Exhibit 38 - Cal Yr 2023 City of Miami Stop Loss - Greater than 50K High Claimant Report De-ID Dx.xlsx
XLSX spreadsheet 40 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
The document is an Excel spreadsheet titled "Exhibit 38 - Cal Yr 2023 City of Miami Stop Loss - Greater than 50K High Claimant Report De-ID Dx.xlsx", which details medical claims exceeding $50,000 for the City of Miami's employee health benefits plan. The report covers claims from January through December 2023 and is associated with Request for Proposals (RFP No. 2130386) for an Employee Health Benefits Plan in Florida. The spreadsheet provides a comprehensive breakdown of individual claims across various employee categories, including active employees (general, SEA, M/C), executives/elected officials, and retirees.
The report uses a pooled stop-loss, retrospectively experience-rated methodology and includes detailed patient information such as member ID, relationship status, gender, age band, diagnosis codes, and total paid claims. Claims range from medical conditions like osteoarthritis, end-stage renal disease, and sepsis to more complex diagnoses involving cardiovascular and neurological issues. The claims data is organized by network type (Network Open Access POS) and covers a diverse range of employee groups, with individual claim amounts varying from a few hundred dollars to over $266,000. The spreadsheet serves as a critical component of the City of Miami's health benefits analysis and potential contract negotiation process.
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Clms Exc De-ID Dx PYTD-1
| CITY OF MIAMI | |||||||||||||
| DE-IDENTIFIED CLAIMS EXCEEDING REPORT | |||||||||||||
| EXHIBIT 38 | |||||||||||||
| January 2023 thru December 2023 | |||||||||||||
| 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) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 8039474256708 | SP | M | 50-59 | Z0000 | ENCNTR FOR GENERAL ADULT MEDICAL EXAM W/O ABNORMAL FINDINGS | 10 | $99,418 | $203 | $99,620 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 03818929867405 | EE | M | 65+ | M1611 | UNILATERAL PRIMARY OSTEOARTHRITIS, RIGHT HIP | 10 | $26,451 | $37,836 | $64,286 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 46747294168428 | EE | M | 50-59 | N186 | END STAGE RENAL DISEASE | 10 | $16,600 | $173,098 | $189,698 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 27273567566557 | EE | F | 50-59 | R0789 | OTHER CHEST PAIN | 10 | $27,832 | $25,817 | $53,649 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 62572376067147 | EE | M | 50-59 | R9720 | ELEVATED PROSTATE SPECIFIC ANTIGEN [PSA] | 10 | $50,712 | $4,595 | $55,307 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 43583567569504 | EE | F | 60-64 | H2510 | AGE-RELATED NUCLEAR CATARACT, UNSPECIFIED EYE | 10 | $2,563 | $155 | $2,718 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 43583567569504 | EE | F | 65+ | I4891 | UNSPECIFIED ATRIAL FIBRILLATION | 10 | $19,569 | $29,365 | $48,934 |
| MEMBER ID Total | $22,131 | $29,521 | $51,652 | ||||||||||
| 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 | $4,571 | $85,618 | $90,188 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 88577600168803 | EE | M | 65+ | A4151 | SEPSIS DUE TO ESCHERICHIA COLI [E. COLI] | 10 | $37,344 | $229,377 | $266,720 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 41905861362590 | EE | M | 30-39 | E8352 | HYPERCALCEMIA | 10 | $80,177 | $371 | $80,548 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 30984584466790 | EE | M | 60-64 | I63219 | CEREB INFRC DUE TO UNSP OCCLS OR STENOSIS OF UNSP VERTEB ART | 10 | $0 | ($1,372) | ($1,372) |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRMC1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 30984584466790 | EE | M | 60-64 | S066X9A | TRAUM SUBRAC HEM W LOC OF UNSP DURATION, INIT | 10 | $1,175 | $72,818 | $73,993 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRMC1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 30984584466790 | EE | M | 65+ | I130 | HYP HRT & CHR KDNY DIS W HRT FAIL AND STG 1-4/UNSP CHR KDNY | 10 | $6,432 | $5,328 | $11,760 |
| MEMBER ID Total | $7,607 | $76,774 | $84,381 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 1 | M | 63166990461889 | EE | F | 40-49 | * | UNSPECIFIED | * | $0 | $11 | $11 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 63166990461889 | EE | F | 40-49 | K51918 | ULCERATIVE COLITIS, UNSPECIFIED WITH OTHER COMPLICATION | 10 | $23,347 | $198,638 | $221,984 |
| MEMBER ID Total | $23,347 | $198,649 | $221,995 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 33584830766779 | CH | M | 1-17 | E230 | HYPOPITUITARISM | 10 | $88,842 | $914 | $89,756 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 50666186064149 | SP | F | 50-59 | R197 | DIARRHEA, UNSPECIFIED | 10 | $165,361 | $3,282 | $168,643 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 81955849862502 | SP | F | 40-49 | Z79899 | OTHER LONG TERM (CURRENT) DRUG THERAPY | 10 | $59,209 | $2,844 | $62,053 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 908087803650465 | EE | M | 18-29 | D619 | APLASTIC ANEMIA, UNSPECIFIED | 10 | $114,819 | $5,407 | $120,226 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 494904851605365 | SP | M | 65+ | J13 | PNEUMONIA DUE TO STREPTOCOCCUS PNEUMONIAE | 10 | $77,112 | $95,473 | $172,585 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 822369558620065 | EE | F | 40-49 | Z1379 | ENCNTR FOR OTH SCREENING FOR GENETIC AND CHROMSOML ANOMALIES | 10 | $12,556 | $78,161 | $90,717 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 379541825640265 | EE | M | 50-59 | R9439 | ABNORMAL RESULT OF OTHER CARDIOVASCULAR FUNCTION STUDY | 10 | $25,222 | $23,923 | $49,146 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 379541825640265 | EE | M | 60-64 | E6601 | MORBID (SEVERE) OBESITY DUE TO EXCESS CALORIES | 10 | $7,662 | $94,135 | $101,797 |
| MEMBER ID Total | $32,884 | $118,058 | $150,942 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 399619204658155 | SP | M | 50-59 | S066X0A | TRAUM SUBRAC HEM W/O LOSS OF CONSCIOUSNESS, INIT | 10 | $777 | $98,613 | $99,390 |
| NPOS2-STANDALONE NETWORK POS PLAN COPY NO RX | RMEPDP-RETIRED MEDICARE ELIGIBLE W/PDP PLAN | 2 | R | 640535675683255 | EE | M | 65+ | L89313 | PRESSURE ULCER OF RIGHT BUTTOCK, STAGE 3 | 10 | $0 | $133,815 | $133,815 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 351979604619685 | EE | F | 50-59 | S199XXA | UNSPECIFIED INJURY OF NECK, INITIAL ENCOUNTER | 10 | $0 | ($706) | ($706) |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 351979604619685 | EE | F | 60-64 | I25110 | ATHSCL HEART DISEASE OF NATIVE COR ART W UNSTABLE ANG PCTRS | 10 | $3,443 | $19,300 | $22,742 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRSEA1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 351979604619685 | EE | F | 60-64 | M1612 | UNILATERAL PRIMARY OSTEOARTHRITIS, LEFT HIP | 10 | $8,937 | $79,356 | $88,293 |
| MEMBER ID Total | $12,379 | $97,950 | $110,329 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 681213040663485 | CH | M | <-1 | Z3801 | SINGLE LIVEBORN INFANT, DELIVERED BY CESAREAN | 10 | $1,562 | $48,594 | $50,156 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 672723881629375 | EE | M | 40-49 | B20 | HUMAN IMMUNODEFICIENCY VIRUS [HIV] DISEASE | 10 | $50,456 | $1,571 | $52,027 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 032466263603745 | CH | M | 1-17 | E049 | NONTOXIC GOITER, UNSPECIFIED | 10 | $115,190 | $2,347 | $117,537 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 811966508631615 | SP | F | 50-59 | K651 | PERITONEAL ABSCESS | 10 | $77,530 | $20,523 | $98,053 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 174835675682015 | EE | F | 50-59 | I340 | NONRHEUMATIC MITRAL (VALVE) INSUFFICIENCY | 10 | $6,083 | $119,162 | $125,245 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 861214951751915 | EE | M | 50-59 | H2511 | AGE-RELATED NUCLEAR CATARACT, RIGHT EYE | 10 | $4,207 | $22,910 | $27,117 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 861214951751915 | EE | M | 60-64 | T8522XA | DISPLACEMENT OF INTRAOCULAR LENS, INITIAL ENCOUNTER | 10 | $11,099 | $23,600 | $34,698 |
| MEMBER ID Total | $15,305 | $46,510 | $61,815 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 593835675643135 | EE | M | 50-59 | Z0001 | ENCOUNTER FOR GENERAL ADULT MEDICAL EXAM W ABNORMAL FINDINGS | 10 | $0 | $42 | $42 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 593835675643135 | EE | M | 50-59 | E559 | VITAMIN D DEFICIENCY, UNSPECIFIED | 10 | $68,571 | $2,080 | $70,651 |
| MEMBER ID Total | $68,571 | $2,122 | $70,693 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 194284717618035 | EE | M | 65+ | N2889 | OTHER SPECIFIED DISORDERS OF KIDNEY AND URETER | 10 | $434 | $53,058 | $53,492 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 559262108637605 | EE | F | 60-64 | R269 | UNSPECIFIED ABNORMALITIES OF GAIT AND MOBILITY | 10 | $0 | $80 | $80 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 559262108637605 | EE | F | 65+ | I472 | VENTRICULAR TACHYCARDIA | 10 | $22,493 | $105,699 | $128,192 |
| MEMBER ID Total | $22,493 | $105,778 | $128,271 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 006435675671405 | EE | M | 65+ | T8361XA | I/I REACT D/T IMPLANTED PENILE PROSTHESIS, INITIAL ENCOUNTER | 10 | $332 | $117,940 | $118,271 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 508253983684295 | EE | M | 50-59 | M00262 | OTHER STREPTOCOCCAL ARTHRITIS, LEFT KNEE | 10 | $4,586 | $51,459 | $56,045 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 720735675624725 | EE | F | 50-59 | Z5111 | ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY | 10 | $1,034 | $227,722 | $228,756 |
| 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 | $28 | $123,343 | $123,371 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 986226831712568 | EE | M | 30-39 | M1612 | UNILATERAL PRIMARY OSTEOARTHRITIS, LEFT HIP | 10 | $0 | $96 | $96 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 986226831712568 | EE | M | 40-49 | M1612 | UNILATERAL PRIMARY OSTEOARTHRITIS, LEFT HIP | 10 | $3,374 | $59,753 | $63,127 |
| MEMBER ID Total | $3,374 | $59,849 | $63,223 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 194485351612458 | EE | F | 65+ | M0579 | RHEU ARTHRITIS W RHEU FACTOR MULT SITE W/O ORG/SYS INVOLV | 10 | $41,216 | $9,093 | $50,309 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 566435675666888 | SP | F | 50-59 | M4712 | OTHER SPONDYLOSIS WITH MYELOPATHY, CERVICAL REGION | 10 | $189 | $50,063 | $50,251 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 566435675666888 | SP | M | 50-59 | PH | PHARMACY | * | $5,462 | $0 | $5,462 |
| MEMBER ID Total | $5,651 | $50,063 | $55,714 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 485093160668788 | CH | F | 18-29 | E1010 | TYPE 1 DIABETES MELLITUS WITH KETOACIDOSIS WITHOUT COMA | 10 | $6,786 | $79,418 | $86,204 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 362735675663488 | SP | M | 50-59 | * | UNSPECIFIED | * | $0 | $3,171 | $3,171 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 362735675663488 | SP | M | 50-59 | T8640 | UNSPECIFIED COMPLICATION OF LIVER TRANSPLANT | 10 | $24,686 | $23,369 | $48,054 |
| MEMBER ID Total | $24,686 | $26,540 | $51,226 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 620144643678988 | SP | M | 40-49 | T8469XA | INFECT/INFLM REACTION DUE TO INT FIX OF SITE, INIT | 10 | $289 | $78,204 | $78,493 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 600247568678978 | SP | F | 40-49 | E6601 | MORBID (SEVERE) OBESITY DUE TO EXCESS CALORIES | 10 | $471 | $60,477 | $60,949 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 947299483647148 | EE | M | 50-59 | H2511 | AGE-RELATED NUCLEAR CATARACT, RIGHT EYE | 10 | $45,197 | $34,961 | $80,158 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 210735675606618 | CH | F | 18-29 | * | UNSPECIFIED | * | $0 | $293,299 | $293,299 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 210735675606618 | CH | F | 18-29 | T8621 | HEART TRANSPLANT REJECTION | 10 | $15,625 | $334,631 | $350,256 |
| MEMBER ID Total | $15,625 | $627,930 | $643,555 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 490735675642538 | EE | F | 50-59 | K3532 | AC APPENDICITIS W PERF, LOC PERITONITIS, & GANGR, W/O ABSCS | 10 | $122,529 | $109,658 | $232,187 |
| 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 | $1,788 | $102,892 | $104,680 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 851035970612167 | CH | M | <-1 | P220 | RESPIRATORY DISTRESS SYNDROME OF NEWBORN | 10 | $0 | $186,624 | $186,624 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 851035970612167 | CH | M | <-1 | * | UNSPECIFIED | * | $0 | $520,680 | $520,680 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 851035970612167 | CH | M | 1-17 | * | UNSPECIFIED | * | $0 | $510 | $510 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 851035970612167 | CH | M | <-1 | Z3831 | TWIN LIVEBORN INFANT, DELIVERED BY CESAREAN | 10 | $576 | $162,800 | $163,376 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 851035970612167 | CH | M | 1-17 | Z00129 | ENCNTR FOR ROUTINE CHILD HEALTH EXAM W/O ABNORMAL FINDINGS | 10 | $0 | $0 | $0 |
| MEMBER ID Total | $576 | $870,614 | $871,190 | ||||||||||
| 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 | $108,615 | $108,615 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 066130301634187 | CH | M | 18-29 | S270XXA | TRAUMATIC PNEUMOTHORAX, INITIAL ENCOUNTER | 10 | $0 | $63,061 | $63,061 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 122735675673287 | CH | F | 18-29 | S82873A | DISPLACED PILON FRACTURE OF UNSP TIBIA, INIT FOR CLOS FX | 10 | $596 | $70,350 | $70,946 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 243685215687177 | SP | F | 50-59 | Z0000 | ENCNTR FOR GENERAL ADULT MEDICAL EXAM W/O ABNORMAL FINDINGS | 10 | $0 | $42 | $42 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 243685215687177 | SP | F | 50-59 | R197 | DIARRHEA, UNSPECIFIED | 10 | $60,575 | $19,160 | $79,735 |
| MEMBER ID Total | $60,575 | $19,202 | $79,777 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 303153423652647 | EE | F | 30-39 | E6601 | MORBID (SEVERE) OBESITY DUE TO EXCESS CALORIES | 10 | $1,279 | $77,971 | $79,250 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 943079651620747 | EE | M | 40-49 | R42 | DIZZINESS AND GIDDINESS | 10 | $8,678 | $84,321 | $92,999 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 377544424693447 | EE | M | 65+ | I2510 | ATHSCL HEART DISEASE OF NATIVE CORONARY ARTERY W/O ANG PCTRS | 10 | $99,759 | $236,096 | $335,855 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 341735675656947 | EE | F | 40-49 | I671 | CEREBRAL ANEURYSM, NONRUPTURED | 10 | $137,084 | $13,528 | $150,612 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 685274737621817 | EE | F | 60-64 | D0511 | INTRADUCTAL CARCINOMA IN SITU OF RIGHT BREAST | 10 | $16,945 | $28,600 | $45,545 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 685274737621817 | EE | F | 65+ | Z9011 | ACQUIRED ABSENCE OF RIGHT BREAST AND NIPPLE | 10 | $63,917 | $2,113 | $66,030 |
| MEMBER ID Total | $80,862 | $30,713 | $111,575 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 709619204612817 | SP | F | 40-49 | R69 | ILLNESS, UNSPECIFIED | 10 | $249 | $50,910 | $51,158 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 434735675697397 | SP | F | 50-59 | Z5111 | ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY | 10 | $5,716 | $98,841 | $104,557 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 434735675697397 | SP | F | 60-64 | PH | PHARMACY | * | $191 | $0 | $191 |
| MEMBER ID Total | $5,907 | $98,841 | $104,748 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 602546421682864 | EE | F | 50-59 | * | UNSPECIFIED | * | $0 | $279,952 | $279,952 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 602546421682864 | EE | F | 50-59 | D61810 | ANTINEOPLASTIC CHEMOTHERAPY INDUCED PANCYTOPENIA | 10 | $2,779 | $347,863 | $350,642 |
| MEMBER ID Total | $2,779 | $627,815 | $630,594 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 590144643672464 | CH | M | 18-29 | S36430A | LACERATION OF DUODENUM, INITIAL ENCOUNTER | 10 | $22 | $225,732 | $225,754 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 078583103652654 | SP | M | 60-64 | R0789 | OTHER CHEST PAIN | 10 | $53,983 | $4,158 | $58,141 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 942799491695384 | EE | M | 30-39 | M50223 | OTHER CERVICAL DISC DISPLACEMENT AT C6-C7 LEVEL | 10 | $248 | $61,639 | $61,887 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 152735675669744 | EE | M | 60-64 | D649 | ANEMIA, UNSPECIFIED | 10 | $0 | $32 | $32 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 152735675669744 | EE | M | 65+ | C61 | MALIGNANT NEOPLASM OF PROSTATE | 10 | $15,621 | $180,319 | $195,940 |
| MEMBER ID Total | $15,621 | $180,352 | $195,972 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 472735675642744 | EE | F | 50-59 | I214 | NON-ST ELEVATION (NSTEMI) MYOCARDIAL INFARCTION | 10 | $9,043 | $67,919 | $76,962 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 602735675630344 | CH | M | 18-29 | K5190 | ULCERATIVE COLITIS, UNSPECIFIED, WITHOUT COMPLICATIONS | 10 | $105,454 | $2,007 | $107,461 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 102862041601614 | EE | M | 60-64 | * | UNSPECIFIED | * | $0 | $387,658 | $387,658 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 102862041601614 | EE | M | 60-64 | Z5112 | ENCOUNTER FOR ANTINEOPLASTIC IMMUNOTHERAPY | 10 | $105,431 | $233,293 | $338,724 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 102862041601614 | EE | M | 65+ | R0602 | SHORTNESS OF BREATH | 10 | $226 | $157 | $383 |
| MEMBER ID Total | $105,657 | $621,108 | $726,765 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 553066263640814 | EE | M | 60-64 | C8510 | UNSPECIFIED B-CELL LYMPHOMA, UNSPECIFIED SITE | 10 | $101,873 | $28,131 | $130,004 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 278027524638714 | EE | M | 30-39 | * | UNSPECIFIED | * | $0 | $1,015 | $1,015 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 278027524638714 | EE | M | 30-39 | K5150 | LEFT SIDED COLITIS WITHOUT COMPLICATIONS | 10 | $331,114 | $18,887 | $350,000 |
| MEMBER ID Total | $331,114 | $19,902 | $351,015 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 657121541617914 | SP | M | 40-49 | R0789 | OTHER CHEST PAIN | 10 | $822 | $100,778 | $101,600 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 412735675601914 | SP | M | 50-59 | N200 | CALCULUS OF KIDNEY | 10 | $62,917 | $25,756 | $88,673 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 470645753699534 | SP | F | 40-49 | K5000 | CROHN'S DISEASE OF SMALL INTESTINE WITHOUT COMPLICATIONS | 10 | $4,553 | $36,699 | $41,252 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 470645753699534 | SP | M | 40-49 | PH | PHARMACY | * | $55,526 | $0 | $55,526 |
| MEMBER ID Total | $60,079 | $36,699 | $96,777 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 369630431602934 | EE | F | 40-49 | PH | PHARMACY | * | $1,755 | $0 | $1,755 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 369630431602934 | EE | M | 40-49 | J020 | STREPTOCOCCAL PHARYNGITIS | 10 | $47,764 | $20,457 | $68,221 |
| MEMBER ID Total | $49,519 | $20,457 | $69,976 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 243641948699994 | EE | F | 40-49 | G35 | MULTIPLE SCLEROSIS | 10 | $92,126 | $6,220 | $98,346 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NASEA-ACTIVE EMPLOYEES (SEA) | 2 | R | 196835675636294 | SP | F | 50-59 | I214 | NON-ST ELEVATION (NSTEMI) MYOCARDIAL INFARCTION | 10 | $2,538 | $114,624 | $117,162 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 409619204629524 | EE | F | 40-49 | N186 | END STAGE RENAL DISEASE | 10 | $6,221 | $94,666 | $100,886 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 349098448640181 | EE | F | 30-39 | N72 | INFLAMMATORY DISEASE OF CERVIX UTERI | 10 | $7,940 | $42,689 | $50,629 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 242486295675641 | EE | F | 40-49 | G35 | MULTIPLE SCLEROSIS | 10 | $2,101 | $182,390 | $184,490 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 507259211625941 | EE | F | 60-64 | N812 | INCOMPLETE UTEROVAGINAL PROLAPSE | 10 | $2,662 | $57,862 | $60,524 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 821624851608311 | EE | M | 65+ | I441 | ATRIOVENTRICULAR BLOCK, SECOND DEGREE | 10 | $1,955 | $70,083 | $72,038 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 834035970615901 | CH | F | <-1 | P220 | RESPIRATORY DISTRESS SYNDROME OF NEWBORN | 10 | $0 | $319,188 | $319,188 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 834035970615901 | CH | F | <-1 | * | UNSPECIFIED | * | $0 | $690,565 | $690,565 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 834035970615901 | CH | F | 1-17 | * | UNSPECIFIED | * | $0 | $512 | $512 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 834035970615901 | CH | F | <-1 | Z3831 | TWIN LIVEBORN INFANT, DELIVERED BY CESAREAN | 10 | $812 | $29,999 | $30,812 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 834035970615901 | CH | F | 1-17 | Z00129 | ENCNTR FOR ROUTINE CHILD HEALTH EXAM W/O ABNORMAL FINDINGS | 10 | $0 | $0 | $0 |
| MEMBER ID Total | $812 | $1,040,264 | $1,041,076 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | MRG1-MEDICARE RETIREE 65+ W/ DEP UNDER 65 | 2 | R | 303331803643591 | EE | F | 60-64 | C569 | MALIGNANT NEOPLASM OF UNSPECIFIED OVARY | 10 | $599 | $202,349 | $202,948 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | MRG1-MEDICARE RETIREE 65+ W/ DEP UNDER 65 | 2 | R | 303331803643591 | EE | F | 65+ | C772 | SECONDARY AND UNSP MALIGNANT NEOPLASM OF INTRA-ABD NODES | 10 | $18,397 | $36,764 | $55,160 |
| MEMBER ID Total | $18,996 | $239,113 | $258,109 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 718470123673791 | SP | F | 30-39 | O99891 | OTH DISEASES AND CONDITIONS COMPLICATING PREGNANCY | 10 | $31 | $66,588 | $66,619 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 688442354631191 | EE | F | 50-59 | * | UNSPECIFIED | * | $0 | $371,949 | $371,949 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 688442354631191 | EE | F | 50-59 | Z5112 | ENCOUNTER FOR ANTINEOPLASTIC IMMUNOTHERAPY | 10 | $2,703 | $346,642 | $349,345 |
| MEMBER ID Total | $2,703 | $718,590 | $721,293 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 1 | M | 252835675632021 | EE | M | 60-64 | * | UNSPECIFIED | * | $0 | $24,320 | $24,320 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 252835675632021 | EE | M | 60-64 | I110 | HYPERTENSIVE HEART DISEASE WITH HEART FAILURE | 10 | $606 | $349,042 | $349,648 |
| MEMBER ID Total | $606 | $373,363 | $373,969 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 391395948690463 | EE | F | 40-49 | D250 | SUBMUCOUS LEIOMYOMA OF UTERUS | 10 | $2,632 | $54,306 | $56,939 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 695063968679063 | EE | F | 60-64 | R110 | NAUSEA | 10 | $102,224 | $7,789 | $110,013 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 515583103644653 | CH | M | 18-29 | D5700 | HB-SS DISEASE WITH CRISIS, UNSPECIFIED | 10 | $123 | $52,980 | $53,103 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 472413251643113 | SP | M | 65+ | * | UNSPECIFIED | * | $0 | $515,871 | $515,871 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 472413251643113 | SP | M | 65+ | Z5111 | ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY | 10 | $5,951 | $341,070 | $347,021 |
| MEMBER ID Total | $5,951 | $856,941 | $862,892 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 561454561612013 | EE | M | 65+ | N400 | BENIGN PROSTATIC HYPERPLASIA WITHOUT LOWER URINRY TRACT SYMP | 10 | $637 | $54,662 | $55,299 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 900244614656213 | EE | M | 50-59 | C61 | MALIGNANT NEOPLASM OF PROSTATE | 10 | $143 | $77,759 | $77,902 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 900244614656213 | EE | M | 60-64 | N529 | MALE ERECTILE DYSFUNCTION, UNSPECIFIED | 10 | $59 | $150 | $209 |
| MEMBER ID Total | $202 | $77,908 | $78,111 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 864817173629133 | CH | F | 1-17 | B003 | HERPESVIRAL MENINGITIS | 10 | $0 | $103,809 | $103,809 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 851886001657703 | SP | M | 50-59 | J339 | NASAL POLYP, UNSPECIFIED | 10 | $54,994 | $1,948 | $56,942 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NRETG1-NON-MEDICARE RETIREE - 65 W/ DEP - 65 | 2 | R | 699227131707023 | SP | M | 60-64 | M48062 | SPINAL STENOSIS, LUMBAR REGION WITH NEUROGENIC CLAUDICATION | 10 | $664 | $52,887 | $53,551 |
| 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 | $4,612 | $170,493 | $175,105 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 557414374647450 | SP | F | 65+ | I4820 | CHRONIC ATRIAL FIBRILLATION, UNSPECIFIED | 10 | $12,571 | $165,108 | $177,679 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 030892641604450 | EE | M | 60-64 | I214 | NON-ST ELEVATION (NSTEMI) MYOCARDIAL INFARCTION | 10 | $709 | $65,385 | $66,094 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 647764251627580 | EE | F | 40-49 | K6289 | OTHER SPECIFIED DISEASES OF ANUS AND RECTUM | 10 | $9,519 | $53,725 | $63,244 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 667593901696670 | EE | M | 50-59 | M5450 | LOW BACK PAIN, UNSPECIFIED | 10 | $57,199 | $2,344 | $59,543 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 038641457642670 | EE | M | 40-49 | C182 | MALIGNANT NEOPLASM OF ASCENDING COLON | 10 | $6,689 | $30,505 | $37,193 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 038641457642670 | EE | M | 50-59 | I2109 | STEMI INVOLVING OTH CORONARY ARTERY OF ANTERIOR WALL | 10 | $5,105 | $60,581 | $65,686 |
| MEMBER ID Total | $11,794 | $91,086 | $102,879 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 488383731672770 | EE | F | 60-64 | * | UNSPECIFIED | * | $0 | $23,947 | $23,947 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 488383731672770 | EE | F | 60-64 | Z5112 | ENCOUNTER FOR ANTINEOPLASTIC IMMUNOTHERAPY | 10 | $7,803 | $342,093 | $349,896 |
| MEMBER ID Total | $7,803 | $366,040 | $373,843 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 206435675683640 | SP | F | 50-59 | * | UNSPECIFIED | * | $0 | $157,899 | $157,899 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 206435675683640 | SP | F | 50-59 | Z5111 | ENCOUNTER FOR ANTINEOPLASTIC CHEMOTHERAPY | 10 | $559 | $350,042 | $350,601 |
| MEMBER ID Total | $559 | $507,941 | $508,500 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 921739271661740 | EE | M | 30-39 | E6601 | MORBID (SEVERE) OBESITY DUE TO EXCESS CALORIES | 10 | $19,313 | $45,686 | $65,000 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 888735675695310 | EE | F | 50-59 | I2510 | ATHSCL HEART DISEASE OF NATIVE CORONARY ARTERY W/O ANG PCTRS | 10 | $9,989 | $68,939 | $78,928 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 888735675695310 | EE | F | 60-64 | N281 | CYST OF KIDNEY, ACQUIRED | 10 | $2,280 | $202 | $2,482 |
| MEMBER ID Total | $12,269 | $69,141 | $81,410 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 704713363656530 | SP | F | 50-59 | C50411 | MALIG NEOPLM OF UPPER-OUTER QUADRANT OF RIGHT FEMALE BREAST | 10 | $6,668 | $94,416 | $101,085 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 195572791669790 | SP | F | 30-39 | U071 | COVID-19 | 10 | $57,457 | $660 | $58,118 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 939619204635490 | EE | M | 65+ | Z510 | ENCOUNTER FOR ANTINEOPLASTIC RADIATION THERAPY | 10 | $12,864 | $119,345 | $132,209 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 119513221687520 | EE | M | 50-59 | I69351 | HEMIPLGA FOLLOWING CEREBRAL INFRC AFF RIGHT DOMINANT SIDE | 10 | $22,723 | $61,537 | $84,260 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 609619204603120 | EE | F | 65+ | R519 | HEADACHE, UNSPECIFIED | 10 | $87,139 | $9,483 | $96,623 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 878683001629159 | SP | M | 30-39 | J4550 | SEVERE PERSISTENT ASTHMA, UNCOMPLICATED | 10 | $55,282 | $456 | $55,738 |
| 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 | $20,493 | $85,046 | $105,539 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 316342611649189 | CH | F | 1-17 | * | UNSPECIFIED | * | $0 | $131 | $131 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 316342611649189 | CH | F | 1-17 | R2689 | OTHER ABNORMALITIES OF GAIT AND MOBILITY | 10 | $332,680 | $11,305 | $343,985 |
| MEMBER ID Total | $332,680 | $11,436 | $344,116 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 572812370645089 | CH | F | 1-17 | M41127 | ADOLESCENT IDIOPATHIC SCOLIOSIS, LUMBOSACRAL REGION | 10 | $0 | $217,086 | $217,086 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 572812370645089 | CH | F | 18-29 | H04123 | DRY EYE SYNDROME OF BILATERAL LACRIMAL GLANDS | 10 | $17 | $141 | $158 |
| MEMBER ID Total | $17 | $217,227 | $217,244 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 742835675625089 | EE | F | 50-59 | I63511 | CEREB INFRC D/T UNSP OCCLS OR STENOS OF RIGHT MID CEREB ART | 10 | $398 | $110,969 | $111,367 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 606475074624579 | CH | F | 18-29 | K5000 | CROHN'S DISEASE OF SMALL INTESTINE WITHOUT COMPLICATIONS | 10 | $328,133 | $7,240 | $335,373 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 762735675614079 | CH | M | 18-29 | G35 | MULTIPLE SCLEROSIS | 10 | $76,411 | $560 | $76,971 |
| 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 | $162,281 | $9,743 | $172,024 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | E1211-EXECUTIVES/ELECTED OFFICIALS | 2 | R | 139427918661849 | SP | M | 50-59 | I63412 | CEREB INFRC DUE TO EMBOLISM OF LEFT MIDDLE CEREBRAL ARTERY | 10 | $8,067 | $120,275 | $128,342 |
| 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 | $3,301 | $320,287 | $323,588 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 450769095657819 | EE | M | 50-59 | I214 | NON-ST ELEVATION (NSTEMI) MYOCARDIAL INFARCTION | 10 | $2,943 | $75,000 | $77,944 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 691907145684419 | EE | F | 60-64 | * | UNSPECIFIED | * | $0 | $25,355 | $25,355 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 691907145684419 | EE | F | 60-64 | K635 | POLYP OF COLON | 10 | $239,651 | ($17,553) | $222,098 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 691907145684419 | EE | F | 65+ | M85852 | OTH DISRD OF BONE DENSITY AND STRUCTURE, LEFT THIGH | 10 | $92,044 | $1,217 | $93,261 |
| MEMBER ID Total | $331,695 | $9,018 | $340,713 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 071394661623919 | EE | M | 50-59 | E10621 | TYPE 1 DIABETES MELLITUS WITH FOOT ULCER | 10 | $2,914 | $229,489 | $232,403 |
| 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 | $64,666 | $30,733 | $95,399 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 998162670690439 | EE | M | 18-29 | E1165 | TYPE 2 DIABETES MELLITUS WITH HYPERGLYCEMIA | 10 | $8,349 | $43,047 | $51,396 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 507641118677609 | SP | F | 60-64 | C786 | SECONDARY MALIGNANT NEOPLASM OF RETROPERITON AND PERITONEUM | 10 | $2,306 | $68,765 | $71,072 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 832535675635509 | EE | M | 50-59 | C182 | MALIGNANT NEOPLASM OF ASCENDING COLON | 10 | $9,020 | $66,031 | $75,051 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 061798834685799 | SP | F | 40-49 | C50912 | MALIGNANT NEOPLASM OF UNSPECIFIED SITE OF LEFT FEMALE BREAST | 10 | $2,994 | $59,624 | $62,617 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 080735675612799 | EE | M | 40-49 | * | UNSPECIFIED | * | $0 | $6,103 | $6,103 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 1 | M | 080735675612799 | EE | M | 50-59 | * | UNSPECIFIED | * | $0 | $380,121 | $380,121 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 080735675612799 | EE | M | 40-49 | I480 | PAROXYSMAL ATRIAL FIBRILLATION | 10 | $1,526 | $331,215 | $332,741 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 080735675612799 | EE | M | 50-59 | L03115 | CELLULITIS OF RIGHT LOWER LIMB | 10 | $23,949 | ($6,887) | $17,062 |
| MEMBER ID Total | $25,476 | $710,551 | $736,026 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 709619204632499 | EE | M | 40-49 | S069X0A | UNSP INTRACRANIAL INJURY W/O LOSS OF CONSCIOUSNESS, INIT | 10 | $4,055 | $59,317 | $63,371 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 484861280681662 | EE | F | 18-29 | M329 | SYSTEMIC LUPUS ERYTHEMATOSUS, UNSPECIFIED | 10 | $327 | $1,659 | $1,987 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 484861280681662 | EE | F | 30-39 | M328 | OTHER FORMS OF SYSTEMIC LUPUS ERYTHEMATOSUS | 10 | $493 | $133,432 | $133,925 |
| MEMBER ID Total | $821 | $135,091 | $135,912 | ||||||||||
| 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 | $90,584 | $164 | $90,748 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 753630307655462 | SP | M | 40-49 | I4720 | VENTRICULAR TACHYCARDIA, UNSPECIFIED | 10 | $21,437 | $57,284 | $78,722 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 544436418689152 | EE | M | 60-64 | M542 | CERVICALGIA | 10 | $69,878 | $13,627 | $83,505 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 809619204662612 | EE | F | 60-64 | K8042 | CALCULUS OF BILE DUCT W ACUTE CHOLECYSTITIS W/O OBSTRUCTION | 10 | $811 | $50,366 | $51,177 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 140633810694312 | CH | M | <-1 | Z3800 | SINGLE LIVEBORN INFANT, DELIVERED VAGINALLY | 10 | $0 | $110,825 | $110,825 |
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAMC-ACTIVE EMPLOYEES (M/C) | 2 | R | 140633810694312 | CH | M | <-1 | Q673 | PLAGIOCEPHALY | 10 | $0 | $6,140 | $6,140 |
| MEMBER ID Total | $0 | $116,965 | $116,965 | ||||||||||
| NPOS-NETWORK OPEN ACCESS POS (ALL EMPLOYEES) | NAGEN-ACTIVE EMPLOYEES (GENERAL) | 2 | R | 766251198669622 | SP | M | 60-64 | N186 | END STAGE RENAL DISEASE | 10 | $310 | $108,273 | $108,583 |
Grand Total $5,140,680 $16,210,917 $21,351,597
&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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