.800.06%
0191414$8,918.70$0.00$6.00$6.00$13.72$0.00$1,527.92$82.08$0.00$1,610.00$1,640.02$3,269.7436.66%
020514$5,067.58$0.00$4.80$4.80$20.58$0.00$0.00$0.00$3.66$3.66$0.00$29.040.57%
0235050$29,729.00$0.00$19.20$19.20$82.32$0.00$1,337.87$4,551.29$941.64$6,830.80$780.19$7,712.5125.94%
024924$11,265.70$0.00$9.60$9.60$6.86$0.00$3,024.47$419.04$184.63$3,628.14$57.42$3,702.0232.86%
C2311$606.47$0.00$0.40$0.40$0.00$0.00$0.00$0.00$0.00$0.00$2,826.88$2,827.28466.19%
R0799$7,132.86$0.00$12.87$12.87$6.86$0.00$0.00$814.19$78.70$892.89$7,619.40$8,532.02119.62%
R0866$4,832.28$0.00$41.88$41.88$13.72$0.00$0.00$1.80$52.00$53.80$0.00$109.402.26%
R1122$792.54$0.00$1.43$1.43$0.00$0.00$0.00$0.00$0.00$0.00$979.04$980.47123.71%
R1233$2,416.14$0.00$20.94$20.94$13.72$0.00$0.00$133.08$0.00$133.08$507.25$674.9927.94%
Total414463$335,338.87$0.00$1,744.68$1,744.68$1,303.40$10,970.97$114,308.90$42,368.76$29,407.39$197,056.02$68,832.89$268,936.9980.20%
Avg2022$15,968.52$0.00$83.08$83.08$62.07$522.43$5,443.28$2,017.56$1,400.35$9,383.62$3,277.76$12,806.5280.20%
20240700144$3,170.16$0.00$5.72$5.72$6.86$0.00$225.00$104.93$0.00$329.93$45.73$388.2412.25%
0021010$8,053.80$0.00$69.80$69.80$34.30$19,029.01$0.00$1,498.24$1,824.17$22,351.42$3,684.89$26,140.41324.57%
00433$2,416.14$0.00$20.94$20.94$6.86$0.00$0.00$50.96$101.94$152.90$0.00$180.707.48%
0051111$8,717.94$0.00$15.73$15.73$13.72$0.00$0.00$492.10$2,919.89$3,411.99$2,764.45$6,205.8971.19%
0061516$12,942.50$0.00$118.66$118.66$48.02$0.00$117.84$2,865.12$366.22$3,349.18$339.61$3,855.4729.79%
0073638$30,021.46$0.00$55.77$55.77$34.30$38,626.00$3,955.07$10,156.96$1,107.21$53,845.24$10,038.38$63,973.69213.09%
0085458$42,532.10$0.00$397.86$397.86$253.82$13,439.00$16,759.43$7,210.17$3,656.75$41,065.35$12,184.44$53,901.47126.73%
0101111$8,859.18$0.00$76.78$76.78$48.02$0.00$0.00$211.98$305.74$517.72$1,254.82$1,897.3421.42%
0116877$56,246.66$0.00$105.82$105.82$157.78$154,605.00$7,055.12$12,240.88$9,740.65$183,641.65$6,203.15$190,108.40337.99%
01299107$78,168.46$0.00$770.19$770.19$507.64$13,718.23$7,413.67$8,994.03$6,004.38$36,130.31$9,571.14$46,979.2860.10%
01788$4,756.64$0.00$3.20$3.20$13.72$0.00$0.00$421.36$58.02$479.38$291.35$787.6516.56%
01812$1,300.56$0.00$0.80$0.80$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.800.06%
0191414$7,729.54$0.00$5.60$5.60$20.58$0.00$0.00$82.08$245.55$327.63$1,610.87$1,964.6825.42%
020514$5,565.52$0.00$5.60$5.60$20.58$13,965.10$0.00$1,095.45$848.69$15,909.24$358.22$16,293.64292.76%
0235252$29,114.60$0.00$19.60$19.60$82.32$0.00$19,726.79$4,585.89$1,834.06$26,146.74$2,112.62$28,361.2897.41%
024924$11,265.70$0.00$9.60$9.60$6.86$0.00$0.00$46.19$670.49$716.68$0.00$733.146.51%
C2311$606.47$0.00$0.40$0.40$0.00$0.00$0.00$0.00$0.00$0.00$0.35$0.750.12%
R0799$7,132.86$0.00$12.87$12.87$6.86$0.00$696.95$93.82$925.76$1,716.53$1,894.51$3,630.7750.90%
R0866$4,832.28$0.00$41.88$41.88$13.72$0.00$0.00$44.29$248.75$293.04$282.23$630.8713.06%
R1122$792.54$0.00$1.43$1.43$0.00$0.00$0.00$42.72$103.50$146.22$523.34$670.9984.66%
R1233$2,416.14$0.00$20.94$20.94$13.72$0.00$0.00$207.72$0.00$207.72$649.15$891.5336.90%
Total421470$326,641.25$0.00$1,759.19$1,759.19$1,289.68$253,382.34$55,949.87$50,444.89$30,961.77$390,738.87$53,809.25$447,596.99137.03%
Avg2022$15,554.35$0.00$83.77$83.77$61.41$12,065.83$2,664.28$2,402.14$1,474.37$18,606.61$2,562.35$21,314.14137.03%
20240800144$3,170.16$0.00$5.72$5.72$13.72$0.00$0.00$0.00$0.00$0.00$2,840.68$2,860.1290.22%
0021010$8,053.80$0.00$69.80$69.80$34.30$4,281.16$1,513.00$1,806.95$596.58$8,197.69$6,328.11$14,629.90181.65%
00433$2,416.14$0.00$20.94$20.94$6.86$0.00$0.00$583.41$0.00$583.41$6,504.26$7,115.47294.50%
0051111$8,717.94$0.00$15.73$15.73$13.72$0.00$2,756.00$3.51$474.32$3,233.83$532.84$3,796.1243.54%
0061516$12,942.50$0.00$104.70$104.70$54.88$0.00$262.00$245.85$390.03$897.88$14.95$1,072.418.29%
0073739$29,228.92$0.00$54.34$54.34$48.02$29,304.72$456.71$2,850.58$5,108.94$37,720.95$5,887.49$43,710.80149.55%
0085559$47,477.22$0.00$418.80$418.80$253.82$0.00$6,052.00$2,603.78$7,182.42$15,838.20$13,397.42$29,908.2462.99%
0101111$8,859.18$0.00$76.78$76.78$48.02$0.00$1,334.24$794.82$264.00$2,393.06$3,079.79$5,597.6563.18%
0116775$57,831.74$0.00$104.39$104.39$205.80$0.00$9,127.86$4,203.72$2,007.14$15,338.72$9,697.33$25,346.2443.83%
01299107$84,611.50$0.00$770.67$770.67$521.36$17,312.31$24,183.54$8,950.78$5,722.00$56,168.63$28,894.63$86,355.29102.06%
01788$4,756.64$0.00$3.20$3.20$13.72$0.00$1,468.00$1,504.64$235.35$3,207.99$167.30$3,392.2171.32%
01812$1,300.56$0.00$0.80$0.80$0.00$0.00$0.00$5.68$0.00$5.68$0.00$6.480.50%
0191414$8,324.12$0.00$5.60$5.60$20.58$0.00$0.00$271.29$877.96$1,149.25$1,981.86$3,157.2937.93%
020514$5,565.52$0.00$5.60$5.60$20.58$0.00$1,867.00$1,169.78$529.13$3,565.91$140.48$3,732.5767.07%
0235050$31,512.74$0.00$20.40$20.40$89.18$571,207.90$520.92$5,893.54$1,097.83$578,720.19$78.26$578,908.031837.06%
024924$11,265.70$0.00$9.60$9.60$6.86$0.00$0.00$738.91$303.56$1,042.47$90.23$1,149.1610.20%
C2311$606.47$0.00$0.40$0.40$0.00$0.00$0.00$0.00$0.00$0.00$0.35$0.750.12%
R0799$7,132.86$0.00$12.87$12.87$6.86$0.00$0.00$884.16$223.16$1,107.32$5,350.65$6,477.7090.81%
R0866$4,832.28$0.00$41.88$41.88$13.72$0.00$0.00$0.00$302.99$302.99$32.58$391.178.09%
R1134$3,170.16$0.00$7.15$7.15$0.00$0.00$3,311.95$219.88$140.04$3,671.87$1,118.54$4,797.56151.33%
R1233$2,416.14$0.00$20.94$20.94$13.72$0.00$1,611.50$50.40$380.79$2,042.69$3,118.78$5,196.13215.06%
Total421470$344,192.29$0.00$1,770.31$1,770.31$1,385.72$622,106.09$54,464.72$32,781.68$25,836.24$735,188.73$89,256.53$827,601.29240.45%
Avg2022$16,390.11$0.00$84.30$84.30$65.99$29,624.10$2,593.56$1,561.03$1,230.30$35,008.99$4,250.31$39,409.59240.45%
20240900144$3,170.16$0.00$5.72$5.72$15.36$0.00$0.00$107.31$315.08$422.39$32.81$476.2815.02%
0021010$8,053.80$0.00$69.80$69.80$38.40$0.00$0.00$334.88$2,204.01$2,538.89$5,841.08$8,488.17105.39%
00433$2,416.14$0.00$20.94$20.94$7.68$0.00$0.00$319.18$0.00$319.18$0.00$347.8014.39%
0051111$8,717.94$0.00$15.73$15.73$15.36$0.00$238.51$2,191.14$231.25$2,660.90$6,821.09$9,513.08109.12%
0061415$12,137.12$0.00$104.70$104.70$61.44$0.00$732.00$539.23$188.35$1,459.58$37.50$1,663.2213.70%
0073638$30,021.46$0.00$54.34$54.34$61.44$0.00$41,345.53$3,436.80$10,042.54$54,824.87$11,925.04$66,865.69222.73%
0085458$45,061.08$0.00$397.86$397.86$284.16$10,269.62$2,648.91$2,911.10$6,657.42$22,487.05$14,622.60$37,791.6783.87%
0101111$8,859.18$0.00$76.78$76.78$53.76$0.00$0.00$602.58$226.54$829.12$334.49$1,294.1514.61%
0116773$51,475.52$0.00$104.39$104.39$222.72$0.00$9,640.62$9,341.01$6,768.32$25,749.95$11,957.04$38,034.1073.89%
01297105$79,779.22$0.00$745.63$745.63$606.72$0.00$28,713.47$13,780.53$7,145.33$49,639.33$12,922.16$63,913.8480.11%
01788$4,756.64$0.00$3.20$3.20$7.68$0.00$0.00$1,221.96$52.00$1,273.96$390.47$1,675.3135.22%
01812$1,300.56$0.00$0.80$0.80$0.00$0.00$0.00$114.80$0.00$114.80$0.00$115.608.89%
0191414$8,324.12$0.00$5.60$5.60$23.04$0.00$1,048.57$1,273.96$240.00$2,562.53$1,469.10$4,060.2748.78%
020514$5,565.52$0.00$5.60$5.60$23.04$0.00$0.00$394.12$570.95$965.07$268.36$1,262.0722.68%
0235050$29,729.00$0.00$21.20$21.20$122.88$0.00$4,169.17$8,032.10$1,405.37$13,606.64$312.34$14,063.0647.30%
024924$11,265.70$0.00$9.60$9.60$15.36$0.00$0.00$678.93$887.99$1,566.92$0.00$1,591.8814.13%
C2311$606.47$0.00$0.40$0.40$0.00$0.00$0.00$0.00$262.96$262.96$2,826.88$3,090.24509.55%
R0799$7,132.86$0.00$12.87$12.87$0.00$0.00$350.42$370.51$924.76$1,645.69$2,142.55$3,801.1153.29%
R0866$4,832.28$0.00$41.88$41.88$15.36$0.00$0.00$78.52$106.49$185.01$16.29$258.545.35%
R1134$3,170.16$0.00$7.15$7.15$0.00$0.00$26,704.51$1,648.33$76.64$28,429.48$1,066.59$29,503.22930.65%
R1233$2,416.14$0.00$20.94$20.94$15.36$0.00$1,815.02$118.09$40.02$1,973.13$526.78$2,536.21104.97%
Total416463$328,791.07$0.00$1,725.13$1,725.13$1,589.76$10,269.62$117,406.73$47,495.08$38,346.02$213,517.45$73,513.17$290,345.5188.31%
Avg2022$15,656.72$0.00$82.15$82.15$75.70$489.03$5,590.80$2,261.67$1,826.00$10,167.50$3,500.63$13,825.9888.31%
AllTotal4,9625,556$3,978,550.18$0.00$20,644.13$20,644.1311914.7$1,438,754.18$793,294.32$441,148.23$366,503.38$3,039,700.11$876,889.92$3,949,148.8699.26%
Grouping Avg414463$331,545.85$0.00$1,720.34$1,720.34$992.89$119,896.18$66,107.86$36,762.35$30,541.95$253,308.34$73,074.16$329,095.7499.26%
Monthly Avg2022$15,787.90$0.00$81.92$81.9247.2805555556$5,709.34$3,147.99$1,750.59$1,454.38$12,062.30$3,479.72$15,671.2399.26%

Notes:

- Grand Total includes Medical FFS, Pharmacy FFS, Incentives and Capitation.

- Grouping Avg – Average of the distinct groupings chosen by the user.

- Monthly Avg – Average of a measure over Service/Paid time period.

- Enrollment is recast to reflect retroactive adjustments.

- FFS = Fee For Service.

- MLR = Medical Loss Ratio.

&"Arial,Regular"&8 This Florida Blue report is proprietary and confidential. Report Run: 10/15/2024 1:11 PM Page 1 of 2

S6 Monitoring by Utiliza Page2

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