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Top 20 Pharmacy Claimants
/hz1n8YNT2tNUpiK6XvPTQ==
+B/l28suTKGElVYalJF5Fw==
XXaXCozpVXiVsDv19i1ljQ==
5M13NNv4gmK3q6+f6WeYEA==
eswcyXOxleVviFLjGfAIWA==
faXwTmrrkF++n0gpfZmzMw==
FrMpTObfEgZwDzGgQMCEwg==
OIkxntrf7+X8vh7EGC29NQ==
Dj95Xm1kAY6D9VkBlTQjcg==
alHsCyuyOKiP+UyFnfBOFw==
atAqx5DfIfW0ovPX+mQfnA==
H5JP9sEPBWr0Y9oSQI1AFQ==
JOKNiqU4RJdhSsGWDpJU1g==
fqgQwLANXMxhnrC7PvUiXQ==
2dmP+ZJVvqo6HcAKwCaX0w==
UHh+3OZlZok2IqzKYh7s3g==
73izAYytqduA3wPGo4HFhg==
SFLSg+17MOeuhLcL9PDfsw==
mfW7uAhTwGc9TDt5DGi82A==
GeZaYBZ/Yf2BECz+ygv9mg==
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
$90,000
TOP CONDITION
RELATIONSHIP
GENDER
AGE
MEMBER PAID
PLAN PAID
MEMBER ID
Leukemia, wo surg, w a/m
HUSBAND
M 53
$1,534.34
$84,840.05
GeZaYBZ/Yf2BECz+ygv9mg
==
Multiple sclerosis, wo surg
WIFE
F
57
$3,280.52
$82,070.29
mfW7uAhTwGc9TDt5DGi82
A==
Hyper-funct adrenal gland,
wo surg
HUSBAND
M 59
$810.40
$72,786.56
SFLSg+17MOeuhLcL9PDfsw
==
Adult rheumatoid arthritis,
wo comp, wo comorb
SUBSCRIBER
F
58
$3,764.03
$57,257.77
73izAYytqduA3wPGo4HFhg
==
Oth hematologic dis, wo
surg
SUBSCRIBER
M 55
$402.96
$51,561.87
UHh+3OZlZok2IqzKYh7s3g=
=
Adult rheumatoid arthritis,
wo comp, wo comorb
SUBSCRIBER
F
53
$2,053.86
$46,612.45
2dmP+ZJVvqo6HcAKwCaX0
w==
Oth skin inflam, wo comp,
wo comorb
SUBSCRIBER
F
32
$1,780.00
$45,953.53
fqgQwLANXMxhnrC7PvUiX
Q==
Multiple sclerosis, wo surg
SUBSCRIBER
F
39
$791.32
$44,535.39
JOKNiqU4RJdhSsGWDpJU1
g==
Adult rheumatoid arthritis,
wo comp, wo comorb
HUSBAND
M 53
$2,318.11
$40,420.77
H5JP9sEPBWr0Y9oSQI1AFQ
==
Autoim rheum disease exc
lupus
SUBSCRIBER
F
40
$2,355.49
$40,340.40
atAqx5DfIfW0ovPX+mQfnA
==
Psoriasis, w comp, wo
comorb
SUBSCRIBER
F
49
$1,026.50
$37,052.02
alHsCyuyOKiP+UyFnfBOFw
==
Page 15 of 41
Incurred: 2/1/2016 to 1/31/2017
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