EPISODE TREATMENT GROUP ANALYSIS Prev. Prev. Claimant Total Paid % of total Top ETG’s by Amount Paid Rank Rank ETG Family Claimants Claimants % Change s/1000 Paid Prev. Paid PMPM Paid 1 4 01501 Pregnancy, Delivered 9 11 -18% 17.3 $222,306 $95,093 $35.69 11.1% • These categories can be 2 19 01805 Joint Degeneration, Localized 51 45 13% 98.3 $193,133 $19,993 $31.01 9.7% skewed by high cost 3 2 00401 Depression 82 66 24% 158.0 $126,099 $126,373 $20.24 6.3% 4 22 00480 Other Mental/Psychological Disorders 12 11 9% 23.1 $134,387 $26,415 $21.57 6.7% claimants. 5 3 02001 Immunizations/Screenings/Routine Exams 344 321 7% 662.7 $121,611 $117,791 $19.52 6.1% 6 8 01703 Inflammation: Skin & Subcutaneous Tissue 94 73 29% 181.1 $102,164 $65,709 $16.40 5.1% 7 9 00402 Anxiety/Phobia 76 76 0% 146.4 $72,714 $68,530 $11.67 3.6% • Behavioral Health, Skin 8 20 00201 Diabetes 18 17 6% 34.7 $61,899 $30,789 $9.94 3.1% Inflammation, Hypertension, 9 - 00609 Brain/Spinal Trauma 3 5.8 $59,840 $9.61 3.0% Obesity, Tonsilitis all 10 14 00406 Autism/Attention Deficit Disorder/Development Disorders 48 42 14% 92.5 $41,477 $45,005 $6.66 2.1% 11 13 01002 Asthma 58 59 -2% 111.7 $39,581 $47,574 $6.35 2.0% experienced double digit 12 - 00803 Congestive Heart Failure 4 7.7 $42,831 $6.88 2.1% increases in occurrence from 13 5 00909 Cancer: Ear/Nose/Throat 1 1 0% 1.9 $39,871 $89,210 $6.40 2.0% 14 24 00807 Conduction Disorder 13 13 0% 25.0 $27,661 $19,363 $4.44 1.4% 2020. 15 - 01705 Benign Neoplasm: Skin 60 115.6 $27,856 $4.47 1.4% 16 - 01011 Viral/Fungal Lung Infections 1 1.9 $30,214 $4.85 1.5% 17 10 00801 Hypertension 58 49 18% 111.7 $20,591 $63,835 $3.31 1.0% • Pregnancy, although fewer 18 - 01121 Bowel Obstruction 1 1.9 $27,852 $4.47 1.4% claimants, was about 134% 19 - 00707 Eye Trauma 3 5.8 $26,377 $4.23 1.3% higher for total paid in 2021. 20 - 01412 Kidney Stones 3 5.8 $22,783 $3.66 1.1% 21 21 00404 Other Neuropsychological/Behavioral Disorder 37 36 3% 71.3 $18,654 $32,789 $2.99 0.9% 22 17 00205 Obesity 52 40 30% 100.2 $18,296 $38,008 $2.94 0.9% • Skin Cancer wasn’t on this 23 - 01901 Neonatal Management 4 7.7 $19,895 $3.19 1.0% 24 - 00710 Visual Disturbances 74 142.6 $17,764 $2.85 0.9% report last year, but recorded 25 16 00903 Tonsillitis, Adenoiditis 57 48 19% 109.8 $16,024 $37,554 $2.57 0.8% 60 claimants for 2021 for #15 Total: Selected Filter(s) 471 907.4 $1,531,881 $245.93 76.6% on the report. Total: All Others 373 718.6 $458,733 $73.64 22.9% Total: All 507 976.7 $2,000,145 $321.10 100.0% [ 7 ]
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