Page 57 - Bird RFP Response_Burnham Benefits

High Cost Members
Population: Book of Business

This report Identifies members whose total paid health care costs have exceeded the threshold during the reporting period. Both medical and pharmacy claims are
included in this report. Costs for the individuals are broken-out by type of cost allowing for identification of which type of services are driving the members' costs.

Threshold: $50,000

Current
Member Id Relationship Gender Age Highest Paid Diagnosis Risk Score Medical Cost Pharmacy Cost Total Cost
Status
1c3331b016ecbccce997a2355b5aa4ed - - - - - - Active Infections 37.08 $744,627 $2,449 $747,075
2465a219fd04eb491b14a6208ea0a35d - - - - - - Termed Cancer -- $684,840 $2,606 $687,446
da41d5a5631e961de9fb776ca0ab6de7 - - - - - - Termed Renal/Urologic Disorders -- $540,895 $2,056 $542,950
ba3adde02773cafddbbedfa38472e71c - - - - - - Active Cancer 28.78 $221,246 $114,619 $335,866
511148730601961e10842cb669172883 - - - - - - Active Health Status/Encounters 16.74 $220,762 $83,362 $304,125
193d3c179a57027f5271eae6a4070759 - - - - - - Active Congenital/Chromosomal Anomalies 9.19 $271,556 $1,302 $272,858
dd4dadf27e252fb0f904a1d75b2ccb86 - - - - - - Active Medical/Surgical Complications 24.58 $260,520 $141 $260,662
934a968a44f07a6a8189778045364882 - - - - - - Active Spine-related Disorders 5.33 $245,491 $346 $245,836
3e743574044511a444f2fc83655a6bfc - - - - - - Termed Cancer -- $239,510 $281 $239,791
378184e39a289e2dd68375a4a6d1aaf7 - - - - - - Active Infections 8.16 $235,138 $899 $236,037
502d421a6c0d5a179fdef62f04ad559a - - - - - - Active Gastrointestinal Disorders 3.45 $230,920 $3,280 $234,200
603b797ff6ab97d4bc52ca01849379aa - - - - - - Active Pregnancy-related Disorders 0.96 $225,101 $0 $225,101
0cb4bee22cf64363c9ea1c3fef3ffac3 - - - - - - Termed Cancer -- $199,069 $23,073 $222,142
500ca26add6a261fdb10666ff6262161 - - - - - - Active Musculoskeletal Disorders 4.45 $41,112 $175,785 $216,897
3b8f2927a7122dbbe68fb7cd2d7519bc - - - - - - Active Renal/Urologic Disorders 32.22 $204,627 $11,923 $216,550
5596ba27cbd3cb0ba8a8ff85702fc325 - - - - - - Active Pulmonary Disorders 49.07 $12,356 $202,413 $214,769
3c47e9540b6248536faff45ba8402173 - - - - - - Active Cancer 17.59 $28,065 $183,783 $211,848
693f0b0580e149dffe506d71c1d98581 - - - - - - Active Cancer 16.97 $195,930 $2,069 $197,999
0fab511cdd34a8b702a8e4c85bbec5f5 - - - - - - Active Cancer 19.13 $520 $196,294 $196,815
40156357be6f04566b38de575a95bcff - - - - - - Active Musculoskeletal Disorders 5.11 $11,767 $184,504 $196,270
8f79174f4cfd905f05899ce48a5bc6e7 - - - - - - Active Renal/Urologic Disorders 3.47 $192,327 $1,645 $193,972
09531cb6e9f8f5002bd03b2f83943ed7 - - - - - - Active Gastrointestinal Disorders 8.84 $189,523 $2,157 $191,680
29e9a98a2503c51e525795ddff7b3806 - - - - - - Active Dermatological Disorders 3.76 $189,610 $1,209 $190,819
93947d24b725699b5496dca76a28ec6f - - - - - - Active Spine-related Disorders 4.99 $177,793 $11,623 $189,416
77e625d454f36c2d24098b33fe0862f9 - - - - - - Active Spine-related Disorders 3.93 $176,478 $3,417 $179,895
b904bd2396e9b1506c75708379d5fe62 - - - - - - Active Cardiac Disorders 8.21 $171,184 $927 $172,111
0fa06a208cfcbdd9f49a46ca7aff1ac4 - - - - - - Active Renal/Urologic Disorders 30.61 $157,900 $2,086 $159,986
24b8490a82c793a2c566a2ccf7770759 - - - - - - Active Cancer 16.61 $90,829 $65,436 $156,265
8f0bdcbe22824ce9b4e93cf0458cc090 - - - - - - Active Neurological Disorders 11.06 $89,810 $62,788 $152,598
e7b76d78e09e1caf14870103ea2fb227 - - - - - - Active Cardiac Disorders 2.74 $145,221 $174 $145,394
87c34df829b39a02ce67d45a1349e446 - - - - - - Active Cardiac Disorders 10.37 $119,227 $25,652 $144,879
faed25f104bd4dd7643635a5d040ceed - - - - - - Active Gastrointestinal Disorders 6.69 $135,929 $4,046 $139,975
c6470a3390054e909f31ddda350f6ffd - - - - - - Active Trauma/Accidents 1.20 $139,221 $26 $139,247
ee7048cde3802c15f703b6412b8c8866 - - - - - - Active Cardiac Disorders 18.80 $3,496 $129,347 $132,843

Reporting Period: Paid January 2018 to December 2018
Benchmark: Commercial February 15, 2019

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