ESBD_521004_1780004140477_Exhibit A-7 Large Claims 3.1.25-12.31.25.xls

This is a catastrophic claimant detail report prepared by Aetna Integrated Informatics for the Travis County Healthcare District's CENT health plan (Plan Sponsor ID 0000000097013764). The report analyzes large claims data for the self-insured plan covering the period of March 1, 2025 through December 31, 2025, with a two-month claims processing lag, and was generated on February 24, 2026. The report identifies 18 catastrophic claimants who exceeded the $150,000 claims threshold, detailing medical, pharmacy, inpatient, and ambulatory service claims by diagnosis code.

The total claims identified across all catastrophic claimants amounted to $4,683,955, consisting of $2,549,123 in pharmacy paid amounts and $2,134,832 in medical paid amounts, with $649,835 in inpatient services and $1,484,997 in ambulatory services. The highest individual claim was $568,034 for a claimant with Hereditary Factor VIII Deficiency (hemophilia), followed by $544,010 for spinal stenosis and $417,022 for HIV disease. Other significant claims involved rare diseases and conditions including Gaucher disease, monoclonal gammopathy, cerebral infarction, autism spectrum disorder, and multiple sclerosis. All identified claimants had service rendered in the final quarter of the reporting period, indicating active ongoing claims management for the district's self-insured health plan.