Exhibit 37 - Cal Yr 2022 City of Miami Stop Loss - Greater than 50K High Claimant Report De-ID Dx.xlsx
XLSX spreadsheet 38 KB Posted
- Attached to
- RFP No. 2130386 - Employee Health Benefits Plan
- Solicitation number
- RFP No. 2130386 - Employee Health Benefits Plan
- Issued by
- Florida
About this file
This document is a de-identified claims report for the City of Miami's health benefits plan for calendar year 2022, covering stop-loss claims exceeding $50,000. The report details medical claims for various employee categories including active employees (general, SEA, M/C), executives/elected officials, and non-Medicare retirees, with claims processed through a Network Open Access POS plan. The data spans January through December 2022 and is structured as a retrospective experience-rated, pooled stop-loss report.
The report contains detailed medical claims information, including member demographics such as age bands, gender, relationship status (employee, spouse, child), and specific medical diagnoses using ICD-10 codes. Total claims range from approximately $10,000 to over $572,000 per member, with diagnoses including conditions like hypertension, cancer, heart disease, liver disorders, and various surgical interventions. The claims are broken down by drug claims, paid claims, and total claimant costs, providing a comprehensive view of high-cost medical utilization for the City of Miami's health benefits plan participants.
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Clms Exc De-ID Dx PYTD-1
| CITY OF MIAMI | |||||||||||||
| DE-IDENTIFIED CLAIMS EXCEEDING REPORT | |||||||||||||
| EXHIBIT 37 | |||||||||||||
| January 2022 thru December 2022 | |||||||||||||
| Rating Type : POOLED STOP LOSS, RETROSPECTIVE EXPERIENCE RATED | |||||||||||||
| Claims Exceeding : $50,000.00 | |||||||||||||
| Reported Claims: InNet, OutNet, Drug | |||||||||||||
| Diagnosis is based on the largest medical claim amount | |||||||||||||
| BENEFIT OPTION | BRANCH | FUNDING TYPE | RATING TYPE | MEMBER ID | REL | GENDER | AGE BAND | ICD CODE | ICD DESCRIPTION | ICD VERSION | DRUG CLAIMS | PAID CLAIMS | CLAIMANT TOTAL |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 8039474256708 | SP | M | 50-59 | L409 | PSORIASIS, UNSPECIFIED | 10 | $37,987 | $119 | $38,106 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 8039474256708 | SP | M | 50-59 | Z0000 | ENCNTR FOR GENERAL ADULT MEDICAL EXAM W/O ABNORMAL FINDINGS | 10 | $37,884 | $182 | $38,066 |
| MEMBER ID Total | $75,871 | $301 | $76,172 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 06083567565085 | EE | M | 60-64 | N390 | URINARY TRACT INFECTION, SITE NOT SPECIFIED | 10 | $2,717 | $66,954 | $69,671 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 06083567565085 | EE | M | 65+ | J320 | CHRONIC MAXILLARY SINUSITIS | 10 | $1 | $15,817 | $15,817 |
| MEMBER ID Total | $2,718 | $82,770 | $85,488 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 03818929867405 | EE | M | 60-64 | PH | PHARMACY | * | ($305) | $0 | ($305) |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 03818929867405 | EE | M | 65+ | K430 | INCISIONAL HERNIA WITH OBSTRUCTION, WITHOUT GANGRENE | 10 | $33,568 | $31,507 | $65,075 |
| MEMBER ID Total | $33,263 | $31,507 | $64,770 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 46747294168428 | EE | M | 50-59 | I132 | HYP HRT & CHR KDNY DIS W HRT FAIL AND W STG 5 CHR KDNY/ESRD | 10 | $9,171 | $139,083 | $148,254 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 27273567566557 | EE | F | 50-59 | H4311 | VITREOUS HEMORRHAGE, RIGHT EYE | 10 | $26,647 | $47,319 | $73,965 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 57273567561724 | EE | F | 60-64 | K8510 | BILIARY ACUTE PANCREATITIS WITHOUT NECROSIS OR INFECTION | 10 | $631 | $189,908 | $190,539 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 59337211168891 | SP | F | 30-39 | K8010 | CALCULUS OF GALLBLADDER W CHRONIC CHOLECYST W/O OBSTRUCTION | 10 | $10,203 | $54,535 | $64,738 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 88580983178483 | CH | M | 18-29 | N319 | NEUROMUSCULAR DYSFUNCTION OF BLADDER, UNSPECIFIED | 10 | $4,477 | $59,558 | $64,035 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 41905861362590 | EE | M | 18-29 | K760 | FATTY (CHANGE OF) LIVER, NOT ELSEWHERE CLASSIFIED | 10 | $94,831 | $1,071 | $95,902 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 41905861362590 | EE | M | 30-39 | R7401 | ELEVATION OF LEVELS OF LIVER TRANSAMINASE LEVELS | 10 | $132 | $230 | $362 |
| MEMBER ID Total | $94,962 | $1,302 | $96,264 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 30984584466790 | EE | M | 60-64 | A419 | SEPSIS, UNSPECIFIED ORGANISM | 10 | $576 | $25,124 | $25,700 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRMC1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 30984584466790 | EE | M | 60-64 | A419 | SEPSIS, UNSPECIFIED ORGANISM | 10 | $3,954 | $210,488 | $214,442 |
| MEMBER ID Total | $4,530 | $235,612 | $240,142 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 1 | M | 63166990461889 | EE | F | 40-49 | * | UNSPECIFIED | * | $0 | $5,026 | $5,026 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 63166990461889 | EE | F | 40-49 | K5090 | CROHN'S DISEASE, UNSPECIFIED, WITHOUT COMPLICATIONS | 10 | $50,551 | $299,190 | $349,741 |
| MEMBER ID Total | $50,551 | $304,216 | $354,767 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 33584830766779 | CH | M | 1-17 | E230 | HYPOPITUITARISM | 10 | $116,076 | $849 | $116,924 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 50666186064149 | SP | F | 50-59 | Z1231 | ENCNTR SCREEN MAMMOGRAM FOR MALIGNANT NEOPLASM OF BREAST | 10 | $182,514 | $1,964 | $184,478 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 66130823462239 | EE | F | 30-39 | E288 | OTHER OVARIAN DYSFUNCTION | 10 | $809 | $54,859 | $55,668 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 19020463469182 | EE | M | 50-59 | K3580 | UNSPECIFIED ACUTE APPENDICITIS | 10 | $13,102 | $38,105 | $51,207 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 35643567565502 | SP | F | 40-49 | M4722 | OTHER SPONDYLOSIS WITH RADICULOPATHY, CERVICAL REGION | 10 | $85 | $53,241 | $53,326 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 35643567565502 | SP | F | 50-59 | N939 | ABNORMAL UTERINE AND VAGINAL BLEEDING, UNSPECIFIED | 10 | $3 | $854 | $856 |
| MEMBER ID Total | $88 | $54,095 | $54,183 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 81955849862502 | SP | F | 30-39 | N6459 | OTHER SIGNS AND SYMPTOMS IN BREAST | 10 | $58,355 | $2,309 | $60,664 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 81955849862502 | SP | F | 40-49 | Z01419 | ENCNTR FOR GYN EXAM (GENERAL) (ROUTINE) W/O ABN FINDINGS | 10 | $20,467 | $704 | $21,171 |
| MEMBER ID Total | $78,822 | $3,013 | $81,835 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 109535675641565 | SP | M | 65+ | H2511 | AGE-RELATED NUCLEAR CATARACT, RIGHT EYE | 10 | $11,507 | $60,000 | $71,507 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 908087803650465 | EE | M | 18-29 | * | UNSPECIFIED | * | $0 | $32,583 | $32,583 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 908087803650465 | EE | M | 18-29 | D619 | APLASTIC ANEMIA, UNSPECIFIED | 10 | $174,363 | $16,192 | $190,555 |
| MEMBER ID Total | $174,363 | $48,775 | $223,138 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 494904851605365 | SP | M | 65+ | I130 | HYP HRT & CHR KDNY DIS W HRT FAIL AND STG 1-4/UNSP CHR KDNY | 10 | $162,584 | $71,232 | $233,816 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 593835675643135 | EE | M | 50-59 | H6983 | OTHER SPECIFIED DISORDERS OF EUSTACHIAN TUBE, BILATERAL | 10 | $19,196 | $3,648 | $22,844 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 593835675643135 | EE | M | 50-59 | L408 | OTHER PSORIASIS | 10 | $38,489 | $1,053 | $39,542 |
| MEMBER ID Total | $57,685 | $4,701 | $62,386 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 559262108637605 | EE | F | 60-64 | R0600 | DYSPNEA, UNSPECIFIED | 10 | $7,123 | $3,470 | $10,593 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 559262108637605 | EE | F | 65+ | I472 | VENTRICULAR TACHYCARDIA | 10 | $2,930 | $93,666 | $96,596 |
| MEMBER ID Total | $10,053 | $97,136 | $107,189 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 205649493612605 | SP | F | 40-49 | Z5111 | ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY | 10 | $160 | $153,372 | $153,531 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 205649493612605 | SP | F | 50-59 | Z5111 | ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY | 10 | $633 | $58,106 | $58,739 |
| MEMBER ID Total | $793 | $211,478 | $212,271 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 376435675601005 | SP | M | 40-49 | L720 | EPIDERMAL CYST | 10 | $1,686 | $53,280 | $54,966 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 438287034775395 | CH | M | 1-17 | K529 | NONINFECTIVE GASTROENTERITIS AND COLITIS, UNSPECIFIED | 10 | $6,968 | $47,807 | $54,775 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 950735675600568 | EE | F | 50-59 | C50112 | MALIGNANT NEOPLASM OF CENTRAL PORTION OF LEFT FEMALE BREAST | 10 | $38 | $53,421 | $53,460 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 528541643607588 | EE | F | 50-59 | PH | PHARMACY | * | $164 | $0 | $164 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 528541643607588 | EE | M | 50-59 | C182 | MALIGNANT NEOPLASM OF ASCENDING COLON | 10 | $1,779 | $126,046 | $127,824 |
| MEMBER ID Total | $1,943 | $126,046 | $127,989 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 362735675663488 | SP | M | 50-59 | * | UNSPECIFIED | * | $0 | $222,264 | $222,264 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 362735675663488 | SP | M | 50-59 | K8301 | PRIMARY SCLEROSING CHOLANGITIS | 10 | $38,760 | $311,210 | $349,970 |
| MEMBER ID Total | $38,760 | $533,474 | $572,234 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 585093160664678 | SP | F | 40-49 | I10 | ESSENTIAL (PRIMARY) HYPERTENSION | 10 | $50 | $51,631 | $51,681 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 947299483647148 | EE | M | 50-59 | R42 | DIZZINESS AND GIDDINESS | 10 | $40,784 | $10,924 | $51,708 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 210735675606618 | CH | F | 18-29 | * | UNSPECIFIED | * | $0 | $43,881 | $43,881 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 210735675606618 | CH | F | 1-17 | Z941 | HEART TRANSPLANT STATUS | 10 | $0 | $218 | $218 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 210735675606618 | CH | F | 18-29 | T8621 | HEART TRANSPLANT REJECTION | 10 | $18,758 | $330,903 | $349,662 |
| MEMBER ID Total | $18,758 | $375,003 | $393,761 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 490735675642538 | EE | F | 50-59 | C50812 | MALIGNANT NEOPLASM OF OVRLP SITES OF LEFT FEMALE BREAST | 10 | $127,377 | $113,750 | $241,126 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 922969145675408 | EE | F | 50-59 | Z1211 | ENCOUNTER FOR SCREENING FOR MALIGNANT NEOPLASM OF COLON | 10 | $49,633 | $4,645 | $54,278 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 455864778638498 | EE | M | 40-49 | K50118 | CROHN'S DISEASE OF LARGE INTESTINE WITH OTHER COMPLICATION | 10 | $0 | $135,865 | $135,866 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 238412881646628 | EE | M | 50-59 | T8130XA | DISRUPTION OF WOUND, UNSPECIFIED, INITIAL ENCOUNTER | 10 | $3,372 | $119,885 | $123,256 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 891435150648128 | CH | F | <-1 | Z3801 | SINGLE LIVEBORN INFANT, DELIVERED BY CESAREAN | 10 | $189 | $53,590 | $53,779 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 049041291604228 | EE | F | 18-29 | O42012 | PRETRM PREM ROM, ONSET LABOR W/N 24 HOURS OF RUPT, 2ND TRI | 10 | $0 | $50,480 | $50,480 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 392317071693967 | EE | F | 40-49 | K8590 | ACUTE PANCREATITIS WITHOUT NECROSIS OR INFECTION, UNSP | 10 | $1,593 | $86,160 | $87,753 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 105178925650967 | EE | M | 30-39 | G129 | SPINAL MUSCULAR ATROPHY, UNSPECIFIED | 10 | $0 | $59,475 | $59,475 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 243685215687177 | SP | F | 50-59 | S83231A | COMPLEX TEAR OF MEDIAL MENSC, CURRENT INJURY, R KNEE, INIT | 10 | $53,333 | $4,045 | $57,379 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 243685215687177 | SP | F | 50-59 | S83281D | OTH TEAR OF LAT MENSC, CURRENT INJURY, RIGHT KNEE, SUBS | 10 | $52,252 | $11,286 | $63,537 |
| MEMBER ID Total | $105,585 | $15,331 | $120,916 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 341735675656947 | EE | F | 40-49 | K529 | NONINFECTIVE GASTROENTERITIS AND COLITIS, UNSPECIFIED | 10 | $183,156 | $6,356 | $189,512 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 685274737621817 | EE | F | 60-64 | R921 | MAMMOGRAPHIC CALCIFCN FOUND ON DIAGNOSTIC IMAGING OF BREAST | 10 | $68,905 | $10,281 | $79,186 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 008087803691197 | EE | M | 30-39 | L400 | PSORIASIS VULGARIS | 10 | $56,866 | $645 | $57,511 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 080964480676327 | CH | F | <-1 | Z3801 | SINGLE LIVEBORN INFANT, DELIVERED BY CESAREAN | 10 | $0 | $316,122 | $316,122 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 575093160669644 | SP | F | 30-39 | O1414 | SEVERE PRE-ECLAMPSIA COMPLICATING CHILDBIRTH | 10 | $72 | $64,336 | $64,408 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 575093160669644 | SP | F | 40-49 | R519 | HEADACHE, UNSPECIFIED | 10 | $2 | $45 | $47 |
| MEMBER ID Total | $73 | $64,381 | $64,454 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 152735675669744 | EE | M | 60-64 | C61 | MALIGNANT NEOPLASM OF PROSTATE | 10 | $0 | $46,520 | $46,520 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 152735675669744 | EE | M | 65+ | Z510 | ENCOUNTER FOR ANTINEOPLASTIC RADIATION THERAPY | 10 | $60,196 | $44,408 | $104,603 |
| MEMBER ID Total | $60,196 | $90,928 | $151,123 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 602735675630344 | CH | M | 18-29 | K5010 | CROHN'S DISEASE OF LARGE INTESTINE WITHOUT COMPLICATIONS | 10 | $44,702 | $12,857 | $57,560 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 278027524638714 | EE | M | 30-39 | K51519 | LEFT SIDED COLITIS WITH UNSPECIFIED COMPLICATIONS | 10 | $108,923 | $22,465 | $131,388 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 412735675601914 | SP | M | 50-59 | L4050 | ARTHROPATHIC PSORIASIS, UNSPECIFIED | 10 | $53,119 | $334 | $53,453 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 369630431602934 | EE | M | 40-49 | K430 | INCISIONAL HERNIA WITH OBSTRUCTION, WITHOUT GANGRENE | 10 | $45,643 | $42,035 | $87,679 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 778835675640094 | EE | M | 50-59 | M1712 | UNILATERAL PRIMARY OSTEOARTHRITIS, LEFT KNEE | 10 | $0 | $441 | $441 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 778835675640094 | EE | M | 60-64 | I480 | PAROXYSMAL ATRIAL FIBRILLATION | 10 | $15,623 | $81,612 | $97,235 |
| MEMBER ID Total | $15,623 | $82,053 | $97,676 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 836435675671994 | EE | M | 40-49 | E1169 | TYPE 2 DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATION | 10 | $3,652 | $153,028 | $156,679 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 836435675671994 | EE | M | 50-59 | PH | PHARMACY | * | $435 | $0 | $435 |
| MEMBER ID Total | $4,086 | $153,028 | $157,114 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 243641948699994 | EE | F | 30-39 | Z20822 | CONTACT WITH AND (SUSPECTED) EXPOSURE TO COVID-19 | 10 | $22,101 | $245 | $22,346 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 243641948699994 | EE | F | 40-49 | G35 | MULTIPLE SCLEROSIS | 10 | $67,939 | $135 | $68,073 |
| MEMBER ID Total | $90,040 | $380 | $90,420 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 746130301677524 | SP | M | 65+ | C641 | MALIGNANT NEOPLASM OF RIGHT KIDNEY, EXCEPT RENAL PELVIS | 10 | $1,163 | $77,227 | $78,390 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 409619204629524 | EE | F | 40-49 | E11621 | TYPE 2 DIABETES MELLITUS WITH FOOT ULCER | 10 | $8,932 | $121,084 | $130,016 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 156435675601824 | SP | F | 40-49 | G4733 | OBSTRUCTIVE SLEEP APNEA (ADULT) (PEDIATRIC) | 10 | $0 | $40 | $40 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 156435675601824 | SP | F | 50-59 | R0789 | OTHER CHEST PAIN | 10 | $10,939 | $39,884 | $50,823 |
| MEMBER ID Total | $10,939 | $39,924 | $50,862 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 176435675640724 | EE | M | 60-64 | U071 | COVID-19 | 10 | $15,712 | $43,538 | $59,250 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 176435675640724 | EE | M | 65+ | D3612 | BEN NEOPLM OF PRPH NRV & AUTONM NRV SYS, UPR LMB, INC SHLDR | 10 | $140 | $12,504 | $12,644 |
| MEMBER ID Total | $15,852 | $56,042 | $71,894 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 165466295689224 | CH | F | 18-29 | K3184 | GASTROPARESIS | 10 | $1,770 | $237,217 | $238,987 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 484489078693651 | EE | F | 30-39 | E6601 | MORBID (SEVERE) OBESITY DUE TO EXCESS CALORIES | 10 | $398 | $107,370 | $107,768 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 949835675648481 | EE | M | 50-59 | I4891 | UNSPECIFIED ATRIAL FIBRILLATION | 10 | $4,483 | $51,049 | $55,532 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 701789724624471 | CH | F | 18-29 | C73 | MALIGNANT NEOPLASM OF THYROID GLAND | 10 | $30 | $60,218 | $60,248 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 991624851649071 | EE | F | 50-59 | * | UNSPECIFIED | * | $0 | $74,731 | $74,731 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 991624851649071 | EE | F | 50-59 | U071 | COVID-19 | 10 | $0 | $349,961 | $349,961 |
| MEMBER ID Total | $0 | $424,692 | $424,692 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 207796198660041 | EE | F | 50-59 | N813 | COMPLETE UTEROVAGINAL PROLAPSE | 10 | $1,196 | $50,350 | $51,545 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | MRG1-MEDICARE RETIREE 65+ W/ DEP UNDER 65 | 2 | R | 303331803643591 | EE | F | 60-64 | M5450 | LOW BACK PAIN, UNSPECIFIED | 10 | $91,535 | $58,531 | $150,066 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 688442354631191 | EE | F | 50-59 | * | UNSPECIFIED | * | $0 | $285,432 | $285,432 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 688442354631191 | EE | F | 50-59 | Z5111 | ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY | 10 | $8,846 | $341,088 | $349,935 |
| MEMBER ID Total | $8,846 | $626,521 | $635,367 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 965735675631621 | EE | M | 65+ | N401 | BENIGN PROSTATIC HYPERPLASIA WITH LOWER URINARY TRACT SYMP | 10 | $717 | $52,631 | $53,348 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 679500621639721 | EE | F | 30-39 | O200 | THREATENED ABORTION | 10 | $5 | $15,780 | $15,785 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 679500621639721 | EE | F | 40-49 | O1414 | SEVERE PRE-ECLAMPSIA COMPLICATING CHILDBIRTH | 10 | $445 | $40,872 | $41,317 |
| MEMBER ID Total | $451 | $56,652 | $57,103 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 252835675632021 | EE | M | 60-64 | R0789 | OTHER CHEST PAIN | 10 | $1,543 | $95,743 | $97,286 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 003894851692021 | EE | F | 40-49 | Z1501 | GENETIC SUSCEPTIBILITY TO MALIGNANT NEOPLASM OF BREAST | 10 | $0 | $68,984 | $68,984 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 994835675666283 | EE | F | 50-59 | B20 | HUMAN IMMUNODEFICIENCY VIRUS [HIV] DISEASE | 10 | $40,052 | $941 | $40,993 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETE1-NON-MEDICARE RETIREE W/DEP - 65 | 2 | R | 994835675666283 | EE | F | 50-59 | B20 | HUMAN IMMUNODEFICIENCY VIRUS [HIV] DISEASE | 10 | $20,057 | $295 | $20,352 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETE1-NON-MEDICARE RETIREE W/DEP - 65 | 2 | R | 994835675666283 | EE | F | 60-64 | PH | PHARMACY | * | $742 | $0 | $742 |
| MEMBER ID Total | $60,851 | $1,236 | $62,087 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 739735675628573 | EE | F | 60-64 | PH | PHARMACY | * | $273 | $0 | $273 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 739735675628573 | EE | M | 60-64 | G8194 | HEMIPLEGIA, UNSPECIFIED AFFECTING LEFT NONDOMINANT SIDE | 10 | $5,745 | $122,842 | $128,586 |
| MEMBER ID Total | $6,018 | $122,842 | $128,860 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 320735675617643 | EE | M | 30-39 | A4151 | SEPSIS DUE TO ESCHERICHIA COLI [E. COLI] | 10 | $0 | $85,577 | $85,577 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 472413251643113 | SP | M | 65+ | * | UNSPECIFIED | * | $0 | $205,883 | $205,883 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 472413251643113 | SP | M | 65+ | Z5111 | ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY | 10 | $6,368 | $347,389 | $353,757 |
| MEMBER ID Total | $6,368 | $553,273 | $559,640 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 545735675684003 | EE | F | 60-64 | I213 | ST ELEVATION (STEMI) MYOCARDIAL INFARCTION OF UNSP SITE | 10 | $3,118 | $165,600 | $168,717 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 995664563699660 | CH | F | 1-17 | R269 | UNSPECIFIED ABNORMALITIES OF GAIT AND MOBILITY | 10 | $35 | $52,748 | $52,783 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 668402478619560 | EE | F | 40-49 | M3214 | GLOMERULAR DISEASE IN SYSTEMIC LUPUS ERYTHEMATOSUS | 10 | $6,524 | $79,702 | $86,226 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 511244867604650 | EE | M | 65+ | S2232XA | FRACTURE OF ONE RIB, LEFT SIDE, INIT FOR CLOS FX | 10 | $1,865 | $88,273 | $90,138 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 557414374647450 | SP | F | 65+ | I4891 | UNSPECIFIED ATRIAL FIBRILLATION | 10 | $9,788 | $110,115 | $119,903 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 661101660632950 | EE | F | 40-49 | A4150 | GRAM-NEGATIVE SEPSIS, UNSPECIFIED | 10 | $7,870 | $107,053 | $114,922 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 647764251627580 | EE | F | 30-39 | Z03818 | ENCNTR FOR OBS FOR SUSP EXPSR TO OTH BIOLG AGENTS RULED OUT | 10 | $839 | $637 | $1,476 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 647764251627580 | EE | F | 40-49 | R55 | SYNCOPE AND COLLAPSE | 10 | $7,040 | $44,013 | $51,053 |
| MEMBER ID Total | $7,880 | $44,650 | $52,530 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 759535675635180 | EE | F | 65+ | E6601 | MORBID (SEVERE) OBESITY DUE TO EXCESS CALORIES | 10 | $1,072 | $57,815 | $58,887 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 667593901696670 | EE | M | 40-49 | K51019 | ULCERATIVE (CHRONIC) PANCOLITIS WITH UNSP COMPLICATIONS | 10 | $877 | $35,608 | $36,485 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 667593901696670 | EE | M | 50-59 | K5100 | ULCERATIVE (CHRONIC) PANCOLITIS WITHOUT COMPLICATIONS | 10 | $21,227 | $19,909 | $41,136 |
| MEMBER ID Total | $22,104 | $55,517 | $77,622 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 488383731672770 | EE | F | 60-64 | C50812 | MALIGNANT NEOPLASM OF OVRLP SITES OF LEFT FEMALE BREAST | 10 | $54,090 | $95,966 | $150,056 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 875824545619070 | CH | M | 1-17 | A045 | CAMPYLOBACTER ENTERITIS | 10 | $0 | $45,359 | $45,359 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 875824545619070 | CH | M | 18-29 | I071 | RHEUMATIC TRICUSPID INSUFFICIENCY | 10 | $0 | $5,984 | $5,984 |
| MEMBER ID Total | $0 | $51,343 | $51,343 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 206435675683640 | SP | F | 50-59 | * | UNSPECIFIED | * | $0 | $174,849 | $174,849 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 206435675683640 | SP | F | 50-59 | Z5111 | ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY | 10 | $17 | $349,983 | $350,000 |
| MEMBER ID Total | $17 | $524,832 | $524,849 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 475735675688530 | EE | F | 60-64 | T8549XA | MECH COMPL OF BREAST PROSTHESIS AND IMPLANT, INIT ENCNTR | 10 | $11,418 | $78,423 | $89,841 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 349235631674830 | EE | F | 50-59 | T8544XA | CAPSULAR CONTRACTURE OF BREAST IMPLANT, INITIAL ENCOUNTER | 10 | $5,687 | $47,998 | $53,685 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 480835675683930 | CH | F | 18-29 | R54 | AGE-RELATED PHYSICAL DEBILITY | 10 | $328 | $55,465 | $55,793 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 477275795677290 | SP | M | 40-49 | E113511 | TYPE 2 DIAB WITH PROLIF DIAB RTNOP WITH MACULAR EDEMA, R EYE | 10 | $28,191 | $23,504 | $51,695 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 939217193699820 | EE | M | 50-59 | N486 | INDURATION PENIS PLASTICA | 10 | $253 | $72,699 | $72,953 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 920072818679159 | EE | F | 50-59 | H35052 | RETINAL NEOVASCULARIZATION, UNSPECIFIED, LEFT EYE | 10 | $1,097 | $58,684 | $59,780 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 930835675673059 | EE | F | 50-59 | N186 | END STAGE RENAL DISEASE | 10 | ($2,443) | $31,651 | $29,208 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 930835675673059 | EE | F | 60-64 | N186 | END STAGE RENAL DISEASE | 10 | $22,882 | $132,163 | $155,045 |
| MEMBER ID Total | $20,439 | $163,814 | $184,253 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 180535675624959 | EE | M | 65+ | I7101 | DISSECTION OF THORACIC AORTA | 10 | $1,094 | $254,743 | $255,838 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 316342611649189 | CH | F | 1-17 | * | UNSPECIFIED | * | $0 | $50,412 | $50,412 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 316342611649189 | CH | F | 1-17 | G129 | SPINAL MUSCULAR ATROPHY, UNSPECIFIED | 10 | $366,155 | ($16,197) | $349,958 |
| MEMBER ID Total | $366,155 | $34,215 | $400,370 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 606475074624579 | CH | F | 18-29 | O26891 | OTH PREGNANCY RELATED CONDITIONS, FIRST TRIMESTER | 10 | $152,158 | $4,820 | $156,977 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 762735675614079 | CH | M | 18-29 | Z03818 | ENCNTR FOR OBS FOR SUSP EXPSR TO OTH BIOLG AGENTS RULED OUT | 10 | $64,385 | $398 | $64,783 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 616130301670649 | SP | F | 40-49 | K5100 | ULCERATIVE (CHRONIC) PANCOLITIS WITHOUT COMPLICATIONS | 10 | $5,230 | $45,830 | $51,060 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 419613615605449 | SP | F | 40-49 | C50411 | MALIG NEOPLM OF UPPER-OUTER QUADRANT OF RIGHT FEMALE BREAST | 10 | $142,145 | $106,348 | $248,493 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 691907145684419 | EE | F | 60-64 | * | UNSPECIFIED | * | $0 | $493 | $493 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 691907145684419 | EE | F | 60-64 | G4733 | OBSTRUCTIVE SLEEP APNEA (ADULT) (PEDIATRIC) | 10 | $372,353 | $2,870 | $375,223 |
| MEMBER ID Total | $372,353 | $3,363 | $375,716 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 737196791625319 | EE | M | 40-49 | M4712 | OTHER SPONDYLOSIS WITH MYELOPATHY, CERVICAL REGION | 10 | $29 | $89,847 | $89,876 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 690311001601539 | CH | M | 1-17 | K5090 | CROHN'S DISEASE, UNSPECIFIED, WITHOUT COMPLICATIONS | 10 | $47 | $56,994 | $57,040 |
| NPOS2-STANDALONE NETWORK POS PLAN COPY NO RX | RMEPDP-RETIRED MEDICARE ELIGIBLE W/PDP PLAN | 2 | R | 188835675651239 | EE | M | 60-64 | G6181 | CHRONIC INFLAMMATORY DEMYELINATING POLYNEURITIS | 10 | $0 | $140,436 | $140,436 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 507641118677609 | SP | F | 60-64 | Z5111 | ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY | 10 | $4,360 | $72,597 | $76,957 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 912535675617599 | EE | F | 60-64 | A419 | SEPSIS, UNSPECIFIED ORGANISM | 10 | $5,079 | $68,294 | $73,373 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 080735675612799 | EE | M | 40-49 | * | UNSPECIFIED | * | $0 | $915 | $915 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 080735675612799 | EE | M | 40-49 | I480 | PAROXYSMAL ATRIAL FIBRILLATION | 10 | $42,976 | $192,808 | $235,784 |
| MEMBER ID Total | $42,976 | $193,723 | $236,700 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 709619204632499 | EE | F | 40-49 | PH | PHARMACY | * | $40 | $0 | $40 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 709619204632499 | EE | M | 40-49 | S72351A | DISPLACED COMMINUTED FRACTURE OF SHAFT OF RIGHT FEMUR, INIT | 10 | $1,193 | $110,037 | $111,230 |
| MEMBER ID Total | $1,233 | $110,037 | $111,270 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 028132224682862 | CH | M | 18-29 | K5000 | CROHN'S DISEASE OF SMALL INTESTINE WITHOUT COMPLICATIONS | 10 | $96,799 | $135 | $96,934 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 544436418689152 | EE | M | 60-64 | E611 | IRON DEFICIENCY | 10 | $30,971 | $26,328 | $57,299 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 787527701655342 | EE | F | 60-64 | K8000 | CALCULUS OF GALLBLADDER W ACUTE CHOLECYST W/O OBSTRUCTION | 10 | $25 | $52,380 | $52,406 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 114364701641042 | EE | F | 30-39 | O480 | POST-TERM PREGNANCY | 10 | $329 | $55,073 | $55,402 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 602090045628942 | EE | M | 60-64 | * | UNSPECIFIED | * | $0 | $1,328 | $1,328 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 602090045628942 | EE | F | 60-64 | PH | PHARMACY | * | $647 | $0 | $647 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 602090045628942 | EE | M | 60-64 | U071 | COVID-19 | 10 | $1,827 | $347,150 | $348,978 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 1 | M | 602090045628942 | EE | M | 60-64 | * | UNSPECIFIED | * | $0 | $2,724 | $2,724 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 602090045628942 | EE | M | 60-64 | I10 | ESSENTIAL (PRIMARY) HYPERTENSION | 10 | $546 | ($461) | $85 |
| MEMBER ID Total | $3,020 | $350,742 | $353,762 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 420003828606312 | EE | F | 50-59 | G35 | MULTIPLE SCLEROSIS | 10 | $70 | $80,888 | $80,958 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 127541158661212 | EE | F | 50-59 | J390 | RETROPHARYNGEAL AND PARAPHARYNGEAL ABSCESS | 10 | $5,986 | $101,000 | $106,987 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 772466263697632 | CH | M | 1-17 | * | UNSPECIFIED | * | $0 | $337,423 | $337,423 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 772466263697632 | CH | M | 1-17 | D619 | APLASTIC ANEMIA, UNSPECIFIED | 10 | $144,953 | $205,047 | $350,000 |
| MEMBER ID Total | $144,953 | $542,470 | $687,423 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 224629208611392 | EE | M | 40-49 | I214 | NON-ST ELEVATION (NSTEMI) MYOCARDIAL INFARCTION | 10 | $16,707 | $253,671 | $270,378 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 648569215696292 | EE | M | 50-59 | I2510 | ATHSCL HEART DISEASE OF NATIVE CORONARY ARTERY W/O ANG PCTRS | 10 | $462 | $109,618 | $110,079 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 648569215696292 | EE | M | 60-64 | I259 | CHRONIC ISCHEMIC HEART DISEASE, UNSPECIFIED | 10 | $107 | $1,536 | $1,643 |
| MEMBER ID Total | $569 | $111,154 | $111,723 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 766251198669622 | SP | M | 60-64 | N186 | END STAGE RENAL DISEASE | 10 | $2,751 | $140,449 | $143,199 |
Grand Total $4,111,781 $12,262,245 $16,374,026
&G &7This report contains proprietary and/or confidential information. Disclosure is strictly prohibited except to the extent required by law. ADVICE Reporting System &8Page &P of &N Date: 4/8/2025
&7Cigna makes no warranty, express or implied, as to content and disclaims all liability arising directly or indirectly from use or reliance upon its contents by any third party even if Cigna has been advised of an intended use.
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