Appendix_H_-_Experience_Reports.xlsx
XLSX spreadsheet 58 KB Posted
- Attached to
- Group Health Insurance
- Solicitation number
- RFP- 24 - 004
- Issued by
- Pinellas County, Florida
About this file
The document is an Excel spreadsheet containing detailed healthcare claims and membership data for the City of St. Petersburg's group health insurance program, administered by UnitedHealthcare. The contract involves comprehensive administrative services for medical benefits, including claims processing, membership management, and detailed utilization reporting covering the period from September 2020 through August 2023. The scope of services includes providing on-site representation, a plan sponsor website with reporting and eligibility functionality, individual internet-based member access, a mobile app, and a toll-free member services number.
The healthcare cost summary reveals total net paid claims of $35,235,332 over the analyzed period, with monthly per member costs averaging $409.82. The membership remained relatively stable, ranging from approximately 3,640 to 3,706 subscribers, with total members between 7,131 and 7,225. Key cost categories include outpatient facility services (42.1% of total net paid), inpatient facility services (31.0%), and physician specialty services (18.3%). The data provides granular insights into healthcare utilization by diagnosis, provider type, and cost management, demonstrating the city's comprehensive approach to managing employee health benefits through a detailed, data-driven insurance program.
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Other files
| File | Type | Posted |
|---|---|---|
| Group_Health_Insurance.pdf | ||
| Business_Associate_Agreement_(BAA).DOCX | DOCX document | |
| Appendix_D_-_Retiree_Policy.pdf | ||
| Appendix_B_-_Fees_Schedule.xlsx | XLSX spreadsheet | |
| Base_Agreement.docx | DOCX document | |
| Appendix_C-_Employee_Policy.pdf | ||
| Appendix_E_-_2023_Employee_Benefits_Guide.pdf | ||
| Appendix_F_-_2023_Retiree_Benefits_Guide.pdf |
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Monthly Claims Paid
| City of St. Petersburg - Payments By Month | ||||
| Benefit Payment | Medical | Managed Pharmacy | HRA | Total |
| Book Year/Month | Payments | Payments | Payments | Payments |
| 2020-09 | $2,912,102 | $1,205,481 | $4,518 | $4,122,102 |
| 2020-10 | $2,732,882 | $1,318,431 | $6,917 | $4,058,230 |
| 2020-11 | $3,429,266 | $1,154,411 | $4,980 | $4,588,657 |
| 2020-12 | $2,994,967 | $1,247,310 | $5,963 | $4,248,240 |
| 2021-01 | $3,081,267 | $1,303,693 | $7,255 | $4,392,215 |
| 2021-02 | $3,514,594 | $1,336,375 | $6,060 | $4,857,029 |
| 2021-03 | $4,659,162 | $1,289,829 | $4,357 | $5,953,348 |
| 2021-04 | $2,789,735 | $1,328,543 | $11,583 | $4,129,861 |
| 2021-05 | $2,739,709 | $1,074,395 | $14,427 | $3,828,531 |
| 2021-06 | $3,605,289 | $1,141,916 | $8,311 | $4,755,517 |
| 2021-07 | $3,458,526 | $1,183,938 | $7,974 | $4,650,438 |
| 2021-08 | $3,399,538 | $1,275,403 | $6,930 | $4,681,872 |
| 2021-09 | $3,325,239 | $1,299,121 | $8,453 | $4,632,813 |
| 2021-10 | $3,197,090 | $1,296,566 | $6,431 | $4,500,087 |
| 2021-11 | $3,133,916 | $1,351,520 | $8,042 | $4,493,478 |
| 2021-12 | $3,069,945 | $1,602,308 | $3,992 | $4,676,245 |
| 2022-01 | $2,856,337 | $1,458,708 | $5,288 | $4,320,333 |
| 2022-02 | $3,259,777 | $1,453,790 | $5,972 | $4,719,539 |
| 2022-03 | $3,662,999 | $1,241,131 | $5,086 | $4,909,217 |
| 2022-04 | $3,391,371 | $1,455,145 | $9,420 | $4,855,937 |
| 2022-05 | $2,983,900 | $1,190,189 | $10,391 | $4,184,481 |
| 2022-06 | $2,390,571 | $1,373,996 | $11,537 | $3,776,105 |
| 2022-07 | $2,805,191 | $1,386,134 | $4,819 | $4,196,144 |
| 2022-08 | $3,405,138 | $1,370,568 | $6,859 | $4,782,564 |
| 2022-09 | $2,932,616 | $1,502,594 | $6,528 | $4,441,738 |
| 2022-10 | $2,501,625 | $1,358,003 | $5,958 | $3,865,586 |
| 2022-11 | $2,963,187 | $1,546,856 | $9,150 | $4,519,193 |
| 2022-12 | $2,984,683 | $1,481,611 | $6,265 | $4,472,559 |
| 2023-01 | $2,271,391 | $1,453,187 | $4,700 | $3,729,278 |
| 2023-02 | $2,846,475 | $1,707,831 | $3,424 | $4,557,730 |
| 2023-03 | $2,681,244 | $1,537,963 | $7,029 | $4,226,236 |
| 2023-04 | $3,561,457 | $1,413,338 | $8,564 | $4,983,358 |
| 2023-05 | $3,471,679 | $1,330,602 | $17,743 | $4,820,024 |
| 2023-06 | $3,071,130 | $1,602,912 | $11,626 | $4,685,668 |
| 2023-07 | $3,039,203 | $1,429,796 | $9,536 | $4,478,536 |
| 2023-08 | $2,974,402 | $1,889,434 | $8,476 | $4,872,312 |
Membership by month
| City of St. Petersburg - Membership By Month | |||||||
| Membership Year/Month | Single Subscribers | Subscribers plus Spouse | Subscribers plus Child/Children | Subscribers plus Family | Total Subscribers | Positively Enrolled Dependents | Total Members |
| 2020-09 | 1,778 | 799 | 271 | 797 | 3,645 | 3,574 | 7,219 |
| 2020-10 | 1,780 | 795 | 271 | 800 | 3,646 | 3,577 | 7,223 |
| 2020-11 | 1,792 | 793 | 277 | 798 | 3,660 | 3,593 | 7,253 |
| 2020-12 | 1,783 | 793 | 280 | 796 | 3,652 | 3,586 | 7,238 |
| 2021-01 | 1,779 | 803 | 279 | 787 | 3,648 | 3,543 | 7,191 |
| 2021-02 | 1,768 | 799 | 274 | 788 | 3,629 | 3,543 | 7,172 |
| 2021-03 | 1,772 | 800 | 275 | 786 | 3,633 | 3,538 | 7,171 |
| 2021-04 | 1,794 | 802 | 277 | 783 | 3,656 | 3,543 | 7,199 |
| 2021-05 | 1,803 | 796 | 278 | 783 | 3,660 | 3,540 | 7,200 |
| 2021-06 | 1,810 | 797 | 275 | 783 | 3,665 | 3,540 | 7,205 |
| 2021-07 | 1,819 | 796 | 277 | 783 | 3,675 | 3,545 | 7,220 |
| 2021-08 | 1,813 | 793 | 279 | 787 | 3,672 | 3,553 | 7,225 |
| 2021-09 | 1,812 | 788 | 279 | 788 | 3,667 | 3,554 | 7,221 |
| 2021-10 | 1,810 | 783 | 275 | 790 | 3,658 | 3,551 | 7,209 |
| 2021-11 | 1,819 | 787 | 275 | 792 | 3,673 | 3,559 | 7,232 |
| 2021-12 | 1,821 | 781 | 276 | 791 | 3,669 | 3,555 | 7,224 |
| 2022-01 | 1,827 | 789 | 268 | 786 | 3,670 | 3,500 | 7,170 |
| 2022-02 | 1,838 | 792 | 266 | 775 | 3,671 | 3,476 | 7,147 |
| 2022-03 | 1,837 | 786 | 262 | 776 | 3,661 | 3,467 | 7,128 |
| 2022-04 | 1,839 | 807 | 258 | 780 | 3,684 | 3,500 | 7,184 |
| 2022-05 | 1,845 | 798 | 260 | 781 | 3,684 | 3,501 | 7,185 |
| 2022-06 | 1,838 | 797 | 261 | 777 | 3,673 | 3,497 | 7,170 |
| 2022-07 | 1,830 | 793 | 260 | 781 | 3,664 | 3,505 | 7,169 |
| 2022-08 | 1,829 | 796 | 260 | 786 | 3,671 | 3,522 | 7,193 |
| 2022-09 | 1,830 | 789 | 262 | 785 | 3,666 | 3,517 | 7,183 |
| 2022-10 | 1,843 | 784 | 261 | 787 | 3,675 | 3,521 | 7,196 |
| 2022-11 | 1,836 | 784 | 259 | 782 | 3,661 | 3,509 | 7,170 |
| 2022-12 | 1,826 | 776 | 261 | 780 | 3,643 | 3,499 | 7,142 |
| 2023-01 | 1,835 | 783 | 255 | 780 | 3,653 | 3,478 | 7,131 |
| 2023-02 | 1,835 | 780 | 252 | 776 | 3,643 | 3,465 | 7,108 |
| 2023-03 | 1,850 | 777 | 252 | 779 | 3,658 | 3,474 | 7,132 |
| 2023-04 | 1,860 | 792 | 251 | 772 | 3,675 | 3,472 | 7,147 |
| 2023-05 | 1,865 | 794 | 252 | 772 | 3,683 | 3,475 | 7,158 |
| 2023-06 | 1,867 | 793 | 251 | 776 | 3,687 | 3,493 | 7,180 |
| 2023-07 | 1,878 | 795 | 252 | 781 | 3,706 | 3,515 | 7,221 |
| 2023-08 | 1,882 | 792 | 251 | 781 | 3,706 | 3,504 | 7,210 |
Utilization by Provider type
| City of St. Petersburg - Utilization by Provider Type | ||||
| 9/2022 thru 8/2023 | ||||
| Place of Service Category | Provider Type Utilization | Number of Units | Covered Amount per Unit | Total Net Paid per Unit |
| Inpatient | Facility | 2,716 | $5,163 | $4,007 |
| Physician Primary Care | 1,628 | $216 | $44 | |
| Physician OB/GYN | 126 | $1,552 | $1,480 | |
| Physician Specialist | 5,474 | $420 | $122 | |
| Allied Health | 966 | $269 | $47 | |
| Miscellaneous | 456 | $149 | $58 | |
| Pharmacy | 12 | $53 | $11 | |
| Outpatient | Facility | 70,086 | $792 | $197 |
| Physician Primary Care | 23,680 | $84 | $45 | |
| Physician OB/GYN | 3,625 | $202 | $173 | |
| Physician Specialist | 58,920 | $250 | $91 | |
| Allied Health | 28,585 | $106 | $36 | |
| Miscellaneous | 9,788 | $252 | $114 | |
| Pharmacy | 528 | $785 | $582 | |
| This document contains UnitedHealthcare’s confidential and/or proprietary business information (PBI). PBI may only be used by |
the recipient person/entity to which it is addressed. Recipient is liable for using and protecting UnitedHealthcare’s PBI from further disclosure or misuse, consistent with recipient’s contractual obligations under any applicable administrative services agreement, group policy contract, non-disclosure agreement or other applicable contract or law, including but not limited to the U.S. Freedom of Information Act and state freedom of information law exemptions for “trade secrets”. The document may also contain protected health information (PHI) and must be handled according to applicable state and federal law, including, but not limited to HIPAA. Recipients who misuse information may be subject to both civil and criminal penalties.
Cost by Provider Type
| City of St. Petersburg - Cost by Provider Type | ||||||||
| 9/2022 thru 8/2023 | ||||||||
| Place of Service Category | Provider Type Utilization | Number of Claimants | Covered Amount | Covered Amount per Claimant | Covered Amount PMPM | Total Net Paid | Total Net Paid per Claimant | Total Net Paid PMPM |
| Inpatient | Facility | 752 | $14,022,207 | $18,647 | $163.09 | 10,881,920 | $14,471 | $126.57 |
| Physician Primary Care | 402 | $351,242 | $874 | $4.09 | 72,284 | $180 | $0.84 | |
| Physician OB/GYN | 76 | $195,526 | $2,573 | $2.27 | 186,482 | $2,454 | $2.17 | |
| Physician Specialist | 610 | $2,299,919 | $3,770 | $26.75 | 667,730 | $1,095 | $7.77 | |
| Allied Health | 165 | $260,325 | $1,578 | $3.03 | 44,981 | $273 | $0.52 | |
| Miscellaneous | 51 | $67,926 | $1,332 | $0.79 | 26,592 | $521 | $0.31 | |
| Pharmacy | 10 | $632 | $63 | $0.01 | 131 | $13 | $0.00 | |
| Outpatient | Facility | 5,358 | $55,508,614 | $10,360 | $645.61 | 13,832,900 | $2,582 | $160.89 |
| Physician Primary Care | 3,560 | $1,991,691 | $559 | $23.17 | 1,066,857 | $300 | $12.41 | |
| Physician OB/GYN | 1,028 | $732,495 | $713 | $8.52 | 627,891 | $611 | $7.30 | |
| Physician Specialist | 4,531 | $14,745,494 | $3,254 | $171.50 | 5,373,965 | $1,186 | $62.50 | |
| Allied Health | 3,206 | $3,042,748 | $949 | $35.39 | 1,030,323 | $321 | $11.98 | |
| Miscellaneous | 901 | $2,467,059 | $2,738 | $28.69 | 1,115,829 | $1,238 | $12.98 | |
| Pharmacy | 169 | $414,595 | $2,453 | $4.82 | 307,445 | $1,819 | $3.58 |
Utilization by Diagnosis
| City of St. Petersburg - Utilization by Diagnosis | ||||||||||
| 9/2021 through 8/2023 | 9/2022 through 8/2023 | |||||||||
| Diagnosis Chapter | Number of Claimants | Claimants per 1000 | Total Net Paid | Total Net Paid % of Total | Total Net Paid PMPM | Number of Claimants | Claimants per 1000 | Total Net Paid | Total Net Paid % of Total | Total Net Paid PMPM |
| INFECTIOUS & PARASITIC DIS | 3,940 | 548.3 | $3,351,766 | 9.0% | $38.87 | 2,169 | 302.7 | $1,922,973 | 5.5% | $22.37 |
| NEOPLASMS | 1,343 | 186.9 | $4,676,234 | 12.5% | $54.23 | 1,446 | 201.8 | $4,263,531 | 12.1% | $49.59 |
| ENDCR NUTRI METABOLIC IMMUN | 1,964 | 273.3 | $1,517,498 | 4.1% | $17.60 | 1,924 | 268.5 | $1,101,123 | 3.1% | $12.81 |
| BLOOD & BLOOD FORM ORGANS | 388 | 54.0 | $281,200 | 0.8% | $3.26 | 379 | 52.9 | $275,084 | 0.8% | $3.20 |
| MENTAL DISORDERS | 979 | 136.2 | $981,907 | 2.6% | $11.39 | 1,068 | 149.1 | $1,129,556 | 3.2% | $13.14 |
| NERVOUS SYS SENSE ORGANS | 2,199 | 306.0 | $2,679,558 | 7.2% | $31.07 | 2,243 | 313.1 | $2,236,875 | 6.3% | $26.02 |
| CIRCULATORY SYSTEM | 1,867 | 259.8 | $3,508,505 | 9.4% | $40.69 | 1,844 | 257.4 | $3,512,466 | 10.0% | $40.85 |
| RESPIRATORY SYSTEM | 1,942 | 270.2 | $2,167,180 | 5.8% | $25.13 | 1,985 | 277.0 | $1,675,697 | 4.8% | $19.49 |
| DIGESTIVE SYSTEM | 1,178 | 163.9 | $2,803,098 | 7.5% | $32.51 | 1,189 | 165.9 | $2,624,175 | 7.4% | $30.52 |
| GENITOURINARY SYSTEM | 1,512 | 210.4 | $1,848,007 | 4.9% | $21.43 | 1,562 | 218.0 | $1,917,612 | 5.4% | $22.30 |
| PREGNANCY CHILDBIRTH PUERP | 295 | 41.1 | $1,676,856 | 4.5% | $19.45 | 299 | 41.7 | $1,403,192 | 4.0% | $16.32 |
| SKIN & SUBCUTANEOUS TISSUE | 1,595 | 222.0 | $487,377 | 1.3% | $5.65 | 1,632 | 227.8 | $596,713 | 1.7% | $6.94 |
| MUSCULO CNCTV TISSUE | 2,218 | 308.7 | $4,180,616 | 11.2% | $48.48 | 2,141 | 298.8 | $3,601,710 | 10.2% | $41.89 |
| CONGENITAL ANOMALIES | 103 | 14.3 | $632,953 | 1.7% | $7.34 | 98 | 13.7 | $203,475 | 0.6% | $2.37 |
| PERINATAL PERIOD | 115 | 16.0 | $623,064 | 1.7% | $7.23 | 86 | 12.0 | $2,273,017 | 6.5% | $26.44 |
| INJURY AND POISONING | 1,148 | 159.8 | $2,457,867 | 6.6% | $28.50 | 1,171 | 163.4 | $2,430,214 | 6.9% | $28.27 |
| OTHER CONDITIONS | 4,625 | 643.6 | $2,879,307 | 7.7% | $33.39 | 4,534 | 632.8 | $3,348,895 | 9.5% | $38.95 |
| RESIDUAL CODES; UNCLASSIFIED; | 1,352 | 188.1 | $649,756 | 1.7% | $7.53 | 1,539 | 214.8 | $719,025 | 2.0% | $8.36 |
Healthcare Cost Summary
| City of St. Petersburg - Healthcare Cost Management Summary - 9/2022 thru 8/2023 | |||||||||
| Metrics | Healthcare Cost Category Detail | Physician - Primary Care | Physician - OB/GYN | Physician - Specialty | Allied Health | Facility Inpatient | Facility Outpatient | Medical Pharmacy | Total |
| Submitted Charges | $3,843,813 | $1,751,718 | $36,426,292 | $6,325,450 | $35,995,300 | $113,842,540 | ($1,942) | $198,183,172 | |
| Savings Due to Ineligible Charges | $294,037 | $102,752 | $7,508,227 | $945,071 | $3,495,755 | $15,904,615 | $1,934 | $28,252,391 | |
| Eligible Charges | $3,549,776 | $1,648,966 | $28,918,065 | $5,380,379 | $32,499,545 | $97,937,925 | ($3,876) | $169,930,781 | |
| Savings Due to Discounts | $1,210,190 | $721,644 | $10,732,665 | $2,099,493 | $18,583,670 | $40,482,644 | $1 | $73,830,308 | |
| Covered Amount | $2,339,586 | $927,323 | $18,185,400 | $3,280,886 | $13,915,875 | $57,455,281 | ($3,876) | $96,100,473 | |
| Savings due to Deductibles | $57,336 | $17,482 | $459,896 | $107,531 | $74,907 | $1,418,907 | $0 | $2,136,059 | |
| Savings due to Coinsurance | $28,593 | $2,528 | $100,166 | $40,903 | $40,479 | $284,285 | $0 | $496,954 | |
| Savings due to Copays | $171,848 | $17,370 | $601,027 | $391,048 | $139,257 | $416,458 | $0 | $1,737,008 | |
| Gross Payable | $2,081,809 | $889,942 | $17,024,311 | $2,741,404 | $13,659,952 | $55,335,631 | ($3,876) | $91,729,172 | |
| Other Savings | $944,463 | $76,920 | $10,584,875 | $1,672,298 | $2,724,883 | $40,561,048 | ($1,303) | $56,563,184 | |
| Plan Net Paid | $1,137,346 | $813,022 | $6,439,437 | $1,069,106 | $10,935,069 | $14,774,582 | ($2,573) | $35,165,988 | |
| HRA Net Paid | $740 | $653 | $9,240 | $1,393 | $3,184 | $54,134 | $0 | $69,344 | |
| Total Net Paid | $1,138,086 | $813,675 | $6,448,677 | $1,070,499 | $10,938,252 | $14,828,717 | ($2,573) | $35,235,332 | |
| Plan Net Paid PMPM | $13.23 | $9.46 | $74.90 | $12.43 | $127.18 | $171.84 | ($0.03) | $409.01 | |
| HRA Net Paid PMPM | $0.01 | $0.01 | $0.11 | $0.02 | $0.04 | $0.63 | $0.00 | $0.81 | |
| Total Net Paid PMPM | $13.24 | $9.46 | $75.00 | $12.45 | $127.22 | $172.47 | ($0.03) | $409.82 | |
| Total Net Paid as a % of Grand Total | 3.2% | 2.3% | 18.3% | 3.0% | 31.0% | 42.1% | (0.0%) | 100.0% |
Claims by size 9_20 thru 8_21
| City of St. Petersburg - Claim Expenses by Size of Payment | |||||
| Payment Category for Interactive Report - Core | Number of Claimants | % Claimants | Payments | % Payments | |
| Total | 7,090 | 100.0% | $53,921,405.04 | 100.0% | |
| <$.01 | 88 | 1.2% | ($184,543.22) | (0.3%) | |
| $.01-$49 | 294 | 4.1% | $7,997.76 | 0.0% | |
| $50-$99 | 320 | 4.5% | $24,031.15 | 0.0% | |
| $100-$249 | 759 | 10.7% | $129,091.73 | 0.2% | |
| $250-$499 | 805 | 11.4% | $294,644.91 | 0.5% | |
| $500-$999 | 1,058 | 14.9% | $764,121.72 | 1.4% | |
| $1,000-$2,499 | 1,344 | 19.0% | $2,205,497.39 | 4.1% | |
| $2,500-$4,999 | 794 | 11.2% | $2,813,122.80 | 5.2% | |
| $5,000-$9,999 | 658 | 9.3% | $4,671,812.17 | 8.7% | |
| $10,000-$14,999 | 253 | 3.6% | $3,088,487.63 | 5.7% | |
| $15,000-$19,999 | 166 | 2.3% | $2,855,353.75 | 5.3% | |
| $20,000-$24,999 | 94 | 1.3% | $2,100,434.92 | 3.9% | |
| $25,000-$29,999 | 70 | 1.0% | $1,903,297.89 | 3.5% | |
| $30,000-$39,999 | 114 | 1.6% | $3,953,767.23 | 7.3% | |
| $40,000-$49,999 | 70 | 1.0% | $3,175,538.77 | 5.9% | |
| $50,000-$74,999 | 77 | 1.1% | $4,752,646.69 | 8.8% | |
| $75,000-$99,999 | 39 | 0.6% | $3,410,209.03 | 6.3% | |
| $100,000-$124,999 | 24 | 0.3% | $2,677,705.94 | 5.0% | |
| $125,000-$149,999 | 17 | 0.2% | $2,324,681.59 | 4.3% | |
| $150,000-$174,999 | 8 | 0.1% | $1,312,122.19 | 2.4% | |
| $175,000-$199,999 | 11 | 0.2% | $2,073,114.40 | 3.8% | |
| $200,000-$249,999 | 12 | 0.2% | $2,581,034.27 | 4.8% | |
| $250,000-$299,999 | 3 | 0.0% | $784,927.40 | 1.5% | |
| $300,000-$349,999 | 2 | 0.0% | $633,440.76 | 1.2% | |
| $350,000-$399,999 | 4 | 0.1% | $1,514,225.04 | 2.8% | |
| $400,000-$449,999 | 1 | 0.0% | $437,999.73 | 0.8% | |
| $450,000-$499,999 | 2 | 0.0% | $968,148.31 | 1.8% | |
| $500,000+ | 3 | 0.0% | $2,648,493.09 | 4.9% |
Claims by size 9_21 thru 8_22
| City of St. Petersburg - Claim Expenses by Size of Payment | |||||
| Payment Category for Interactive Report - Core | Number of Claimants | % Claimants | Payments | % Payments | |
| Total | 7,288 | 100.0% | $53,745,744.06 | 100.0% | |
| <$.01 | 107 | 1.5% | ($177,719.04) | (0.3%) | |
| $.01-$49 | 282 | 3.9% | $8,232.65 | 0.0% | |
| $50-$99 | 285 | 3.9% | $21,983.39 | 0.0% | |
| $100-$249 | 706 | 9.7% | $121,151.49 | 0.2% | |
| $250-$499 | 827 | 11.3% | $301,545.56 | 0.6% | |
| $500-$999 | 1,034 | 14.2% | $743,865.49 | 1.4% | |
| $1,000-$2,499 | 1,458 | 20.0% | $2,380,774.23 | 4.4% | |
| $2,500-$4,999 | 850 | 11.7% | $3,059,690.83 | 5.7% | |
| $5,000-$9,999 | 720 | 9.9% | $5,162,250.97 | 9.6% | |
| $10,000-$14,999 | 259 | 3.6% | $3,169,968.56 | 5.9% | |
| $15,000-$19,999 | 196 | 2.7% | $3,408,428.74 | 6.3% | |
| $20,000-$24,999 | 119 | 1.6% | $2,659,126.48 | 4.9% | |
| $25,000-$29,999 | 79 | 1.1% | $2,160,909.91 | 4.0% | |
| $30,000-$39,999 | 93 | 1.3% | $3,211,236.14 | 6.0% | |
| $40,000-$49,999 | 66 | 0.9% | $2,958,380.13 | 5.5% | |
| $50,000-$74,999 | 87 | 1.2% | $5,346,954.49 | 9.9% | |
| $75,000-$99,999 | 48 | 0.7% | $4,173,365.22 | 7.8% | |
| $100,000-$124,999 | 15 | 0.2% | $1,648,280.47 | 3.1% | |
| $125,000-$149,999 | 19 | 0.3% | $2,606,781.35 | 4.9% | |
| $150,000-$174,999 | 9 | 0.1% | $1,452,341.94 | 2.7% | |
| $175,000-$199,999 | 6 | 0.1% | $1,131,432.90 | 2.1% | |
| $200,000-$249,999 | 6 | 0.1% | $1,337,010.80 | 2.5% | |
| $250,000-$299,999 | 5 | 0.1% | $1,390,509.80 | 2.6% | |
| $300,000-$349,999 | 2 | 0.0% | $632,657.99 | 1.2% | |
| $350,000-$399,999 | 2 | 0.0% | $741,937.35 | 1.4% | |
| $400,000-$449,999 | 3 | 0.0% | $1,249,198.30 | 2.3% | |
| $500,000+ | 5 | 0.1% | $2,845,447.92 | 5.3% |
Claims by size 9_22 thru 8_23
| City of St. Petersburg - Claim Expenses by Size of Payment | |||||
| Payment Category for Interactive Report - Core | Number of Claimants | % Claimants | Payments | % Payments | |
| Total | 6,950 | 100.0% | $53,232,166.36 | 100.0% | |
| <$.01 | 123 | 1.8% | ($388,274.88) | (0.7%) | |
| $.01-$49 | 311 | 4.5% | $7,542.28 | 0.0% | |
| $50-$99 | 250 | 3.6% | $18,977.06 | 0.0% | |
| $100-$249 | 562 | 8.1% | $96,587.53 | 0.2% | |
| $250-$499 | 787 | 11.3% | $290,853.64 | 0.5% | |
| $500-$999 | 963 | 13.9% | $711,135.79 | 1.3% | |
| $1,000-$2,499 | 1,383 | 19.9% | $2,243,151.50 | 4.2% | |
| $2,500-$4,999 | 847 | 12.2% | $3,003,033.76 | 5.6% | |
| $5,000-$9,999 | 677 | 9.7% | $4,787,245.76 | 9.0% | |
| $10,000-$14,999 | 304 | 4.4% | $3,712,421.35 | 7.0% | |
| $15,000-$19,999 | 204 | 2.9% | $3,544,370.77 | 6.7% | |
| $20,000-$24,999 | 117 | 1.7% | $2,616,517.26 | 4.9% | |
| $25,000-$29,999 | 76 | 1.1% | $2,074,138.03 | 3.9% | |
| $30,000-$39,999 | 89 | 1.3% | $3,087,992.11 | 5.8% | |
| $40,000-$49,999 | 57 | 0.8% | $2,554,218.87 | 4.8% | |
| $50,000-$74,999 | 78 | 1.1% | $4,760,865.95 | 8.9% | |
| $75,000-$99,999 | 48 | 0.7% | $4,124,085.01 | 7.7% | |
| $100,000-$124,999 | 18 | 0.3% | $1,969,013.69 | 3.7% | |
| $125,000-$149,999 | 8 | 0.1% | $1,102,358.76 | 2.1% | |
| $150,000-$174,999 | 18 | 0.3% | $2,940,289.47 | 5.5% | |
| $175,000-$199,999 | 6 | 0.1% | $1,117,291.20 | 2.1% | |
| $200,000-$249,999 | 9 | 0.1% | $1,923,019.44 | 3.6% | |
| $250,000-$299,999 | 1 | 0.0% | $296,057.23 | 0.6% | |
| $300,000-$349,999 | 5 | 0.1% | $1,631,389.86 | 3.1% | |
| $350,000-$399,999 | 1 | 0.0% | $372,035.65 | 0.7% | |
| $400,000-$449,999 | 1 | 0.0% | $438,848.58 | 0.8% | |
| $450,000-$499,999 | 1 | 0.0% | $457,973.45 | 0.9% | |
| $500,000+ | 6 | 0.1% | $3,739,027.24 | 7.0% |
Top Hospitals
| City of St. Petersburg - Top Hospitals | |||||||||||||
| 9/2022 thru 8/2023 | |||||||||||||
| Provider MPIN | Provider TIN | Hospital Name | City | State | Provider Participation Status Category | Number of Inpatient Admissions | Number of Inpatient Days | Inpatient Covered Amount | Inpatient Total Net Paid | Outpatient Number of Services | Outpatient Covered Amount | Outpatient Total Net Paid | Total Net Paid |
| 594444 | 845074208 | BAYFRONT HEALTH ST PETERSBURG | SAINT PETERSBURG | Florida | Participating Provider | 88 | 295 | $1,792,611 | $1,632,888 | 2,738 | $5,630,543 | $2,818,142 | $4,451,029 |
| 596971 | 592043026 | ST ANTHONY'S HOSPITAL INC | SAINT PETERSBURG | Florida | Participating Provider | 106 | 398 | $1,729,576 | $1,656,257 | 3,209 | $10,772,795 | $2,452,376 | $4,108,633 |
| 680475 | 590683252 | JOHNS HOPKINS ALL CHILDREN'S HOSPITAL | SAINT PETERSBURG | Florida | Participating Provider | 16 | 256 | $2,346,405 | $2,335,832 | 929 | $674,431 | $508,140 | $2,843,972 |
| 270091 | 590624462 | MORTON PLANT HOSPITAL | CLEARWATER | Florida | Participating Provider | 26 | 134 | $895,095 | $869,494 | 546 | $1,777,703 | $618,291 | $1,487,785 |
| 730689 | 593238634 | H LEE MOFFITT CANCER CTR & RESEARCH INST | TAMPA | Florida | Participating Provider | 5 | 20 | $546,676 | $545,623 | 2,109 | $3,920,998 | $930,172 | $1,475,795 |
| 43344 | 593458145 | TAMPA GENERAL HOSPITAL | TAMPA | Florida | Participating Provider | 21 | 93 | $656,862 | $644,520 | 241 | $743,670 | $244,254 | $888,773 |
| 490624 | 590855412 | MEASE COUNTRYSIDE HOSPITAL | SAFETY HARBOR | Florida | Participating Provider | 9 | 33 | $350,271 | $342,871 | 191 | $600,435 | $241,150 | $584,021 |
| 380944 | 621026428 | HCA FLORIDA LARGO HOSPITAL | LARGO | Florida | Participating Provider | 3 | 17 | $350,981 | $347,903 | 52 | $114,875 | $79,528 | $427,431 |
| 730063 | 591113901 | ADVENTHEALTH TAMPA | TAMPA | Florida | Participating Provider | 9 | 39 | $283,169 | $278,145 | 31 | $83,591 | $62,235 | $340,380 |
| 195444 | 591174716 | HCA FLORIDA ST. PETERSBURG HOSPITAL | SAINT PETERSBURG | Florida | Participating Provider | 12 | 39 | $444,610 | $134,567 | 214 | $1,301,124 | $174,462 | $309,029 |
| 645893 | 590774199 | ST JOSEPHS HOSPITAL INC | TAMPA | Florida | Participating Provider | 8 | 47 | $180,554 | $178,093 | 246 | $629,080 | $128,770 | $306,863 |
| 951320 | 562070036 | DUKE UNIVERSITY HOSPITAL | DURHAM | North Carolina | Participating Provider | 8 | 39 | $245,560 | $244,960 | 55 | $26,832 | $26,832 | $271,792 |
| 315437 | 610947837 | HCA FLORIDA NORTHSIDE HOSPITAL | SAINT PETERSBURG | Florida | Participating Provider | 10 | 41 | $49,901 | $44,651 | 275 | $1,369,407 | $158,466 | $203,118 |
| Non-Participating Provider | 1 | 9 | $60,835 | $59,705 | 0 | $0 | $0 | $59,705 | |||||
| Subtotal | 11 | 50 | $110,736 | $104,356 | 275 | $1,369,407 | $158,466 | $262,822 | |||||
| 1280452 | 621113740 | HCA FLORIDA BAYONET POINT HOSPITAL | HUDSON | Florida | Participating Provider | 2 | 25 | $203,761 | $201,961 | 32 | $204,586 | $15,064 | $217,025 |
| 499785 | 590855412 | MEASE DUNEDIN HOSPITAL | DUNEDIN | Florida | Participating Provider | 2 | 7 | $114,128 | $112,928 | 69 | $255,891 | $53,819 | $166,747 |
| 625547 | 592047041 | HCA FLORIDA TRINITY HOSPITAL | NEW PORT RICHEY | Florida | Participating Provider | 1 | 5 | $1,600 | $1,600 | 47 | $230,061 | $157,213 | $158,813 |
| 191058 | 800935610 | HCA FLORIDA PASADENA HOSPITAL | SAINT PETERSBURG | Florida | Participating Provider | 10 | 37 | $110,870 | $107,169 | 121 | $740,472 | $43,700 | $150,869 |
| 5303854 | 590774199 | ST JOSEPHS HOSPITAL - SOUTH | RIVERVIEW | Florida | Participating Provider | 4 | 9 | $81,037 | $76,766 | 39 | $98,973 | $72,660 | $149,426 |
| 705775 | 590898901 | ADVENTHEALTH NORTH PINELLAS | TARPON SPRINGS | Florida | Participating Provider | 2 | 12 | $39,786 | $39,115 | 126 | $99,218 | $77,117 | $116,232 |
| 117992 | 580572412 | CHILDRENS HEALTHCARE AT EGLESTON INC | ATLANTA | Georgia | Participating Provider | 0 | 0 | $0 | $0 | 49 | $115,290 | $114,805 | $114,805 |
| 657401 | 590774199 | ST JOSEPHS WOMENS HOSPITAL | TAMPA | Florida | Participating Provider | 3 | 6 | $52,521 | $48,661 | 45 | $68,092 | $64,169 | $112,831 |
| 2921184 | 050615150 | BAYCARE ALLIANT HOSPITAL | DUNEDIN | Florida | Participating Provider | 1 | 41 | $106,559 | $105,659 | 0 | $0 | $0 | $105,659 |
| 716946 | 596012500 | SARASOTA MEMORIAL HOSPITAL | SARASOTA | Florida | Participating Provider | 2 | 4 | $82,290 | $81,990 | 61 | $31,279 | $16,370 | $98,360 |
| 383737 | 262037695 | GRADY HEALTH SYSTEM CORP | ATLANTA | Georgia | Participating Provider | 1 | 2 | $95,282 | $94,682 | 0 | $0 | $0 | $94,682 |
| 3121121 | 590774199 | ST JOSEPH'S HOSPITAL-NORTH | LUTZ | Florida | Participating Provider | 1 | 5 | $37,901 | $37,001 | 35 | $75,547 | $56,665 | $93,666 |
| 678197 | 590724459 | ADVENTHEALTH ORLANDO | ORLANDO | Florida | Participating Provider | 2 | 10 | $49,500 | $48,600 | 6 | $42,219 | $32,176 | $80,775 |
| 3496187 | 208488713 | ADVENTHEALTH WESLEY CHAPEL | WESLEY CHAPEL | Florida | Participating Provider | 0 | 0 | $0 | $0 | 33 | $237,108 | $70,180 | $70,180 |
| 234768 | 020364103 | PORTSMOUTH REGIONAL HOSPITAL | PORTSMOUTH | New Hampshire | Participating Provider | 0 | 0 | $0 | $0 | 50 | $60,629 | $59,861 | $59,861 |
| 518600 | 232798290 | MANATEE MEMORIAL HOSPITAL LP | BRADENTON | Florida | Participating Provider | 4 | 10 | $38,501 | $32,150 | 46 | $184,262 | $26,386 | $58,535 |
| 1766384 | 520591656 | JOHNS HOPKINS HOSPITAL | BALTIMORE | Maryland | Participating Provider | 2 | 8 | $57,356 | $56,903 | 10 | $1,188 | $1,109 | $58,013 |
| 1090821 | 591113901 | ADVENTHEALTH CARROLLWOOD | TAMPA | Florida | Participating Provider | 1 | 4 | $19,403 | $18,503 | 16 | $96,113 | $33,606 | $52,110 |
| 754918 | 566017737 | WAKEMED RALEIGH CAMPUS | RALEIGH | North Carolina | Participating Provider | 0 | 0 | $0 | $0 | 39 | $51,160 | $50,475 | $50,475 |
| 491440 | 471455535 | HCA FLORIDA CITRUS HOSPITAL | INVERNESS | Florida | Participating Provider | 1 | 1 | $9,951 | $8,901 | 62 | $528,614 | $34,251 | $43,152 |
| 1683320 | 746001118 | MD ANDERSON CANCER CTR | HOUSTON | Texas | Participating Provider | 1 | 4 | $27,225 | $26,815 | 82 | $78,481 | $11,415 | $38,230 |
| 2770728 | 208489105 | MOUNTAINSIDE MEDICAL CENTER | MONTCLAIR | New Jersey | Participating Provider | 1 | 4 | $37,636 | $36,736 | 0 | $0 | $0 | $36,736 |
| 665179 | 364764806 | HCA FLORIDA WEST TAMPA HOSPITAL LP | TAMPA | Florida | Participating Provider | 0 | 0 | $0 | $0 | 10 | $34,986 | $34,949 | $34,949 |
| 461040 | 610947837 | HCA FLORIDA BRANDON HOSPITAL | BRANDON | Florida | Participating Provider | 1 | 4 | $14,678 | $13,778 | 37 | $191,219 | $20,546 | $34,325 |
| 619359 | 590624462 | MORTON PLANT NORTH BAY HOSP | LUTZ | Florida | Participating Provider | 1 | 4 | $1,600 | $1,600 | 25 | $229,148 | $32,153 | $33,753 |
| 891233 | 811723202 | PRISMA HEALTH HILLCREST HOSPITAL | SIMPSONVILLE | South Carolina | Participating Provider | 0 | 0 | $0 | $0 | 3 | $33,154 | $32,943 | $32,943 |
| 6863956 | 812457339 | RECOVERY VILLAGE MARYLAND | UPPER MARLBORO | Maryland | Participating Provider | 3 | 41 | $36,300 | $31,741 | 0 | $0 | $0 | $31,741 |
| 130078 | 611269294 | HCA FLORIDA NORTH FLORIDA HOSPITAL | GAINESVILLE | Florida | Participating Provider | 2 | 10 | $10,563 | $10,563 | 40 | $154,114 | $19,948 | $30,511 |
| 244452 | 340714585 | CLEVELAND CLINIC FOUNDATION | CLEVELAND | Ohio | Participating Provider | 0 | 0 | $0 | $0 | 106 | $1,000,376 | $30,493 | $30,493 |
| 365439 | 822567308 | ADVENTHEALTH DADE CITY | DADE CITY | Florida | Participating Provider | 1 | 2 | $1,556 | $1,556 | 14 | $54,477 | $25,804 | $27,360 |
| 1413105 | 330592165 | TREASURE VALLEY HOSPITAL | BOISE | Idaho | Participating Provider | 0 | 0 | $0 | $0 | 15 | $77,419 | $25,658 | $25,658 |
| 2403637 | 731666433 | LAKEWOOD RANCH MEDICAL CENTER INC | BRADENTON | Florida | Participating Provider | 4 | 19 | $13,860 | $12,307 | 35 | $43,902 | $12,047 | $24,353 |
| 572632 | 592108057 | ADVENTHEALTH ZEPHYRHILLS | ZEPHYRHILLS | Florida | Participating Provider | 2 | 5 | $22,491 | $21,591 | 37 | $131,887 | $2,054 | $23,645 |
| 2247388 | 621113740 | HCA FLORIDA BLAKE HOSPITAL | BRADENTON | Florida | Participating Provider | 0 | 0 | $0 | $0 | 30 | $28,195 | $23,248 | $23,248 |
| 458316 | 590973502 | ADVENTHEALTH DAYTONA BEACH | DAYTONA BEACH | Florida | Participating Provider | 1 | 1 | $22,503 | $21,911 | 1 | $1,066 | $1,066 | $22,977 |
| 390534 | 621113740 | HCA FLORIDA OAK HILL HOSPITAL | BROOKSVILLE | Florida | Participating Provider | 4 | 16 | $6,400 | $6,400 | 59 | $382,795 | $15,855 | $22,255 |
| 375847 | 621026428 | LARGO MEDICAL CENTER INC | LARGO | Florida | Participating Provider | 10 | 42 | $23,413 | $17,456 | 16 | $48,075 | $3,702 | $21,158 |
| 315437 | 610947837 | HCA FLORIDA NORTHSIDE HOSPITAL | SAINT PETERSBURG | Florida | Participating Provider | 10 | 41 | $49,901 | $44,651 | 275 | $1,369,407 | $158,466 | $203,118 |
| Non-Participating Provider | 1 | 9 | $60,835 | $59,705 | 0 | $0 | $0 | $59,705 | |||||
| Subtotal | 11 | 50 | $110,736 | $104,356 | 275 | $1,369,407 | $158,466 | $262,822 |
Top Physicians
| City of St. Petersburg - Top Physicians over $10,000 |
| 9/2022 - 8/2023 |
| Provider MPIN | Provider TIN | Physician Name | State | Provider Participation Status Category | Number of Claimants | Number of Visits | Number of Services | Covered Amount | Total Net Paid |
| 2530079 | 650825133 | MICHAEL DIAZ | Florida | Participating Provider | 26 | 116 | 499 | $425,193 | $409,536 |
| 2405345 | 650825133 | VU T HO | Florida | Participating Provider | 21 | 41 | 185 | $152,673 | $120,141 |
| 2895843 | 820619126 | SUSAN L ZITO | Florida | Participating Provider | 6 | 23 | 378 | $114,802 | $111,391 |
| 1186682 | 593398308 | WESTCOAST NEONATOLOGY INC | Florida | Participating Provider | 34 | 228 | 236 | $106,585 | $96,684 |
| 986821 | 593140335 | MICHAEL ARNOLD FRANKLIN | Florida | Participating Provider | 7 | 12 | 71 | $96,572 | $95,031 |
| 1436621 | 650825133 | RICHARD ALAN KNIPE | Florida | Participating Provider | 48 | 113 | 436 | $114,665 | $93,040 |
| 739586 | 590971075 | SHERIDAN HEALTHCORP INC | Florida | Non-Participating Provider | 240 | 23 | 331 | $212,864 | $86,350 |
| 7639834 | 845089150 | SUNSHINE STATE ANESTHESIA PART | Florida | Participating Provider | 73 | 10 | 114 | $204,099 | $75,123 |
| 2913939 | 593443182 | CARLOS E REYES | Florida | Participating Provider | 90 | 156 | 275 | $77,124 | $73,163 |
| 2664382 | 472965904 | JEAN-RAPHAEL SCHNEIDER | Florida | Participating Provider | 5 | 5 | 15 | $72,774 | $72,531 |
| 1765146 | 591934417 | CHARLES A SNINSKY | Florida | Participating Provider | 1 | 3 | 26 | $68,975 | $68,870 |
| 3314060 | 593443182 | RAPHAEL S GUICHARD | Florida | Participating Provider | 91 | 206 | 271 | $72,122 | $67,926 |
| 3237847 | 270602251 | GREATER FLORIDA ANESTHESIOLOGISTS LLC | Florida | Non-Participating Provider | 300 | 50 | 527 | $497,256 | $67,766 |
| 1939113 | 593623752 | LORI MCAULIFFE | Florida | Participating Provider | 106 | 518 | 1,661 | $73,258 | $63,475 |
| 7793667 | 852233241 | ABA GULF COAST | Florida | Non-Participating Provider | 1 | 163 | 1,130 | $55,246 | $54,496 |
| 1877722 | 650825133 | VIVIAN D GRIFFIN | Florida | Participating Provider | 2 | 2 | 9 | $50,520 | $50,485 |
| 1062738 | 593140335 | ALLAN S WEISS | Florida | Participating Provider | 6 | 21 | 58 | $52,695 | $47,425 |
| 1128928 | 650825133 | GEETHA J KAMATH | Florida | Participating Provider | 8 | 28 | 148 | $50,828 | $45,474 |
| 2103743 | 593443182 | KIMBERLY O BISS | Florida | Participating Provider | 83 | 142 | 227 | $48,211 | $41,552 |
| 2104079 | 270709861 | STEVEN BELJIC | Florida | Participating Provider | 4 | 5 | 17 | $41,857 | $41,276 |
| 5293233 | 471431670 | BLUFF KNOLL EMERGENCY PHYSICIANS LLC | Florida | Non-Participating Provider | 60 | 62 | 72 | $62,150 | $41,130 |
| 1240040 | 650825133 | JOHN ANDREW PETERSON | Florida | Participating Provider | 33 | 55 | 227 | $72,626 | $40,916 |
| 1652881 | 833031637 | PRATIBHA K DESAI | Florida | Participating Provider | 14 | 26 | 127 | $67,992 | $40,704 |
| 120918 | 592643611 | STEPHEN J KLEMAWESCH | Florida | Participating Provider | 58 | 107 | 1,519 | $139,796 | $38,620 |
| 5304053 | 471441096 | VENADO EMERGENCY PHYSICIANS LLC | Florida | Non-Participating Provider | 54 | 59 | 72 | $72,844 | $38,015 |
| 2052879 | 593140335 | JAMES B CONNORS | Maine | Participating Provider | 53 | 112 | 300 | $121,369 | $37,422 |
| 6248012 | 814232425 | AMERICAN ANESTHESIOLOGY SERV OF FLORIDA | Florida | Participating Provider | 25 | 8 | 63 | $47,955 | $33,495 |
| 3034400 | 592643611 | PATRICK J KLEMAWESCH | Florida | Participating Provider | 42 | 74 | 1,128 | $54,042 | $32,152 |
| 5307412 | 593443182 | SARAH MILLER | Florida | Participating Provider | 33 | 52 | 96 | $30,997 | $29,992 |
| 8198405 | 852733660 | NAYANA E GEORGE | Florida | Participating Provider | 80 | 156 | 181 | $46,342 | $29,839 |
| 2905799 | 262054411 | CRISTIAN V CHIRITESCU | Florida | Participating Provider | 63 | 189 | 835 | $30,799 | $27,861 |
| 2780326 | 820619127 | RODNEY S DANIEL | Florida | Participating Provider | 52 | 143 | 200 | $51,546 | $26,953 |
| 3337428 | 852733660 | ANGELA TURNER | Florida | Participating Provider | 56 | 131 | 223 | $45,257 | $25,597 |
| 1067624 | 593256838 | JEFFREY B NEUSTADT | Florida | Participating Provider | 9 | 15 | 41 | $26,151 | $25,351 |
| 1431634 | 593411711 | GULF TO BAY ANESTHESIOLOGY ASSOCIATES PA | Florida | Non-Participating Provider | 53 | 29 | 111 | $56,669 | $25,203 |
| 2554745 | 591501675 | DAVID A EICHENBAUM | Florida | Participating Provider | 12 | 35 | 115 | $39,690 | $24,990 |
| 2175237 | 593443182 | LINDA J TIJERINO | Florida | Participating Provider | 36 | 52 | 74 | $26,534 | $24,452 |
| 1139682 | 650825133 | LANE D ZIEGLER | Florida | Participating Provider | 5 | 21 | 71 | $83,134 | $24,169 |
| 2534445 | 650825133 | NURUDDIN JOOMA | Florida | Participating Provider | 6 | 41 | 231 | $28,163 | $24,166 |
| 2789023 | 300414511 | ALLERGY ASTHMA ASSOCIATES | Florida | Participating Provider | 29 | 47 | 1,102 | $33,321 | $24,156 |
| 3739969 | 800879511 | ANESTHESIA MANAGEMENT SOLUTIONS LLC | Florida | Participating Provider | 34 | 0 | 37 | $26,508 | $23,527 |
| 4493780 | 592929608 | TODD P BEERY | Florida | Participating Provider | 52 | 155 | 357 | $124,500 | $22,726 |
| 3252688 | 593443182 | NADIA M PILE | Florida | Participating Provider | 32 | 38 | 77 | $25,013 | $22,400 |
| 2794451 | 592929608 | MATTHEW J SWICK | Florida | Participating Provider | 41 | 111 | 279 | $33,422 | $21,593 |
| 1875563 | 650825133 | JOSEPH R MACE | Florida | Participating Provider | 18 | 43 | 192 | $151,096 | $21,471 |
| 2867266 | 650825133 | AYMAN BARAKAT | Florida | Participating Provider | 4 | 14 | 133 | $32,662 | $21,382 |
| 1728661 | 752722593 | COASTLINE EMERGENCY PHYSICIANS | Florida | Non-Participating Provider | 43 | 46 | 51 | $29,223 | $20,621 |
| 1843315 | 593405327 | ATHENA L RICHARDSON | Florida | Participating Provider | 57 | 110 | 397 | $22,341 | $20,613 |
| 6858408 | 592929608 | PATRICK JUDSON SMITH | Florida | Participating Provider | 21 | 119 | 351 | $36,219 | $20,553 |
| 3289728 | 592929608 | KURT C HIRSHORN | Florida | Participating Provider | 35 | 83 | 238 | $91,770 | $20,205 |
| 3192084 | 650825133 | FADI M KAYALI | Florida | Participating Provider | 2 | 15 | 91 | $249,263 | $20,174 |
| 2696677 | 593282073 | KRISTIN J WITFILL | Florida | Participating Provider | 26 | 66 | 152 | $97,925 | $20,005 |
| 2381041 | 650825133 | ANANTH KRISHNAN IYER | Florida | Participating Provider | 6 | 37 | 180 | $22,944 | $19,716 |
| 2175593 | 030526533 | BAY AREA EMERGENCY PHYSICIANS LLC | Florida | Participating Provider | 86 | 103 | 135 | $71,739 | $19,715 |
| 2564307 | 852733660 | MICHAEL A MALONE SR | Florida | Participating Provider | 45 | 106 | 179 | $40,572 | $19,701 |
| 2429195 | 593443182 | BETH DINER | Florida | Participating Provider | 42 | 59 | 103 | $20,721 | $19,667 |
| 2803741 | 852733660 | GEORGE ERIC BLANCO | Florida | Participating Provider | 41 | 128 | 209 | $52,266 | $19,659 |
| 3346896 | 593159954 | BRETT A ALMOND | Florida | Participating Provider | 17 | 70 | 103 | $149,413 | $19,637 |
| 941116 | 852733660 | PETER C WASSMER | Florida | Participating Provider | 33 | 75 | 158 | $38,756 | $19,260 |
| 2605594 | 593677604 | TAMPA BAY EMERGENCY PHYSICIANS LLC | Florida | Participating Provider | 36 | 48 | 59 | $34,455 | $18,542 |
| 7053039 | 592929608 | HOLDEN DAVID HEITNER | Florida | Participating Provider | 31 | 161 | 528 | $46,476 | $18,519 |
| 3323148 | 463463495 | AJAY VARANASI | Florida | Participating Provider | 78 | 234 | 291 | $32,227 | $18,449 |
| 1299378 | 593400241 | RICHARD JOSEPH HAIRSTON | Florida | Participating Provider | 26 | 60 | 181 | $62,476 | $18,402 |
| 1176584 | 591501675 | STEVEN M COHEN | Florida | Participating Provider | 20 | 63 | 195 | $108,329 | $18,269 |
| 6316268 | 650825133 | MICHAEL TYLER SCOTT | Florida | Participating Provider | 1 | 1 | 61 | $18,279 | $18,244 |
| 5309532 | 471360324 | SUNBEAM POINT EMERGENCY PHYSICIANS LLC | Florida | Non-Participating Provider | 26 | 27 | 30 | $35,732 | $17,833 |
| 6223318 | 593443182 | PRASHANTI LOGESWARAN | Florida | Participating Provider | 30 | 39 | 68 | $19,941 | $17,729 |
| 2115955 | 592929608 | GEORGE H CANIZARES | Florida | Participating Provider | 33 | 90 | 230 | $35,836 | $17,525 |
| 1240233 | 830428548 | KATULLE K EATON | Florida | Participating Provider | 45 | 96 | 190 | $42,046 | $17,330 |
| 3615471 | 593341738 | SCOTT M GREENE | Florida | Participating Provider | 27 | 61 | 291 | $44,094 | $17,318 |
| 2176360 | 650825133 | DAVID D WRIGHT | Florida | Participating Provider | 5 | 32 | 249 | $28,603 | $17,305 |
| 7424727 | 208734686 | STEPHEN JOSEPH SHAMP | Florida | Participating Provider | 11 | 8 | 131 | $55,520 | $17,191 |
| 2074785 | 593443182 | DONNA A HARGROVE | Florida | Participating Provider | 28 | 62 | 81 | $17,198 | $17,018 |
| 5608021 | 852733660 | KATHERINE FLACHS WOJNOWICH | Florida | Participating Provider | 100 | 182 | 283 | $28,453 | $17,015 |
| 2808247 | 208405765 | KEVIN L HUGUET | Florida | Participating Provider | 41 | 64 | 71 | $44,888 | $16,025 |
| 6892586 | 593398308 | TARA ELIZABETH TAYLOR | Florida | Participating Provider | 17 | 30 | 63 | $23,501 | $15,952 |
| 6234657 | 852733660 | LINDSAY MICHELLE GATES | Florida | Participating Provider | 30 | 71 | 98 | $26,728 | $15,644 |
| 3637424 | 592929608 | DZI-VIET PHUOC NGUYEN | Florida | Participating Provider | 37 | 79 | 189 | $40,519 | $15,635 |
| 6520885 | 593443182 | MICHAEL KINDER | Florida | Participating Provider | 19 | 24 | 49 | $18,766 | $15,540 |
| 341283 | 020657734 | GARY L HELLER | Florida | Participating Provider | 29 | 87 | 356 | $24,716 | $15,446 |
| 3348850 | 593140335 | SANJAY MENON | Florida | Participating Provider | 24 | 38 | 38 | $19,159 | $15,378 |
| 3176265 | 592015566 | ANDREW A NELSON | Florida | Participating Provider | 15 | 24 | 68 | $37,404 | $15,335 |
| 3386589 | 452773050 | EMERGENCY MEDICAL ASCS OF TAMPA BAY LLC | Florida | Participating Provider | 41 | 42 | 51 | $37,438 | $15,319 |
| 6971485 | 593443182 | JENNA HARRISON | Florida | Participating Provider | 39 | 48 | 92 | $16,472 | $15,084 |
| 6165919 | 593443182 | ANNA L MCNEILL | Florida | Participating Provider | 10 | 10 | 21 | $14,986 | $14,956 |
| 2744703 | 592015566 | CHRISTOPHER G NELSON JR | Florida | Participating Provider | 72 | 115 | 323 | $33,742 | $14,943 |
| 3088894 | 830604863 | WILLIAM N UPSHAW | Florida | Participating Provider | 4 | 0 | 61 | $16,725 | $14,895 |
| 2102387 | 650790741 | SHELLEY S JAQUISH | Florida | Participating Provider | 31 | 57 | 420 | $24,062 | $14,891 |
| 2591019 | 852733660 | ALEXANDER R JOHNSON | Florida | Participating Provider | 56 | 88 | 150 | $37,068 | $14,823 |
| 7768779 | 853484809 | BREATHE FREE SINUS & ALLERGY CENTERS OF | Florida | Non-Participating Provider | 4 | 7 | 21 | $23,812 | $14,549 |
| 2889366 | 593206683 | BAY PINES VAMC | Florida | Participating Provider | 60 | 158 | 362 | $96,908 | $14,531 |
| 1914753 | 320223568 | DANIEL B BELL | Florida | Participating Provider | 26 | 120 | 348 | $24,386 | $14,204 |
| 2307832 | 203356783 | STEPHEN B KARGES | Florida | Participating Provider | 47 | 112 | 238 | $15,637 | $13,952 |
| 1454881 | 593405327 | STEPHEN M VOLTAREL | Florida | Participating Provider | 38 | 77 | 267 | $15,152 | $13,942 |
| 8551974 | 922099454 | EMERGENCY MEDICINE SERVICES OF FL LLC | Florida | Participating Provider | 67 | 73 | 80 | $32,583 | $13,933 |
| 1917781 | 593414818 | WEST FLORIDA PAIN MGMNT PA | Florida | Participating Provider | 8 | 40 | 80 | $17,854 | $13,853 |
| 2181184 | 010635810 | SYCAMORE EMERGENCY PHYSICIANS LLC | Tennessee | Non-Participating Provider | 1 | 1 | 1 | $13,791 | $13,791 |
| 4813906 | 593140335 | JAIMIN GIRISH SHAH | Florida | Participating Provider | 61 | 114 | 158 | $31,979 | $13,788 |
| 2548951 | 462439971 | NICOLAS G ZOUAIN | Florida | Participating Provider | 5 | 5 | 318 | $166,297 | $13,722 |
| 3223041 | 650825133 | EVA GUPTA | Florida | Participating Provider | 3 | 6 | 39 | $17,314 | $13,609 |
| 2454008 | 592105555 | ALYSSA Z WEINBERGER | Florida | Participating Provider | 46 | 62 | 277 | $14,331 | $13,556 |
| 2181307 | 462439971 | SHAW W ZHOU | Florida | Participating Provider | 16 | 37 | 99 | $24,335 | $13,425 |
| 7409536 | 591198552 | RACHEL SINGER | Florida | Participating Provider | 41 | 73 | 234 | $14,462 | $13,417 |
| 2325640 | 562660478 | MATTHEW H MAHONEY | Massachusetts | Participating Provider | 55 | 108 | 194 | $28,403 | $13,291 |
| 1399559 | 320223568 | ALBERTO B VASQUEZ | Florida | Participating Provider | 47 | 86 | 248 | $28,400 | $13,276 |
| 2087542 | 593443182 | MOLLY LONG | Florida | Participating Provider | 22 | 24 | 55 | $14,252 | $13,274 |
| 1945209 | 593140335 | JEFFREY N BOTT | Florida | Participating Provider | 1 | 8 | 7 | $12,652 | $13,143 |
| 1344657 | 593336029 | JETH V SALOMON | Florida | Participating Provider | 55 | 126 | 280 | $14,983 | $13,074 |
| 547221 | 592929608 | MICHAEL J SMITH | Florida | Participating Provider | 23 | 73 | 188 | $34,264 | $12,995 |
| 6839737 | 830854228 | INPATIENT SPECIALISTS GROUP LLC | Florida | Participating Provider | 65 | 173 | 173 | $27,743 | $12,981 |
| 3342289 | 260609255 | CHRISTINA M SHAMAS | Florida | Participating Provider | 10 | 15 | 24 | $13,693 | $12,892 |
| 1240854 | 320223568 | CHRISTINA M DIAZ | Florida | Participating Provider | 38 | 79 | 186 | $27,705 | $12,812 |
| 2616192 | 204041180 | VISAGE DERMATOLOGY LLC | Florida | Participating Provider | 97 | 146 | 274 | $17,396 | $12,759 |
| 6814456 | 593028408 | HERSHEL RAJENDRAKUMAR PATEL | Florida | Participating Provider | 2 | 18 | 82 | $66,732 | $12,601 |
| 1795663 | 593516645 | JEFFREY A HIRSCHFIELD | Florida | Participating Provider | 22 | 69 | 248 | $13,015 | $12,120 |
| 2808920 | 593140335 | JASON C LEVINE | Florida | Participating Provider | 85 | 93 | 204 | $32,979 | $12,037 |
| 1340457 | 593443182 | THOMAS M MCNEILL JR | Florida | Participating Provider | 24 | 38 | 65 | $12,729 | $12,017 |
| 2079848 | 592929608 | PAUL J PAGANO | Florida | Participating Provider | 19 | 47 | 98 | $103,131 | $11,950 |
| 2373044 | 262003898 | RONALD EUGENE PERROTT | Florida | Participating Provider | 46 | 90 | 211 | $33,769 | $11,911 |
| 804106 | 593692217 | MICHAEL M NEWAN | Florida | Participating Provider | 12 | 37 | 207 | $72,616 | $11,692 |
| 605652 | 710955196 | CAROL JEANNE SIMS-ROBERTSON | Florida | Participating Provider | 54 | 114 | 213 | $21,759 | $11,469 |
| 2034299 | 593443182 | GEORGETTE J MCCANCE | Florida | Participating Provider | 11 | 19 | 23 | $13,431 | $11,452 |
| 2918909 | 593443182 | BROOKE E RITTER | Florida | Participating Provider | 16 | 27 | 48 | $13,196 | $11,430 |
| 5368736 | 472608878 | BALLAN WRASSE EMERG PHYSICIANS LLC | Florida | Non-Participating Provider | 27 | 26 | 29 | $30,484 | $11,191 |
| 1812776 | 593405327 | SHAYNE GADEA | Florida | Participating Provider | 22 | 59 | 212 | $12,067 | $11,177 |
| 2597322 | 593443182 | VICTORIA BELOGOLOVKIN | Florida | Participating Provider | 7 | 7 | 29 | $10,970 | $10,970 |
| 3289713 | 813255800 | ELIZABETH ANNE ARRINGTON | Florida | Participating Provider | 51 | 105 | 227 | $14,835 | $10,949 |
| 2747870 | 134354001 | WESTCOAST HOSPITALISTS LLC | Florida | Participating Provider | 43 | 224 | 225 | $41,791 | $10,940 |
| 5632772 | 471561133 | JESSICA D WILLOUGHBY | Florida | Participating Provider | 5 | 4 | 15 | $12,857 | $10,929 |
| 6803538 | 650790741 | KEITH BASLER | Florida | Participating Provider | 28 | 42 | 211 | $19,850 | $10,832 |
| 3460850 | 593156212 | JULIO A GONZALEZ-PAOLI | Florida | Participating Provider | 5 | 13 | 25 | $10,693 | $10,359 |
| 3679066 | 593140335 | SONIALY LUGO RUIZ | Florida | Participating Provider | 28 | 72 | 99 | $34,380 | $10,296 |
| 1988884 | 593443182 | KATHERINE E DADISMAN | Florida | Participating Provider | 16 | 28 | 57 | $11,079 | $10,258 |
| 7692476 | 592929608 | BENJAMIN D STREUFERT | Florida | Participating Provider | 20 | 51 | 120 | $16,017 | $10,214 |
| 2556680 | 830428548 | DOUGLAS EUGENE CARLAN | Florida | Participating Provider | 36 | 59 | 142 | $23,225 | $10,194 |
| 1183647 | 593398308 | JOSE ANTONIO PRIETO | Florida | Participating Provider | 7 | 7 | 35 | $10,194 | $10,155 |
Managed Pharmacy
| City of St. Petersburg - Managed Pharmacy Plan Performance | |||||||||||||||||||
| 9/2022 through 8/2023 | |||||||||||||||||||
| Tier Level | Submission Method Category | Number of Claimants | Number of Prescriptions | Discounts | Ingredient Cost Paid Amount | Dispensing Fee | Sales Tax Amount | Deductible | Coinsurance/Copay | Employee Cost Sharing PMPM | Plan Net Paid | HRA Net Paid | Total Net Paid | Plan Net Paid Per Prescription | HRA Net Paid Per Prescription | Total Net Paid Per Prescription | Plan Net Paid PMPM | HRA Net Paid PMPM | Total Net Paid PMPM |
| Tier 1 | Retail | 5,877 | 115,329 | $12,601,442 | $3,683,554 | $77,652 | $286 | $9,748 | $944,120 | $11.09 | $2,805,220 | $389 | $2,805,609 | $24.32 | $0.00 | $24.33 | $32.63 | $0.00 | $32.63 |
| Home Delivery | 70 | 308 | $111,131 | $51,914 | $91 | $0 | $0 | $6,113 | $0.07 | $45,892 | $0 | $45,892 | $149.00 | $0.00 | $149.00 | $0.53 | $0.00 | $0.53 | |
| Tier 2 | Retail | 868 | 7,807 | $2,524,967 | $11,007,093 | $4,822 | $122 | $92,339 | $301,881 | $4.59 | $10,340,209 | $4,309 | $10,344,518 | $1,324.48 | $0.55 | $1,325.03 | $120.27 | $0.05 | $120.32 |
| Home Delivery | 12 | 31 | $19,418 | $56,692 | $7 | $0 | $0 | $315 | $0.00 | $56,279 | $0 | $56,279 | $1,815.45 | $0.00 | $1,815.45 | $0.65 | $0.00 | $0.65 | |
| Tier 3 | Retail | 2,214 | 7,358 | $1,161,582 | $5,232,958 | $3,816 | $32 | $106,869 | $206,736 | $3.65 | $4,903,345 | $9,098 | $4,912,444 | $666.40 | $1.24 | $667.63 | $57.03 | $0.11 | $57.14 |
| Home Delivery | 11 | 29 | $29,571 | $83,131 | $0 | $0 | $651 | $2,850 | $0.04 | $78,780 | $200 | $78,980 | $2,716.55 | $6.90 | $2,723.45 | $0.92 | $0.00 | $0.92 |
File details come from the government source that posted it. Updated .