Optum - City of Long Beach -Total Pharmacy Summary 2025.xlsx
XLSX spreadsheet 14 KB Posted
- Attached to
- Workers Compensation Pharmacy Benefit Network
- Solicitation number
- HR-24-380
- Issued by
- Los Angeles County, California
About this file
This is a Total Pharmacy Summary report for the City of Long Beach's pharmacy benefit management services provided by Optum for the 2025 calendar year. The report tracks pharmacy service utilization across four service categories: Retail, Home Delivery, PharmaComplete, and RX360, along with Hard Block transactions and Out-of-Network (OON) claims. The City of Long Beach processed a total of 5,927 pharmacy transactions throughout 2025, with Retail accounting for 4,263 transactions and Home Delivery representing 396 transactions. The service term covers the full calendar year 2025, with monthly performance data reported from January through December.
The pharmacy benefit plan achieved substantial cost savings throughout 2025, with total savings of $554,931.21 against a total reference price of $1,253,056.78, representing an overall savings rate of 37.06%. Retail pharmacy services generated $214,002.45 in savings at a 22.47% savings rate across 4,263 transactions, while Home Delivery services produced $96,465.16 in savings at a 32.07% savings rate. Hard Block transactions totaling 1,268 generated $244,463.60 in additional savings. The network penetration rate maintained 100% throughout all 12 months, indicating full network compliance. The average cost per script across all services was $235.30, with the average cost per day of therapy at $5.08. Home Delivery penetration averaged 16.07% of total transactions, demonstrating moderate utilization of mail-order pharmacy services. No transactions were recorded for PharmaComplete, RX360, or Out-of-Network services during the 2025 reporting period.
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Other files
| File | Type | Posted |
|---|---|---|
| Pro Forma Agreement Sample~6.pdf | ||
| Attachment A~11.pdf | ||
| Mandatory Attachment B Equal Benefits Ordinance Form~26.pdf | ||
| RFP HR-24-380.pdf | ||
| Attachment C~11.pdf | ||
| Addendum 1 RFP HR-24-380 QA Final.pdf |
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Total Pharmacy Summary
| Total Pharmacy Summary | |||||||||||||
| Bill Month | 2025 Jan | 2025 Feb | 2025 Mar | 2025 Apr | 2025 May | 2025 Jun | 2025 Jul | 2025 Aug | 2025 Sep | 2025 Oct | 2025 Nov | 2025 Dec | Total |
| Retail Transactions | 287 | 350 | 401 | 349 | 382 | 397 | 309 | 429 | 350 | 317 | 410 | 282 | 4,263 |
| Retail Reference Price | $77,421.80 | $97,048.08 | $101,766.27 | $87,708.65 | $93,769.02 | $77,255.56 | $52,822.52 | $106,536.81 | $60,220.56 | $62,546.21 | $73,667.67 | $61,459.05 | $952,222.20 |
| Retail Bill Amount | $56,715.71 | $75,802.13 | $76,327.28 | $73,347.25 | $70,358.40 | $55,294.61 | $54,094.83 | $111,657.32 | $62,135.54 | $69,748.64 | $82,573.15 | $63,119.24 | $851,174.10 |
| Retail Savings | $26,602.26 | $30,359.77 | $35,080.82 | $23,316.09 | $31,238.85 | $31,109.09 | $8,967.84 | $7,723.06 | $5,935.51 | $3,832.43 | $5,251.95 | $4,584.78 | $214,002.45 |
| Retail Savings % | 34.36% | 31.28% | 34.47% | 26.58% | 33.31% | 40.27% | 16.98% | 7.25% | 9.86% | 6.13% | 7.13% | 7.46% | 22.47% |
| Home Delivery Transactions | 25 | 32 | 37 | 28 | 24 | 32 | 34 | 42 | 29 | 38 | 39 | 36 | 396 |
| Home Delivery Reference Price | $41,707.57 | $28,461.85 | $64,030.67 | $42,567.66 | $41,827.61 | $17,204.54 | $17,745.66 | $10,846.60 | $5,981.98 | $13,710.48 | $6,889.50 | $9,860.46 | $300,834.58 |
| Home Delivery Bill Amount | $32,822.80 | $14,871.31 | $57,701.47 | $32,557.32 | $33,779.70 | $9,711.77 | $14,428.63 | $10,936.10 | $5,624.21 | $13,951.48 | $8,156.80 | $10,545.59 | $245,087.18 |
| Home Delivery Savings | $14,689.65 | $15,402.57 | $17,878.94 | $16,046.82 | $14,643.48 | $9,007.81 | $3,963.88 | $1,410.12 | $1,329.87 | $938.96 | $432.60 | $720.46 | $96,465.16 |
| Home Delivery Savings % | 35.22% | 54.12% | 27.92% | 37.70% | 35.01% | 52.36% | 22.34% | 13.00% | 22.23% | 6.85% | 6.28% | 7.31% | 32.07% |
| PharmaComplete Transactions | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| PharmaComplete Reference Price | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| PharmaComplete Bill Amount | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| PharmaComplete Savings | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| PharmaComplete Savings % | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% |
| RX360 Transactions | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| RX360 Submitted Amount | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| RX360 Bill Amount | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| RX360 Bill Review Savings | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| RX360 Network Savings | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Total RX360 Savings | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| RX360 Savings % | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% | 0.00% |
| Hard Block Transactions | 129 | 96 | 86 | 103 | 110 | 103 | 118 | 97 | 105 | 130 | 103 | 88 | 1,268 |
| Hard Block Savings | $18,191.92 | $11,368.27 | $11,707.59 | $19,649.27 | $33,276.03 | $15,398.59 | $21,220.76 | $26,697.79 | $15,639.32 | $33,079.44 | $18,809.50 | $19,425.12 | $244,463.60 |
| OON Transactions | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| OON Submitted Amount | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| OON Allowable Amount | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| OON Savings | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| OON Savings % | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% | 0.0% |
| Total Pharmacy Transactions | 441 | 478 | 524 | 480 | 516 | 532 | 461 | 568 | 484 | 485 | 552 | 406 | 5,927 |
| Total Reference Price/Submitted Amount | $119,129.37 | $125,509.93 | $165,796.94 | $130,276.31 | $135,596.63 | $94,460.10 | $70,568.18 | $117,383.41 | $66,202.54 | $76,256.69 | $80,557.17 | $71,319.51 | $1,253,056.78 |
| Total Pharmacy Bill Amount/Allowable Amount | $89,538.51 | $90,673.44 | $134,028.75 | $105,904.57 | $104,138.10 | $65,006.38 | $68,523.46 | $122,593.42 | $67,759.75 | $83,700.12 | $90,729.95 | $73,664.83 | $1,096,261.28 |
| Total Pharmacy Savings | $59,483.83 | $57,130.61 | $64,667.35 | $59,012.18 | $79,158.36 | $55,515.49 | $34,152.48 | $35,830.97 | $22,904.70 | $37,850.83 | $24,494.05 | $24,730.36 | $554,931.21 |
| Total Pharmacy Savings % | 43.32% | 41.74% | 36.43% | 39.36% | 46.87% | 50.53% | 37.21% | 24.87% | 27.99% | 34.62% | 24.65% | 27.25% | 37.06% |
| Network Penetration | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% |
| Network Penetration (Normalized) | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% | 100.00% |
| Home Delivery Penetration | 14.16% | 16.38% | 14.99% | 13.74% | 11.40% | 14.04% | 18.93% | 16.82% | 15.94% | 20.54% | 15.45% | 22.20% | 16.07% |
| Average Cost per Script | $286.98 | $237.37 | $306.00 | $280.91 | $256.50 | $151.53 | $199.78 | $260.28 | $178.79 | $235.77 | $202.07 | $231.65 | $235.30 |
| Average Cost per Day of Therapy | $5.96 | $5.11 | $6.62 | $6.07 | $5.83 | $3.33 | $4.24 | $5.51 | $4.12 | $5.04 | $4.07 | $5.14 | $5.08 |
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