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CatastrqpIltb GI6i iiir n IIII iiirnIpact ��������$50,000 0
<br />HIUB,
<br />Claimants Above Threshold'
<br />Prii4Dr
<br />Current Change, Aetna 805
<br />N umb eiir of Chaima, n Ls
<br />112,
<br />12 -36.811% NIA
<br />Cla�,mianm Per 1,000 Members
<br />113,2
<br />12,5 NYA 12,7
<br />Medical Paid Arnount for
<br />thase Claimamts
<br />52,076,782
<br />$1,475,0811 WA.
<br />Avi-ragap Pai,d, Per Caastror+lc Claima, ni,
<br />S 1,09,304,211
<br />12 � 5,yu N;A
<br />% 'of T'otal Paid AMOUnt
<br />44.1%
<br />370% 44.4%
<br />Curmut
<br />ToW IT1edic'aull
<br />Wpatient
<br />Andvulatory
<br />Magnasils
<br />aWant
<br />PaW Amount
<br />Paild Amouni
<br />PaW Amount
<br />Code
<br />I)OgnoMs, Description
<br />1
<br />$912 2'24
<br />$,1M,f,74
<br />$17,550
<br />Ell C59
<br />TYPE 2 DIASFTIFS ruIFLUTUF WITH QTHFR SPECIRFID COPAPHCATNQN
<br />2
<br />$2,60290
<br />$2 r 1, 754
<br />W,536
<br />Z51.11
<br />ENCOUNTER FOR ANTI NE ORLAST IC CHEMOTHERAPY
<br />3
<br />$220,37B
<br />$2011,129
<br />$20.249
<br />E 11.43
<br />TYPE:2 DIABETES VV DIABETIC AUTONIONTIC gIPOLY)NEUROPATIHY
<br />4
<br />1$130,664
<br />$%16,235
<br />$14,430
<br />10,9
<br />C,"ERESRAI INFARCTION, UNSPECW�EID
<br />5
<br />$91,3,33
<br />$0
<br />$91,a33
<br />Z51.12
<br />INCOUN'rck rOk AN nNEOPLA81"IC INwMUNo n IERAPY
<br />6
<br />3:79,C14
<br />$a
<br />$79,� ld
<br />Ifi).9 12'R
<br />QTH 5PFFGHe1,AN(3, DFFICJ5 FOL10VAING) CFRFE3,RAL INFARCTION
<br />7
<br />SM6158
<br />$:36,284
<br />W,,374
<br />M17 11
<br />UNILA'IERAILPRilMAI3YOSU'EC: AR'It1l�3ii'luS, RuGI,ITKNEE.
<br />8
<br />$71,826
<br />$62,937
<br />$8.0,B8
<br />MIT 11
<br />UNILATERAL PRIMARY OSTEGARTIHIRIITS, MGH7 KNEE.EE.
<br />9
<br />$63,2100
<br />$68,963
<br />$4,236
<br />DISPI ACFD RICONDYI AR FRACTURE OF I FFT TIBIA, MT
<br />10
<br />$62,5216
<br />$35,68?
<br />$27,23a
<br />K543.912
<br />CROil tN'S MSEASE, uNgpmrim, wl"n tiN rin,niNAL OBs"muc"rION
<br />11
<br />5553,4016
<br />17,0C1
<br />$41f3,345
<br />Z4 8.21
<br />ENCQlJNTFR FOR AFTERCARE FOL 1.0%"Nq5 IHEART TRAM�PLAJNT
<br />12
<br />s5o,M1
<br />$0
<br />W,861
<br />M05 79
<br />RHEO ARI HRI I US W RHEui FAM OR MuLT SITE WO ORUSYS WVOLV
<br />ToW
<br />$1,475,081
<br />$1,023,725,
<br />8,451,356
<br />T f0rull, ni�DA "mms, "A'
<br />ON
<br />ap
<br />13 1
<br />
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