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HHSM-500-2015-RFP-0122 Attachment J.6.C UPIC
CLAIMS VOLUME - JURISDICTION ONE
FY 2014 - October 1, 2013 - September 30, 2014
**Medicare Fee-for-Service, Final Action Claims with claim payment amounts greater than 0
Demographic Statistics-Part A
**Include Inpatient, Outpatient, Home Health, Hospice and Skilled Nursing Facility
| State |
| No. of Providers |
| No. of Beneficiaries |
| Total Claims Paid |
| Total Paid Dollars |
| Illinois |
| 2,871 |
| 1,399,732 |
| 9,369,979 |
| $11,199,944,419 |
| Indiana |
| 1,481 |
| 751,177 |
| 4,865,944 |
| $5,854,939,009 |
| Kentucky |
| 1,057 |
| 550,785 |
| 3,375,833 |
| $3,860,195,860 |
| Michigan |
| 2,226 |
| 1,162,555 |
| 8,685,513 |
| $9,177,567,683 |
| Minnesota |
| 1,170 |
| 591,538 |
| 4,014,816 |
| $4,272,348,238 |
| Ohio |
| 2,890 |
| 1,187,303 |
| 8,044,865 |
| $9,278,756,088 |
| Wisconsin |
| 1,059 |
| 591,921 |
| 4,223,602 |
| $4,166,378,935 |
| Iowa |
| 1,211 |
| 411,238 |
| 3,182,999 |
| $2,621,457,737 |
| Kansas |
| 1,083 |
| 326,499 |
| 2,382,581 |
| $2,556,629,042 |
| Missouri |
| 1,804 |
| 737,854 |
| 5,219,591 |
| $5,483,178,403 |
| Nebraska |
| 703 |
| 231,103 |
| 1,627,116 |
| $1,711,442,470 |
Demographic Statistics-Part B
| State |
| No. of Providers |
| No. of Beneficiaries |
| Total Claims Paid |
| Total Claim Line Paid Dollars |
| Illinois |
| 47,065 |
| 1,873,717 |
| 34,858,010 |
| 3,845,155,121 |
| Indiana |
| 23,133 |
| 951,136 |
| 17,183,663 |
| 1,823,155,612 |
| Kentucky |
| 16,689 |
| 689,671 |
| 12,324,791 |
| 1,217,272,361 |
| Michigan |
| 41,192 |
| 1,330,249 |
| 31,514,388 |
| 2,997,496,405 |
| Minnesota |
| 26,945 |
| 590,536 |
| 7,874,992 |
| 774,080,173 |
| Ohio |
| 52,656 |
| 3,888,529 |
| 30,664,201 |
| 2,890,803,937 |
| Wisconsin |
| 26,921 |
| 765,557 |
| 12,259,006 |
| 1,104,647,215 |
| Iowa |
| 13,527 |
| 522,825 |
| 9,089,242 |
| $775,862,782 |
| Kansas |
| 12,185 |
| 780,694 |
| 9,653,019 |
| $877,154,572 |
| Missouri |
| 24,244 |
| 1,070,813 |
| 17,858,365 |
| $1,639,335,144 |
| Nebraska |
| 8,340 |
| 316,556 |
| 5,445,641 |
| $529,060,658 |
Demographic Statistics-DME
| State |
| No. of Providers |
| No. of Beneficiaries |
| Total Claims Paid |
| Total Claim Line Paid Dollars |
| Illinois |
| 19,642 |
| 1,417,483 |
| 5,887,381 |
| $1,099,116,336 |
| Indiana |
| 1,160 |
| 179,038 |
| 768,794 |
| $106,327,273 |
| Kentucky |
| 942 |
| 138,704 |
| 667,908 |
| $84,282,742 |
| Michigan |
| 1,933 |
| 289,259 |
| 1,269,191 |
| $166,979,073 |
| Minnesota |
| 2,790 |
| 222,409 |
| 1,007,147 |
| $123,830,785 |
| Ohio |
| 2,286 |
| 312,471 |
| 1,434,340 |
| $186,477,804 |
| Wisconsin |
| 1,489 |
| 118,886 |
| 537,346 |
| $61,163,893 |
| Iowa |
| 1,283 |
| 140,341 |
| 809,902 |
| $74,652,123 |
| Kansas |
| 1,015 |
| 118,429 |
| 681,336 |
| $83,271,807 |
| Missouri |
| 1,858 |
| 356,066 |
| 2,352,163 |
| $230,946,596 |
| Nebraska |
| 718 |
| 92,287 |
| 545,448 |
| $68,621,066 |
Demographic Statistics-(HH + H only)
**Include only Home Health and Hospice claims
| State |
| No. of Providers |
| No. of Beneficiaries |
| Total Claims Paid |
| Total Paid Dollars |
| Illinois |
| 939 |
| 214,977 |
| 515,820 |
| $1,477,694,883 |
| Indiana |
| 332 |
| 83,002 |
| 184,918 |
| $552,937,399 |
| Kentucky |
| 136 |
| 67,355 |
| 145,198 |
| $381,595,347 |
| Michigan |
| 770 |
| 183,727 |
| 400,783 |
| $1,156,284,943 |
| Minnesota |
| 244 |
| 54,243 |
| 115,686 |
| $370,131,811 |
| Ohio |
| 832 |
| 170,814 |
| 409,820 |
| $1,247,317,023 |
| Wisconsin |
| 180 |
| 59,066 |
| 137,120 |
| $434,377,598 |
| Iowa |
| 259 |
| 43,085 |
| 87,637 |
| $242,015,216 |
| Kansas |
| 204 |
| 37,354 |
| 83,328 |
| $243,169,444 |
| Missouri |
| 311 |
| 96,352 |
| 202,807 |
| $580,044,418 |
| Nebraska |
| 120 |
| 22,281 |
| 46,589 |
| $138,117,143 |
Demographic Statistics-Part D
** Paid Dollars includes CLM_LINE_INGRDNT_CST_AMT + CLM_LINE_SLS_TAX_AMT + CLM_LINE_SRVC_CST_AMT
| State |
| No. of Pharmacies |
| No. of Beneficiaries |
| Total Claims Paid |
| Total Paid Dollars |
| Illinois |
| 3,452 |
| 1,830,363 |
| 48,271,884 |
| $4,130,352,472 |
| Indiana |
| 1,897 |
| 818,472 |
| 27,059,935 |
| $1,844,175,189 |
| Kentucky |
| 1,326 |
| 631,900 |
| 26,262,616 |
| $1,588,908,325 |
| Michigan |
| 2,901 |
| 1,370,618 |
| 36,597,952 |
| $3,371,855,400 |
| Minnesota |
| 2,167 |
| 660,167 |
| 18,937,749 |
| $1,392,716,155 |
| Ohio |
| 3,670 |
| 1,962,727 |
| 54,031,618 |
| $4,863,363,548 |
| Wisconsin |
| 2,456 |
| 693,970 |
| 22,153,382 |
| $1,570,260,072 |
| Iowa |
| 22,135 |
| 493,079 |
| 16,348,298 |
| $1,036,722,278 |
| Kansas |
| 18,932 |
| 423,159 |
| 13,520,738 |
| $990,196,669 |
| Missouri |
| 34,711 |
| 978,626 |
| 33,944,211 |
| $2,635,685,252 |
| Nebraska |
| 15,834 |
| 268,894 |
| 8,983,484 |
| $633,081,568 |
Table 6: Medicaid Spending by Type of Service (in $ millions), FY 2013
| State |
| Total |
| Acute Care |
| Long-Term Care |
| DSH Payments |
| United States |
| $438,233 |
| $298,840 |
| 68% |
| $123,016 |
| 28% |
| $16,377 |
| 4% |
| Alabama |
| $5,039 |
| $3,135 |
| 62% |
| $1,432 |
| 28% |
| $471 |
| 9% |
| Alaska |
| $1,356 |
| $815 |
| 60% |
| $520 |
| 38% |
| $22 |
| 2% |
| Arizona |
| $8,438 |
| $8,219 |
| 97% |
| $45 |
| 1% |
| $173 |
| 2% |
| Arkansas |
| $4,207 |
| $2,703 |
| 64% |
| $1,443 |
| 34% |
| $61 |
| 1% |
| California |
| $61,904 |
| $45,018 |
| 73% |
| $14,766 |
| 24% |
| $2,120 |
| 3% |
| Colorado |
| $5,092 |
| $3,332 |
| 65% |
| $1,566 |
| 31% |
| $194 |
| 4% |
| Connecticut |
| $6,726 |
| $3,469 |
| 52% |
| $2,983 |
| 44% |
| $273 |
| 4% |
| Delaware |
| $1,563 |
| $1,418 |
| 91% |
| $133 |
| 9% |
| $11 |
| 1% |
| DC |
| $2,288 |
| $1,449 |
| 63% |
| $782 |
| 34% |
| $56 |
| 2% |
| Florida |
| $18,561 |
| $13,499 |
| 73% |
| $4,727 |
| 25% |
| $335 |
| 2% |
| Georgia |
| $8,960 |
| $6,203 |
| 69% |
| $2,327 |
| 26% |
| $430 |
| 5% |
| Hawaii |
| $1,630 |
| $1,489 |
| 91% |
| $117 |
| 7% |
| $25 |
| 2% |
| Idaho |
| $1,672 |
| $1,092 |
| 65% |
| $556 |
| 33% |
| $24 |
| 1% |
| Illinois |
| $15,658 |
| $10,640 |
| 68% |
| $4,571 |
| 29% |
| $447 |
| 3% |
| Indiana |
| $7,968 |
| $4,703 |
| 59% |
| $2,927 |
| 37% |
| $338 |
| 4% |
| Iowa |
| $3,709 |
| $1,984 |
| 53% |
| $1,670 |
| 45% |
| $55 |
| 1% |
| Kansas |
| $2,578 |
| $1,863 |
| 72% |
| $639 |
| 25% |
| $77 |
| 3% |
| Kentucky |
| $5,822 |
| $3,970 |
| 68% |
| $1,636 |
| 28% |
| $216 |
| 4% |
| Louisiana |
| $7,147 |
| $4,199 |
| 59% |
| $2,181 |
| 31% |
| $767 |
| 11% |
| Maine |
| $2,887 |
| $2,013 |
| 70% |
| $837 |
| 29% |
| $37 |
| 1% |
| Maryland |
| $7,781 |
| $5,373 |
| 69% |
| $2,274 |
| 29% |
| $134 |
| 2% |
| Massachusetts |
| $13,166 |
| $9,340 |
| 71% |
| $3,827 |
| 29% |
| $0 |
| 0% |
| Michigan |
| $12,386 |
| $9,239 |
| 75% |
| $2,760 |
| 22% |
| $388 |
| 3% |
| Minnesota |
| $8,919 |
| $5,681 |
| 64% |
| $3,191 |
| 36% |
| $46 |
| 1% |
| Mississippi |
| $4,736 |
| $3,099 |
| 65% |
| $1,419 |
| 30% |
| $218 |
| 5% |
| Missouri |
| $8,951 |
| $5,962 |
| 67% |
| $2,286 |
| 26% |
| $703 |
| 8% |
| Montana |
| $1,007 |
| $614 |
| 61% |
| $376 |
| 37% |
| $18 |
| 2% |
| Nebraska |
| $1,834 |
| $1,015 |
| 55% |
| $773 |
| 42% |
| $45 |
| 2% |
| Nevada |
| $1,823 |
| $1,325 |
| 73% |
| $417 |
| 23% |
| $81 |
| 4% |
| New Hampshire |
| $1,203 |
| $576 |
| 48% |
| $585 |
| 49% |
| $41 |
| 3% |
| New Jersey |
| $10,606 |
| $5,648 |
| 53% |
| $3,659 |
| 35% |
| $1,298 |
| 12% |
| New Mexico |
| $3,295 |
| $2,914 |
| 88% |
| $356 |
| 11% |
| $25 |
| 1% |
| New York |
| $54,420 |
| $32,358 |
| 59% |
| $18,640 |
| 34% |
| $3,423 |
| 6% |
| North Carolina |
| $11,915 |
| $8,999 |
| 76% |
| $2,299 |
| 19% |
| $617 |
| 5% |
| North Dakota |
| $784 |
| $298 |
| 38% |
| $485 |
| 62% |
| $1 |
| 0% |
| Ohio |
| $16,803 |
| $10,056 |
| 60% |
| $6,098 |
| 36% |
| $649 |
| 4% |
| Oklahoma |
| $4,796 |
| $3,497 |
| 73% |
| $1,257 |
| 26% |
| $42 |
| 1% |
| Oregon |
| $5,111 |
| $3,541 |
| 69% |
| $1,493 |
| 29% |
| $77 |
| 1% |
| Pennsylvania |
| $21,092 |
| $12,489 |
| 59% |
| $7,755 |
| 37% |
| $847 |
| 4% |
| Rhode Island |
| $1,920 |
| $1,443 |
| 75% |
| $348 |
| 18% |
| $130 |
| 7% |
| South Carolina |
| $4,907 |
| $3,258 |
| 66% |
| $1,191 |
| 24% |
| $457 |
| 9% |
| South Dakota |
| $766 |
| $465 |
| 61% |
| $300 |
| 39% |
| $1 |
| 0% |
| Tennessee |
| $8,716 |
| $7,652 |
| 88% |
| $984 |
| 11% |
| $80 |
| 1% |
| Texas |
| $28,339 |
| $22,518 |
| 79% |
| $5,594 |
| 20% |
| $227 |
| 1% |
| Utah |
| $2,130 |
| $1,631 |
| 77% |
| $470 |
| 22% |
| $29 |
| 1% |
| Vermont |
| $1,474 |
| $1,312 |
| 89% |
| $124 |
| 8% |
| $37 |
| 3% |
| Virginia |
| $7,291 |
| $4,592 |
| 63% |
| $2,513 |
| 34% |
| $186 |
| 3% |
| Washington |
| $8,171 |
| $5,497 |
| 67% |
| $2,308 |
| 28% |
| $367 |
| 4% |
| West Virginia |
| $3,024 |
| $1,680 |
| 56% |
| $1,269 |
| 42% |
| $75 |
| 2% |
| Wisconsin |
| $7,106 |
| $5,264 |
| 74% |
| $1,841 |
| 26% |
| $1 |
| 0% |
| Wyoming |
| $554 |
| $288 |
| 52% |
| $265 |
| 48% |
| $0 |
| 0% |
| Location |
| Acute Care |
| Long-Term Care |
| DSH Payments |
| Total |
| United States |
| 68.20% |
| 28.10% |
| 3.70% |
| 100.00% |
| Alabama |
| 62.20% |
| 28.40% |
| 9.30% |
| 100.00% |
| Alaska |
| 60.10% |
| 38.30% |
| 1.60% |
| 100.00% |
| Arizona |
| 97.40% |
| 0.50% |
| 2.10% |
| 100.00% |
| Arkansas |
| 64.20% |
| 34.30% |
| 1.50% |
| 100.00% |
| California |
| 72.70% |
| 23.90% |
| 3.40% |
| 100.00% |
| Colorado |
| 65.40% |
| 30.80% |
| 3.80% |
| 100.00% |
| Connecticut |
| 51.60% |
| 44.40% |
| 4.10% |
| 100.00% |
| Delaware |
| 90.80% |
| 8.50% |
| 0.70% |
| 100.00% |
| District of Columbia |
| 63.30% |
| 34.20% |
| 2.50% |
| 100.00% |
| Florida |
| 72.70% |
| 25.50% |
| 1.80% |
| 100.00% |
| Georgia |
| 69.20% |
| 26.00% |
| 4.80% |
| 100.00% |
| Hawaii |
| 91.30% |
| 7.20% |
| 1.50% |
| 100.00% |
| Idaho |
| 65.30% |
| 33.30% |
| 1.40% |
| 100.00% |
| Illinois |
| 68.00% |
| 29.20% |
| 2.90% |
| 100.00% |
| Indiana |
| 59.00% |
| 36.70% |
| 4.20% |
| 100.00% |
| Iowa |
| 53.50% |
| 45.00% |
| 1.50% |
| 100.00% |
| Kansas |
| 72.20% |
| 24.80% |
| 3.00% |
| 100.00% |
| Kentucky |
| 68.20% |
| 28.10% |
| 3.70% |
| 100.00% |
| Louisiana |
| 58.70% |
| 30.50% |
| 10.70% |
| 100.00% |
| Maine |
| 69.70% |
| 29.00% |
| 1.30% |
| 100.00% |
| Maryland |
| 69.10% |
| 29.20% |
| 1.70% |
| 100.00% |
| Massachusetts |
| 70.90% |
| 29.10% |
| 0.00% |
| 100.00% |
| Michigan |
| 74.60% |
| 22.30% |
| 3.10% |
| 100.00% |
| Minnesota |
| 63.70% |
| 35.80% |
| 0.50% |
| 100.00% |
| Mississippi |
| 65.40% |
| 30.00% |
| 4.60% |
| 100.00% |
| Missouri |
| 66.60% |
| 25.50% |
| 7.90% |
| 100.00% |
| Montana |
| 60.90% |
| 37.30% |
| 1.80% |
| 100.00% |
| Nebraska |
| 55.30% |
| 42.20% |
| 2.50% |
| 100.00% |
| Nevada |
| 72.70% |
| 22.90% |
| 4.50% |
| 100.00% |
| New Hampshire |
| 47.90% |
| 48.70% |
| 3.40% |
| 100.00% |
| New Jersey |
| 53.30% |
| 34.50% |
| 12.20% |
| 100.00% |
| New Mexico |
| 88.40% |
| 10.80% |
| 0.80% |
| 100.00% |
| New York |
| 59.50% |
| 34.30% |
| 6.30% |
| 100.00% |
| North Carolina |
| 75.50% |
| 19.30% |
| 5.20% |
| 100.00% |
| North Dakota |
| 38.00% |
| 61.80% |
| 0.20% |
| 100.00% |
| Ohio |
| 59.80% |
| 36.30% |
| 3.90% |
| 100.00% |
| Oklahoma |
| 72.90% |
| 26.20% |
| 0.90% |
| 100.00% |
| Oregon |
| 69.30% |
| 29.20% |
| 1.50% |
| 100.00% |
| Pennsylvania |
| 59.20% |
| 36.80% |
| 4.00% |
| 100.00% |
| Rhode Island |
| 75.10% |
| 18.10% |
| 6.80% |
| 100.00% |
| South Carolina |
| 66.40% |
| 24.30% |
| 9.30% |
| 100.00% |
| South Dakota |
| 60.70% |
| 39.10% |
| 0.20% |
| 100.00% |
| Tennessee |
| 87.80% |
| 11.30% |
| 0.90% |
| 100.00% |
| Texas |
| 79.50% |
| 19.70% |
| 0.80% |
| 100.00% |
| Utah |
| 76.60% |
| 22.10% |
| 1.40% |
| 100.00% |
| Vermont |
| 89.10% |
| 8.40% |
| 2.50% |
| 100.00% |
| Virginia |
| 63.00% |
| 34.50% |
| 2.60% |
| 100.00% |
| Washington |
| 67.30% |
| 28.20% |
| 4.50% |
| 100.00% |
| West Virginia |
| 55.60% |
| 41.90% |
| 2.50% |
| 100.00% |
| Wisconsin |
| 74.10% |
| 25.90% |
| 0.00% |
| 100.00% |
| Wyoming |
| 52.10% |
| 47.90% |
| 0.10% |
| 100.00% |