Operational Reports Table Listings
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Medicaid Managed Care MMCOR
Managed Long Term Care MLTCOR
Here is a List of the Medicaid Managed Care Tables from 2016 Q3 Operational Report. Use the Filters or Search Bar to explore what data is captured in these reports.
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Type Of Data | Table # and Name | Program | Premium Group | Dimensions | Metric | |||
---|---|---|---|---|---|---|---|---|
Type Of Data | Table # and Name | Program | Premium Group | Dimensions | Dollars | Units | Members | Metric |
Enrollment | 1A-ENROLLMENT BY PRIMARY CARE SITE by County | Medicaid | Aggregate | Primary Care Site (clinics/Outpatient and Medical Groups) and County | x | |||
Enrollment | 1C-Enrollment Summary by County | Medicaid | By Premium Group | By County | x | |||
Enrollment | 2-Enrollment Summary by Premium Group | Medicaid | By Premium Group | Total Enrollment | x | |||
Inpatient Delivery | 2A-Accrued Births | Medicaid | Aggregate | Accrued Births by Birth Weight (Normal Birth Weight >= 1200 Grams, Low Birth Weight <1200 Grams) | x | x | ||
Inpatient Delivery | 2B&C-Accrued Maternity Deliveries Medicaid and HARP | Medicaid | Aggregate | Accrued Maternity | x | x | ||
Enrollment | 2D-Health Home Enrollment by Premium Group | Medicaid | By Premium Group | Health Home | x | |||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Medicaid Revenue: Premium Capitation | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Newborn Supplemental Payments ("kick")(>=12g wgt) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Low Birth Supplemental Payments ("kick")(<12g wgt) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Maternity Supplemental Payments | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Spendown and NAMI | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | C.O.B. (Third Party Recoveries) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Reinsurance Recoveries | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Net Investment Income | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Other Revenue | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Medicaid Expenses: Medical and Hospital Inpatient Care Inpatient Medical Surgical | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Inp. Mental Health and Substance Abuse | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Inpatient Newborn Births (excluding Maternity)(>=12g wgt) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Inpatient Newborn Births (excluding Maternity)Low Birth weight (<12g wgt) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Inpatient Maternity Delivery | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Other Medical and Hospital: Primary Care | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Specialty Care Prenatal/Postpartum Maternity Services | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Ambulatory Surgery | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Outpatient Physical Rehab/Therapy | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Other Professional Services | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Emergency Room | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Outpatient Mental Health | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Outpatient SUD Treatment | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Behavioral Health HCBS Services | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Dental | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Pharmacy | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Home Health Care | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Nursing Facility | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Personal Care | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Personal Emergency Response Services | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Transportation Emergent | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Transportation Nonemergent | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Diagnostic Test, Lab & X-ray | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Family Planning | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Vision Care Inc. Eyeglasses | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Foot Care | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Other Medical | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Durable Medical Equipment | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Global Capitation Surplus or (Loss) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | VBP QIP Expense | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | VBP EPP Expense | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Administration Compensation | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Occupancy, Depreciation and Amortization | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Marketing and Facilitated Enrollment | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Other | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Total Allowable Administration Expenses | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | PREMIUM INCOME/(LOSS) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Nonallowable Administration Expense | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | OPERATING INCOME/(LOSS) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Aggregate Write-ins for Other Expenses | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Prior Period Revenue Adjustments and Extraordinary Items | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Federal and Foreign Income Taxes Incurred | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | Adjustments for prior period IBNR estimates | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid | Aggregate | NET INCOME (LOSS) | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Medicaid Member Months | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Members | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Premium Capitation | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Newborn Supplemental Payments ("kick")(>=12g wgt) | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Low Birth Supplemental Payments ("kick")(<12g wgt) | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Maternity Supplemental Payments | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | C.O.B. (Third Party Recoveries) | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Reinsurance Recoveries | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Net Investment Income | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Other Revenue | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Medicaid Expenses | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Medical and Hospital | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Hospital Inpatient Care Inpatient Medical Surgical | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Inp. Mental Health and Substance Abuse | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Inpatient Newborn Births (excluding Maternity)(>=12g wgt) | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Inpatient Newborn Births (excluding Maternity)Low Birth weight (<12g wgt) | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Inpatient Maternity Delivery | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Other Medical and Hospital: Primary Care | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Specialty Care Prenatal/Postpartum Maternity Services | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Ambulatory Surgery | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Outpatient Physical Rehab/Therapy | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Other Professional Services | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Emergency Room | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Outpatient Mental Health | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Outpatient SUD Treatment | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Behavioral Health HCBS Services | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Dental | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Pharmacy | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Home Health Care | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Nursing Facility | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Personal Care | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Personal Emergency Response Services | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Transportation Emergent | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Transportation Nonemergent | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Diagnostic Test, Lab & X-ray | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Family Planning | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Vision Care Inc. Eyeglasses | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Foot Care | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Other Medical | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Durable Medical Equipment | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Global Capitation Surplus or (Loss) | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | VBP QIP Expense | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | VBP EPP Expense | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Administration Compensation | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Occupancy, Depreciation and Amortization | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Marketing and Facilitated Enrollment | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Other | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Total Allowable Administration Expenses | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | PREMIUM INCOME/(LOSS) | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Nonallowable Administration Expense | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | OPERATING INCOME/(LOSS) | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Aggregate Write-ins for Other Expenses | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Prior Period Revenue Adjustments and Extraordinary Items | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Federal and Foreign Income Taxes Incurred | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | Adjustments for prior period IBNR estimates | x | x | ||
Revenue and Expense | 7-1-TANF/SN KIDS | Medicaid | Tanf/SN Kids | NET INCOME (LOSS) | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Medicaid Member Months | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Members | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Premium Capitation | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Newborn Supplemental Payments ("kick")(>=12g wgt) | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Low Birth Supplemental Payments ("kick")(<12g wgt) | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Maternity Supplemental Payments | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | C.O.B. (Third Party Recoveries) | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Reinsurance Recoveries | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Net Investment Income | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Other Revenue | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Medicaid Expenses | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Medical and Hospital | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Hospital Inpatient Care Inpatient Medical Surgical | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Inp. Mental Health and Substance Abuse | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Inpatient Newborn Births (excluding Maternity)(>=12g wgt) | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Inpatient Newborn Births (excluding Maternity)Low Birth weight (<12g wgt) | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Inpatient Maternity Delivery | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Other Medical and Hospital: Primary Care | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Specialty Care Prenatal/Postpartum Maternity Services | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Ambulatory Surgery | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Outpatient Physical Rehab/Therapy | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Other Professional Services | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Emergency Room | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Outpatient Mental Health | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Outpatient SUD Treatment | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Behavioral Health HCBS Services | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Dental | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Pharmacy | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Home Health Care | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Nursing Facility | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Personal Care | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Personal Emergency Response Services | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Transportation Emergent | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Transportation Nonemergent | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Diagnostic Test, Lab & X-ray | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Family Planning | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Vision Care Inc. Eyeglasses | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Foot Care | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Other Medical | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Durable Medical Equipment | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Global Capitation Surplus or (Loss) | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | VBP QIP Expense | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | VBP EPP Expense | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Administration Compensation | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Occupancy, Depreciation and Amortization | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Marketing and Facilitated Enrollment | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Other | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Total Allowable Administration Expenses | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | PREMIUM INCOME/(LOSS) | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Nonallowable Administration Expense | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | OPERATING INCOME/(LOSS) | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Aggregate Write-ins for Other Expenses | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Prior Period Revenue Adjustments and Extraordinary Items | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Federal and Foreign Income Taxes Incurred | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | Adjustments for prior period IBNR estimates | x | x | ||
Revenue and Expense | 7-2-TANF/SN ADULTS | Medicaid | Tanf/SN Adults | NET INCOME (LOSS) | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Medicaid Member Months | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Members | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Premium Capitation | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Newborn Supplemental Payments ("kick")(>=12g wgt) | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Low Birth Supplemental Payments ("kick")(<12g wgt) | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Maternity Supplemental Payments | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | C.O.B. (Third Party Recoveries) | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Reinsurance Recoveries | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Net Investment Income | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Other Revenue | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Medicaid Expenses | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Medical and Hospital | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Hospital Inpatient Care Inpatient Medical Surgical | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Inp. Mental Health and Substance Abuse | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Inpatient Newborn Births (excluding Maternity)(>=12g wgt) | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Inpatient Newborn Births (excluding Maternity)Low Birth weight (<12g wgt) | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Inpatient Maternity Delivery | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Other Medical and Hospital: Primary Care | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Specialty Care Prenatal/Postpartum Maternity Services | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Ambulatory Surgery | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Outpatient Physical Rehab/Therapy | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Other Professional Services | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Emergency Room | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Outpatient Mental Health | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Outpatient SUD Treatment | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Behavioral Health HCBS Services | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Dental | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Pharmacy | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Home Health Care | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Nursing Facility | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Personal Care | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Personal Emergency Response Services | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Transportation Emergent | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Transportation Nonemergent | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Diagnostic Test, Lab & X-ray | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Family Planning | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Vision Care Inc. Eyeglasses | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Foot Care | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Other Medical | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Durable Medical Equipment | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Global Capitation Surplus or (Loss) | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | VBP QIP Expense | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | VBP EPP Expense | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Administration Compensation | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Occupancy, Depreciation and Amortization | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Marketing and Facilitated Enrollment | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Other | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Total Allowable Administration Expenses | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | PREMIUM INCOME/(LOSS) | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Nonallowable Administration Expense | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | OPERATING INCOME/(LOSS) | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Aggregate Write-ins for Other Expenses | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Prior Period Revenue Adjustments and Extraordinary Items | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Federal and Foreign Income Taxes Incurred | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | Adjustments for prior period IBNR estimates | x | x | ||
Revenue and Expense | 7-3-SSI | Medicaid | SSI | NET INCOME (LOSS) | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Medicaid Member Months | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Members | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Premium Capitation | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Newborn Supplemental Payments ("kick")(>=12g wgt) | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Low Birth Supplemental Payments ("kick")(<12g wgt) | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Maternity Supplemental Payments | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Spendown and NAMI | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | C.O.B. (Third Party Recoveries) | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Reinsurance Recoveries | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Net Investment Income | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Other Revenue | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Medicaid Expenses | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Medical and Hospital | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Hospital Inpatient Care Inpatient Medical Surgical | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Inp. Mental Health and Substance Abuse | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Inpatient Newborn Births (excluding Maternity)(>=12g wgt) | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Inpatient Newborn Births (excluding Maternity)Low Birth weight (<12g wgt) | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Inpatient Maternity Delivery | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Other Medical and Hospital: Primary Care | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Specialty Care Prenatal/Postpartum Maternity Services | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Ambulatory Surgery | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Outpatient Physical Rehab/Therapy | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Other Professional Services | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Emergency Room | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Outpatient Mental Health | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Outpatient SUD Treatment | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Behavioral Health HCBS Services | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Dental | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Pharmacy | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Home Health Care | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Nursing Facility | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Personal Care | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Personal Emergency Response Services | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Transportation Emergent | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Transportation Nonemergent | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Diagnostic Test, Lab & X-ray | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Family Planning | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Vision Care Inc. Eyeglasses | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Foot Care | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Other Medical | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Durable Medical Equipment | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Global Capitation Surplus or (Loss) | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | VBP QIP Expense | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | VBP EPP Expense | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Administration Compensation | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Occupancy, Depreciation and Amortization | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Marketing and Facilitated Enrollment | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Other | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Total Allowable Administration Expenses | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | PREMIUM INCOME/(LOSS) | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Nonallowable Administration Expense | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | OPERATING INCOME/(LOSS) | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Aggregate Write-ins for Other Expenses | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Prior Period Revenue Adjustments and Extraordinary Items | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Federal and Foreign Income Taxes Incurred | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | Adjustments for prior period IBNR estimates | x | x | ||
Revenue and Expense | 7-4-Nursing Home | Medicaid | Nursing Home | NET INCOME (LOSS) | x | x | ||
Revenue and Expense | 8A-INPATIENT MENTAL HEALTH/SUD COST | Medicaid | By Premium Group | Cost by Type of Treatment | x | |||
Utilization | 8A-1-INPATIENT MENTAL HEALTH/SUD UTILIZATION DISCHARGES | Medicaid | By Premium Group | Discharges by Type of Treatment | x | |||
Utilization | 8A-2-INPATIENT MENTAL HEALTH/SUD UTILIZATION DAYS | Medicaid | By Premium Group | Days by Type of Treatment | x | |||
Pharmacy Costs | 8B-PHARMACY OUTPATIENT COST | Medicaid | By Premium Group | Cost by type of Outpatient Pharmacy | x | |||
Utilization | 8B-1 PHARMACY OUTPATIENT UTILIZATION SCRIPTS | Medicaid | By Premium Group | Cost by type of Outpatient Pharmacy | x | |||
Revenue and Expense | 8C-OUTPATIENT MENTAL HEALTH COST | Medicaid | By Premium Group | Costs by Type of Treatment | x | |||
Utilization | 8C-1-Outpatient MENTAL HEALTH UTILIZATION VISITS | Medicaid | By Premium Group | Visits by Type of Treatment | x | |||
Revenue and Expense | 8D-OUTPATIENT SUD SERVICES COST | Medicaid | By Premium Group | Costs by Type of Treatment | x | |||
Utilization | 8D-1-OUTPATIENT SUD SERVICES UTILIZATION VISITS | Medicaid | By Premium Group | Visits by Type of Treatment | x | |||
Revenue and Expense | 8E-HCBS & 1115 DEMO OUTPATIENT SERVICES COST | Medicaid | By Premium Group | Costs by Type of Treatment | x | |||
Utilization | 8E-1-HCBS & 1115 DEMO OUTPATIENT SERVICES UTILIZATION VISITS | Medicaid | By Premium Group | Visits by Type of Treatment | x | |||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | Medicaid | Aggregate | Inpatient | x | |||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | Medicaid | Aggregate | Primary Care | x | |||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | Medicaid | Aggregate | Physician Specialty Services | x | |||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | Medicaid | Aggregate | Emergency Room | x | |||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | Medicaid | Aggregate | All other medical services | x | |||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | Medicaid | Aggregate | Total Expenses Capitated | x | |||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | Medicaid | Aggregate | Totals Expenses FFS | x | |||
Claims | 9B-CLAIMS ANALYSIS CLAIMS UNPAID | Medicaid | Aggregate | Inpatient | x | |||
Claims | 9B-CLAIMS ANALYSIS CLAIMS UNPAID | Medicaid | Aggregate | Primary Care | x | |||
Claims | 9B-CLAIMS ANALYSIS CLAIMS UNPAID | Medicaid | Aggregate | Physician Specialty Services | x | |||
Claims | 9B-CLAIMS ANALYSIS CLAIMS UNPAID | Medicaid | Aggregate | Emergency Room | x | |||
Claims | 9B-CLAIMS ANALYSIS CLAIMS UNPAID | Medicaid | Aggregate | All other medical services | x | |||
IBNR | 9C-CLAIMS ANALYSIS RECONCILIATION OF PRIOR PERIOD IBNR | Medicaid | Aggregate | Inpatient | x | |||
IBNR | 9C-CLAIMS ANALYSIS RECONCILIATION OF PRIOR PERIOD IBNR | Medicaid | Aggregate | Primary Care | x | |||
IBNR | 9C-CLAIMS ANALYSIS RECONCILIATION OF PRIOR PERIOD IBNR | Medicaid | Aggregate | Physician Specialty Services | x | |||
IBNR | 9C-CLAIMS ANALYSIS RECONCILIATION OF PRIOR PERIOD IBNR | Medicaid | Aggregate | Emergency Room | x | |||
IBNR | 9C-CLAIMS ANALYSIS RECONCILIATION OF PRIOR PERIOD IBNR | Medicaid | Aggregate | All other medical services | x | |||
Global Capitation | 9D-GLOBAL CAPITATION SURPLUS OR (LOSS) | Medicaid | Aggregate | Member Months | x | |||
Global Capitation | 9D-GLOBAL CAPITATION SURPLUS OR (LOSS) | Medicaid | Aggregate | Premium Revenue | x | |||
Global Capitation | 9D-GLOBAL CAPITATION SURPLUS OR (LOSS) | Medicaid | Aggregate | Total Global Capitation Paid | x | |||
Global Capitation | 9D-GLOBAL CAPITATION SURPLUS OR (LOSS) | Medicaid | Aggregate | Additional Plan Payments | x | |||
Global Capitation | 9D-GLOBAL CAPITATION SURPLUS OR (LOSS) | Medicaid | Aggregate | Total Global Capitation Payments | x | |||
Global Capitation | 9D-GLOBAL CAPITATION SURPLUS OR (LOSS) | Medicaid | Aggregate | Actual Claims Paid | x | |||
Global Capitation | 9D-GLOBAL CAPITATION SURPLUS OR (LOSS) | Medicaid | Aggregate | Claims Reported but Not Paid | x | |||
Global Capitation | 9D-GLOBAL CAPITATION SURPLUS OR (LOSS) | Medicaid | Aggregate | Claims Incurred but Not Reported | x | |||
Global Capitation | 9D-GLOBAL CAPITATION SURPLUS OR (LOSS) | Medicaid | Aggregate | Total Global Capitation Expenses | x | |||
Global Capitation | 9D-GLOBAL CAPITATION SURPLUS OR (LOSS) | Medicaid | Aggregate | IPA/Provider's Surplus or (Loss) | x | |||
Utilization | 12-INPATIENT UTILIZATION DISCHARGES ACTUAL AND ACCRUED UTILIZATION | Medicaid | By Premium Group | Actual and Accrued Discharges and Costs by Type of Admission | x | x | ||
Utilization | 12A-NURSING HOME UTILIZATION | Medicaid | By Premium Group | Days and Discharges | x | |||
Utilization | 13-INPATIENT UTILIZATION DAYS ACTUAL UTILIZATION | Medicaid | By Premium Group | Days by type of Admission | x | |||
Utilization | 14-UTILIZATION OF MEDICAL SERVICES AMBULATORY CARE | Medicaid | By Premium Group | by Type of Service | x | x | ||
Utilization | 14A-PHARMACY UTILIZATION | Medicaid | By Premium Group | by Type of Script | ||||
Pharmacy Costs | 14A-1 PHARMACY COST (NET OF NYS SUGGESTED COPAYS) | Medicaid | By Premium Group | by Type of Script | x | x | ||
Pharmacy CoPay | 14A-2 PHARMACY COPAY SCHEDULE (TANF/SNADULTS) | Medicaid | Tanf Adult | by type of Script | ||||
Pharmacy CoPay | 14A-3 PHARMACY COPAY SCHEDULE (SSI) | Medicaid | SSI | By Type of Script | x | x | ||
Utilization | 14A-4 PHARMACY FAMILY PLANNING UTILIZATION | Medicaid | By Premium Group | by Type of Script | x | x | ||
Pharmacy Costs | 14A-5 PHARMACY COSTS (NET OF NYS SUGGESTED COPAYS) FAMILY PLANNING | Medicaid | By Premium Group | by Type of Script | x | x | ||
Utilization | 15A/B-HMO/HOSPITAL PAYMENTS MEDICAL SURGICAL PSYCHIATRIC SUD REHAB | Medicaid | Aggregate | By Hospital and Type of Admission | x | x | ||
Utilization | 16-MEDICAID UTILIZATION OF HHC SERVICES TOTAL ALL PREMIUM GROUPS | Medicaid | Aggregate | By Hours and Visits | x | |||
Utilization | 16A-1-MEDICAID UTILIZATION OF HHC SERVICES TANF/SN KIDS | Medicaid | Tanf Kids | By Hours and Visits | x | |||
Utilization | 16A-2-MEDICAID UTILIZATION OF HHC SERVICES TANF/SN ADULTS | Medicaid | Tanf Adult | By Hours and Visits | x | |||
Utilization | 16A-3 MEDICAID UTILIZATION OF HHC SERVICES SSI | Medicaid | SSI | By Hours and Visits | x | |||
Utilization | 16A-4 MEDICAID UTILIZATION OF HHC SERVICES NURSING HomeE | Medicaid | Nursing Home | By Hours and Visits | x | |||
Revenue and Expense | 19-VBP- QIP EXPENSE AND REVENUE DETAILS | Medicaid | All | By PPS | x | x | ||
Revenue and Expense | 19-VBP- QIP EXPENSE AND REVENUE DETAILS | Medicaid | All | By PPS | x | x | ||
Revenue and Expense | 19-VBP- QIP EXPENSE AND REVENUE DETAILS | Medicaid | All | By PPS | x | x | ||
Claims | 20-Claims ANALYSIS FOR ACTIVE MEBERS NON DUPLICATIVE CLAIMS | Medicaid | By Premium Group | By paid and Denied | x | x | ||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid | Aggregate | Interest Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid | Aggregate | Dividend and Real Estate Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid | Aggregate | Net Realized Capital Gains or Losses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid | Aggregate | Investment Expenses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid | Aggregate | Interest Expense | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid | Aggregate | Interest on Claims paid after 45 days | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid | Aggregate | Other Revenue and Expense | x | |||
Revenue and Expense | 26A-SCHEDULE OF AGGREGATE WRITEINS FOR OTHER EXPENSES | Medicaid | Aggregate | By Type of Write ins | x | |||
Revenue and Expense | 26B-SCHEDULE OF EXTRAORDINARY ITEMS | Medicaid | Aggregate | by Type of Item | x | |||
IBNR | 28C-SCHEDULE OF ADJUSTMENTS FOR PRIOR PERIOD IBNR | Medicaid | Aggregate | By Prior Year | x | |||
Revenue and Expense | 26D-DETAIL OF OTHER MEDICAL COST | Medicaid | Aggregate | by Other Medical Expenses | x | |||
Revenue and Expense | 26R-NEW REINSURANCE RECOVERIES | Medicaid | Aggregate | By Type of Reinsurance | x | |||
DRG | 27A-1-2-INPATIENT NEWBORN BIRTH DRGs | Medicaid | Aggregate | by APRDRG | x | x | ||
APRDRG | 27B-1-INPATIENT MATERNITY DELIVERY APRDRGs | Medicaid | Aggregate | by APRDRG | x | x | ||
Non Adirondack Medical Home Provider | 30-NON ADIRONDACK MEDICAL Home | Medicaid | Aggregate | by NCQA Level | x | x | x | |
Non Adirondack Medical Home Provider | 30A-NON ADIRONDACK MEDICAL HomeES-TANF KIDS | Medicaid | Tanf Kids | by NCQA Level | x | x | x | |
Non Adirondack Medical Home Provider | 30B-NON ADIRONDACK MEDICAL HomeES-TANF ADULTS | Medicaid | Tanf Adult | by NCQA Level | x | x | x | |
Non Adirondack Medical Home Provider | 30C-NON ADIRONDACK MEDICAL HomeESSSI | Medicaid | SSI | by NCQA Level | x | x | x | |
Adirondack Medical Home | 31-ADIRONDACK MEDICAL Home TOTAL | Medicaid | By Premium Group | by | x | x | x | |
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Member Months | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Members | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | COMMERICIAL REVENUE: Premium Premium Revenue | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | C.O.B. (Third Party Recoveries) | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Reinsurance Recoveries | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Premium Revenue (inc. COB and Recoveries) | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Net Investment Income | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Other Revenue | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | COMMERICAL EXPENSES: Medical and Hospital Inpatient Care Inpatient Medical Surgical | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Inp. Mental Health and Substance Abuse | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Inpatient Newborn Births (excluding Maternity) (>=12g wgt) | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Inpatient Newborn Births (excluding Maternity) Low birth weight (<12g) | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Inpatient Maternity Delivery | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Other Medical and Hospital: Primary Care | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Specialty Care | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Prenatal/Postpartum Maternity Services | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Ambulatory Surgery | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Outpatient Physical Rehab/Therapy | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Other Professional Services | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Emergency Room | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Outpatient Mental Health | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Dental | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Pharmacy | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Home Health Care | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Nursing Facility | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Personal Care | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Personal Emergency Response Services | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Transportation Emergent | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Transportation Nonemergent | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Diagnostic Test, Lab & X-ray | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Family Planning | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Vision Care Inc. Eyeglasses | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Foot Care | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Other Medical | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Durable Medical Equipment | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Subtotal Medical & Hospital | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Global Capitation Surplus or (Loss) | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Federal Risk Sharing Program (enter receipt as a negative number, and a payment as a positive number)Total Medical & Hospital (ln 3 + ln 6 + ln 56 + ln 29) | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Administration Compensation | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Occupancy, Depreciation & Amortization | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Marketing and Facilitated Enrollment | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Other | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Total Allowable Administration Expenses | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | TOTAL MEDICAL AND ADMINISTRATIVE EXPENSES | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | PREMIUM INCOME/(LOSS) | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Nonallowable Administration Expense | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | OPERATING INCOME/(LOSS) | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Aggregate Write-ins for Other Expenses | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Prior Period Revenue Adjustments and Extraordinary Items | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Federal and Foreign Income Taxes Incurred | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | Adjustments for prior period IBNR estimates | x | x | ||
Revenue and Expense | 7-1H-STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSSMALL GROUPS | EXCHANGE | Small Group | NET INCOME (LOSS) | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Member Months | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Members | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | COMMERICIAL REVENUE: Premium Premium Revenue | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | C.O.B. (Third Party Recoveries) | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Reinsurance Recoveries | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Premium Revenue (inc. COB and Recoveries) | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Net Investment Income | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Other Revenue | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | COMMERICAL EXPENSES: Medical and Hospital Inpatient Care Inpatient Medical Surgical | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Inp. Mental Health and Substance Abuse | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Inpatient Newborn Births (excluding Maternity) (>=12g wgt) | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Inpatient Newborn Births (excluding Maternity) Low birth weight (<12g) | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Inpatient Maternity Delivery | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Other Medical and Hospital: Primary Care | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Specialty Care | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Prenatal/Postpartum Maternity Services | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Ambulatory Surgery | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Outpatient Physical Rehab/Therapy | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Other Professional Services | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Emergency Room | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Outpatient Mental Health | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Dental | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Pharmacy | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Home Health Care | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Nursing Facility | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Personal Care | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Personal Emergency Response Services | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Transportation Emergent | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Transportation Nonemergent | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Diagnostic Test, Lab & X-ray | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Family Planning | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Vision Care Inc. Eyeglasses | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Foot Care | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Other Medical | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Durable Medical Equipment | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Subtotal Medical & Hospital | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Global Capitation Surplus or (Loss) | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Federal Transitional Reinsurance Program (enter receipt as a negative number) | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Federal Risk Sharing Program (enter receipt as a negative number, and a payment as a positive number)Total Medical & Hospital (ln 3 + ln 6 + ln 56 + ln 29) | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Administration Compensation | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Occupancy, Depreciation & Amortization | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Marketing and Facilitated Enrollment | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Other | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Total Allowable Administration Expenses | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | TOTAL MEDICAL AND ADMINISTRATIVE EXPENSES | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | PREMIUM INCOME/(LOSS) | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Nonallowable Administration Expense | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | OPERATING INCOME/(LOSS) | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Aggregate Write-ins for Other Expenses | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Prior Period Revenue Adjustments and Extraordinary Items | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Federal and Foreign Income Taxes Incurred | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | Adjustments for prior period IBNR estimates | x | x | ||
Revenue and Expense | 7-2H STATEMENT OF REVENUE AND EXPENSESCOMMERCIAL BUSINESSINIVIDUALS | EXCHANGE | Individual | NET INCOME (LOSS) | x | x | ||
Utilization | 12-INPATIENT UTILIZATION DISCHARGES ACTUAL AND ACCRUED UTILIZATION | EXCHANGE | By Premium Group | Actual and Accrued Discharges and Costs by Type of Admission | x | x | ||
Utilization | 13-INPATIENT UTILIZATION DAYS ACTUAL UTILIZATION | EXCHANGE | By Premium Group | Days by type of Admission | x | x | ||
Utilization | 14-UTILIZATION OF MEDICAL SERVICES AMBULATORY CARE | EXCHANGE | By Premium Group | by Type of Service | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Member Months | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Members | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Premium Medicare Capitation | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Medicaid Capitation | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Spenddown & NAMI | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Premium Revenue | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | C.O.B. (Third Party Recoveries) | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Reinsurance Recoveries | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Premium Revenue (inc. COB and Recoveries) | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Net Investment Income | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Other Revenue | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | TOTAL MAP ELIGIBLE REVENUE | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | MEDICAID ADVANTAGE PLUS EXPENSES: Medical and Hospital: Hospital Inpatient Care: Inpatient Medical Surgical | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Inp. Mental Health & Substance Abuse | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Other Medical and Hospital Primary Care | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Specialty Care | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Ambulatory Surgery | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Outpatient Physical Rehab/Therapy | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Other Professional Services | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Emergency Room | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Outpatient Mental Health | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Outpatient SUD Treatment | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Dental | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Pharmacy | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Home Health Care Medicare | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Home Health Care Non Medicare | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Nursing Facility | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Transportation Emergent | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Transportation Nonemergent | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Diagnostic Test, Lab & X-ray | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Family Planning | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Vision Care Inc. Eyeglasses | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Other Medical | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Durable Medical Equipment | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Hearing Services | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Private Duty Nursing | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Personal Care | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Foot Care | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Supplemental Benefits | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Subtotal Medical & Hospital | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Global Capitation Surplus or (Loss) | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Total Medical & Hospital (ln 3 + ln 6 + ln 56 + ln 29) | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Administration Compensation | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Occupancy, Depreciation & Amortization | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Marketing and Facilitated Enrollment | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Other | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Total Administration | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | TOTAL MEDICAL AND ADMINISTRATIVE EXPENSES | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | PREMIUM INCOME/(LOSS) | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Nonallowable Administrative Expense | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | OPERATING INCOME/(LOSS) | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Aggregate Write-ins for Other Expenses | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Prior Period Revenue Adjustments and Extraordinary Items | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Federal and Foreign Income Taxes Incurred | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Adjustments for prior period IBNR estimates | x | x | ||
Revenue and Expense | 6E-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | NET INCOME (LOSS) | x | x | ||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Investment Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Dividend and Real Estate Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Net Realized Capital Gains or Losses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Deductions Investment Expenses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Interest Expense | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Interest on Claims paid after 45 days | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Other Deductions | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Interest Expense | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Interest on Claims paid after 45 days | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | Other Deductions | x | |||
Revenue and Expense | 26A-SCHEDULE OF AGGREGATE WRITEINS FOR OTHER EXPENSES | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | By Type of Write ins | x | |||
Revenue and Expense | 26B-SCHEDULE OF EXTRAORDINARY ITEMS | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | by Type of Item | x | |||
IBNR | 28C-SCHEDULE OF ADJUSTMENTS FOR PRIOR PERIOD IBNR | MEDICAID ADVANTAGE PLUS (see Comment) | Aggregate | By Prior Year | x | |||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Member Months | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Members | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Capitation | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | b. Newborn Supplemental Payments ("kick") | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Premium Revenue | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | C.O.B. (Third Party Recoveries) | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Reinsurance Recoveries | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Premium Revenue (inc. COB and Recoveries) | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Net Investment Income | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Other Revenue | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | TOTAL MAP ELIGIBLE REVENUE | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | MEDICARE EXPENSES: Medical and Hospital: Hospital Inpatient Care: Inpatient Medical Surgical | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Inp. Mental Health & Substance Abuse | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Other Medical and Hospital Primary Care | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Specialty Care | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Ambulatory Surgery | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Outpatient Physical Rehab/Therapy | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Other Professional Services | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Emergency Room | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Outpatient Mental Health | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Outpatient SUD Treatment | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Dental | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Pharmacy | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Home Health Care Medicare | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Home Health Care Non Medicare | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Nursing Facility | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Transportation Emergent | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Transportation Nonemergent | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Diagnostic Test, Lab & X-ray | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Family Planning | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Vision Care Inc. Eyeglasses | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Other Medical | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Durable Medical Equipment | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Hearing Services | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Private Duty Nursing | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Personal Care | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Foot Care | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Supplemental Benefits | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Subtotal Medical & Hospital | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Global Capitation Surplus or (Loss) | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Total Medical & Hospital (ln 3 + ln 6 + ln 56 + ln 29) | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Administration Compensation | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Occupancy, Depreciation & Amortization | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Marketing and Facilitated Enrollment | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Other | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Total Administration | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | TOTAL MEDICAL AND ADMINISTRATIVE EXPENSES | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | PREMIUM INCOME/(LOSS) | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Nonallowable Administrative Expense | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | OPERATING INCOME/(LOSS) | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Aggregate Write-ins for Other Expenses | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Prior Period Revenue Adjustments and Extraordinary Items | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Federal and Foreign Income Taxes Incurred | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | Adjustments for prior period IBNR estimates | x | x | ||
Revenue and Expense | 6F-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) | Medicare | Aggregate | NET INCOME (LOSS) | x | x | ||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicare | Aggregate | Interest Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicare | Aggregate | Dividend and Real Estate Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicare | Aggregate | Net Realized Capital Gains or Losses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicare | Aggregate | Deductions Investment Expenses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicare | Aggregate | Interest Expense | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicare | Aggregate | Interest on Claims paid after 45 days | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicare | Aggregate | Other Deductions | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicare | Aggregate | Total Deductions | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicare | Aggregate | Net Investment Income | x | |||
Revenue and Expense | 28A-SCHEDULE OF AGGREGATE WRITEINS FOR OTHER EXPENSES | Medicare | Aggregate | By Type of Write ins | x | |||
Revenue and Expense | 28B-SCHEDULE OF EXTRAORDINARY ITEMS | Medicare | Aggregate | by Type of Item | x | |||
IBNR | 28C-SCHEDULE OF ADJUSTMENTS FOR PRIOR PERIOD IBNR | Medicare | Aggregate | By Prior Year | x | |||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Members | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | HIVSNP Member Months | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | REVENUE: | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Premium | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Capitation | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Newborn Supplemental Payments("kick") >=g wgt | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Low Birth Weight-Newborn Supplemental Payments ("kick") (< g) | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Maternity Supplemental Kick Payments | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Spendown & NAMI | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Premium Revenue | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | C.O.B. (Third Party Recoveries) | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Reinsurance Recoveries | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Premium Revenue (inc. COB and Recoveries) | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Risk Share Adjustment | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Net Investment Income | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Other Revenue | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | TOTAL HIVSNP REVENUE | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | EXPENSES: | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Medical and Hospital: | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Hospital Inpatient Care: | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | a. Inpatient Medical Surgical | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | b. Inp. Mental Health & Substance Abuse | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | c. Inpatient Newborn Births (>=g wgt) | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | d. Inpatient Newborn Births Low birth weight (
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Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | e. Inpatient Maternity Delivery | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | f. Total Hospital Inpatient Care (a thru e) | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Other Medical and Hospital: | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Primary Care | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Specialty Care | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Prenatal/Postpartum Maternity Services | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Ambulatory Surgery | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Outpatient Physical Rehab/Therapy | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Other Professional Services | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Emergency Room | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Outpatient Mental Health | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | HCBS Services | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Dental | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Pharmacy | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Home Health Care | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Nursing Facility | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Personal Care | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Transportation - Emergent | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Transportation - Non-Emergent | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Diagnostic Test, Lab & X-Ray | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Family Planning | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Vision Care Including Eyeglasses | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Foot Care | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | HIVSNP Case Management | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Other Medical | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Durable Medical Equipment | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Subtotal Medical & Hospital | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Reinsurance Premium Cost | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Global Capitation Surplus or (Loss) | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Provider and Quality Incentive Payments | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Total Medical & Hospital (ln + ln + ln + ln ) | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Administration: | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Compensation | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Occupancy, Depreciation & Amortization | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Marketing and Facilitated Enrollment | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Other | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Total Allowable Administration Expenses | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | TOTAL MEDICAL AND ADMINISTRATIVE EXPENSES | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | PREMIUM INCOME/(LOSS) | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Nonallowable Administration Expense | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | OPERATING INCOME/(LOSS) | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Aggregate Write-ins for Other Expenses | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Prior Period Revenue Adjustments and Extraordinary Items | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Federal and Foreign Income Taxes Incurred | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | Adjustments for prior period IBNR estimates | ||||
Revenue and Expense | 6C - STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | HIVSNP | Aggregate | NET INCOME (LOSS) | ||||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HIVSNP | Aggregate | Interest Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HIVSNP | Aggregate | Dividend and Real Estate Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HIVSNP | Aggregate | Net Realized Capital Gains or Losses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HIVSNP | Aggregate | Investment Expenses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HIVSNP | Aggregate | Interest Expenses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HIVSNP | Aggregate | Interest on Claims paid after 45 days | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HIVSNP | Aggregate | Other Revenue and Expense | x | |||
Revenue and Expense | 26A-SCHEDULE OF AGGREGATE WRITEINS FOR OTHER EXPENSES | HIVSNP | Aggregate | By Type of Write ins | x | |||
Revenue and Expense | 26B-SCHEDULE OF Extraordinary Items FOR OTHER EXPENSES | HIVSNP | Aggregate | by Type of Item | x | |||
IBNR | 26C - SCHEDULE OF ADJUSTMENTS FOR PRIOR PERIOD IBNR | HIVSNP | Aggregate | By Prior Year | x | |||
Revenue and Expense | 26R - NET INSURANCE RECOVERIES | HIVSNP | Aggregate | By Type of Reinsurance | x | |||
Balance Sheet Data | 4A - BALANCE SHEET - ASSET | All Government Programs | Aggregate | by type of asset | x | |||
Balance Sheet Data | 4B-Balance Sheet -Liabilities | All Government Programs | Aggregate | By Type of Liability | x | |||
Balance Sheet Data | 4C-Net Worth Reconcilliation | All Government Programs | Aggregate | by Net worth line item | x | |||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Members | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Member Months | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Premium | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | a. Capitation | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | b. Newborn Supplemental Payments ("kick") (>=g wgt) | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | c. Low Birth Weight-Nwbrn Supp. Payments ("kick") (< g wgt) | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | d. Maternity Supplemental Kick Payments | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | e. Spendown & NAMI | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | f. Subscriber Premiums | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | g. NYS Premiums | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Premium Revenue | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | C.O.B. (Third Party Recoveries) | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Reinsurance Recoveries | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Premium Revenue (inc. COB and Recoveries) | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Net Investment Income | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Risk Share Adjustment | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Other Revenue | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | TOTAL REVENUE | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Medical and Hospital: | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Hospital Inpatient Care: | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | a. Inpatient Medical Surgical | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | b. Inp. Mental Health & Substance Abuse | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | c. Inpatient Newborn Births (>=g wgt) | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | d. Inpatient Newborn Births-Low Birth Weight x |
| x |
| |
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | e. Inpatient Maternity Delivery | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | f. Total Hospital Inpatient Care (a thru e) | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Other Medical and Hospital: | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Primary Care | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Specialty Care | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Prenatal/Postpartum Maternity Services | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Ambulatory Surgery | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Outpatient Physical Rehab/Therapy | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Other Professional Services | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Emergency Room | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Outpatient Mental Health | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Outpatient SUD Treatment | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Behavioral Health HCBS Services | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Dental | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Pharmacy | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Home Health Care | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Nursing Facility | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Personal Care | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Personal Emergency Response Services | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Transportation - Emergent | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Transportation - Non-Emergent | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Diagnostic Test Lab & X-Ray | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Family Planning | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Vision Care Inc. Eyeglasses | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Foot Care | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Other Medical | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Durable Medical Equipment | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | HIVSNP Case Management | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Covered Lives Assessment | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Supplemental Benefits | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Subtotal Medical & Hospital | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Global Capitation Surplus or (Loss) | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | VBP QIP Expense | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | VBP EIP Expense | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | VBP EPP Expense | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Total Medical & Hospital (ln + ln + ln + ln + ln + ln ) | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Administration: | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Compensation | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Occupancy Depreciation & Amortization | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Marketing and Facilitated Enrollment | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Other | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Total Allowable Administration Expenses | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | TOTAL MEDICAL AND ADMINISTRATIVE EXPENSES | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | x | x | |||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | PREMIUM INCOME/(LOSS) - - - | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Nonallowable Administration Expense | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | OPERATING INCOME/(LOSS) - - - | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Aggregate Write-ins for Other Expenses | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Prior Period Revenue Adjustments and Extraordinary Items - - - | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Federal and Foreign Income Taxes Incurred | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | Adjustments for prior period IBNR estimates - - - | x | x | ||
Revenue and Expense | 6-CONSOLIDATED - STATEMENT OF REVENUE | All Government Programs | Aggregate | NET INCOME (LOSS) | x | x | ||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | By Government Program/ direct and contracted | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Rent ($ for Occupancy of Own Building) | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Salaries and Fringe Benefits | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Employee Recruitment and Retention | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Legal Fees and Expenses | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Utilization Management/Quality Improvement | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Traveling Expenses | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Advertising | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Marketing | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Facilitated Enrollment | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Finance Auditing Actuarial | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Claims Processing | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Provider Relations and Provider Recruitment | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Member Services | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Management Information Systems (MIS) | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Telephone Postage Express and Telegraph | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Printing and Stationary | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Occupancy Depreciation & Amortization | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Rental of Equipment | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Boards Bureaus and Association Fees | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Insurance Except on Real Estate | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Collection and Bank Service Charges | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | State Premium Taxes | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Payroll Taxes | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Franchise Tax | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | ACA Tax | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | VBP QIP Administrative Expense | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | VBP EIP Administrative Expense | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | VBP EPP Administrative Expense | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Other Taxes (Excluding Income and Real Estate taxes) | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Aggregate Write-ins for Other Expenses(Detail Below) | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Total Allowable Administrative Expenses | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Contributions and Donations | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Lobbying Expenses | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Entertainment Costs | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Interest Fines and Penalties | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | State Income Taxes | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Uncollectible Spendown and NAMI | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Other Nonallowable Expenses | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Total Nonallowable Administrative Expenses | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Total Administrative Expenses | x | |||
Revenue and Expense | 22A-ADMINISTRATIVE Expenses | All Government Programs | Aggregate | Detail of Aggregate Write-ins for Other Expenses | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Members | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | By Government Program/ direct and contracted | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Rent ($ for Occupancy of Own Building) | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Salaries and Fringe Benefits | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Employee Recruitment and Retention | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Legal Fees and Expenses | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Utilization Management/Quality Improvement | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Traveling Expenses | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Advertising | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Marketing | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Facilitated Enrollment | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Finance Auditing Actuarial | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Claims Processing | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Provider Relations and Provider Recruitment | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Member Services | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Management Information Systems (MIS) | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Telephone Postage Express and Telegraph | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Printing and Stationary | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Occupancy Depreciation & Amortization | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Rental of Equipment | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Boards Bureaus and Association Fees | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Insurance Except on Real Estate | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Collection and Bank Service Charges | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | State Premium Taxes | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Payroll Taxes | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Franchise Tax | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | ACA Tax | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | VBP QIP Administrative Expense | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | VBP EIP Administrative Expense | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | VBP EPP Administrative Expense | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Other Taxes (Excluding Income and Real Estate taxes) | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Aggregate Write-ins for Other Expenses(Detail Below) | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Total Allowable Administrative Expenses | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Contributions and Donations | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Lobbying Expenses | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Entertainment Costs | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Interest Fines and Penalties | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | State Income Taxes | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Uncollectible Spendown and NAMI | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Other Nonallowable Expenses | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Total Nonallowable Administrative Expenses | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Total Administrative Expenses | x | |||
Revenue and Expense | 22A-1 - ADMINISTRATIVE Expenses - TOTAL | All Government Programs | Aggregate | Detail of Aggregate Write-ins for Other Expenses | x | |||
Revenue and Expense | 22B-ADMINISTRATIVE Expenses - DETAIL OF CONTRACTED Expense | All Government Programs | Aggregate | Detail of contracted Expenses by Contractor | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Executive Management | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Medical Director | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Utilization Management/ Quality Improvement | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Finance Auditing Actuarial | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Marketing | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Facilitated Enrollment | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Member Services | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Legal Services | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Claims Processing | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Provider Relations Recruitment Credentialing and Contracting | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | MIS | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Advertising | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Employee Recruitment and Retention | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Aggregate Write-in for Other Administrative | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Totals | x | x | ||
Revenue and Expense | 22C-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Detail of Aggregate Write-in for Other Administrative Support | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Executive Management | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Medical Director | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Utilization Management/ Quality Improvement | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Finance Auditing Actuarial | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Marketing | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Facilitated Enrollment | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Member Services | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Legal Services | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Claims Processing | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Provider Relations Recruitment Credentialing and Contracting | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | MIS | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Advertising | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Employee Recruitment and Retention | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Aggregate Write-in for Other Administrative | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Totals | x | x | ||
Revenue and Expense | 22C-1-ADMINISTRATIVE Expenses PERSONNEL COSTS AND WRITE-INS | All Government Programs | Aggregate | Detail of Aggregate Write-in for Other Administrative Support | x | x | ||
Enrollment | 22D-STATEWIDE MEMBER MONTHS - TO BE USED WITH ADMINISTRATIVE TABLES | All Government Programs | Aggregate | Member Months and Claims processed | x | x | ||
Revenue and Expense | 22D-2-STATEWIDE ADMINISTRATIVE Expenses - NURSING HomeE | All Government Programs | Nursing Home | By administrative Expense Category | x | x | ||
Medical Home Payables | 32-SUMMARY OF MEDICAL HomeE PAYABLES (NON-ADIRONDACK) - TOTAL PLAn | All Government Programs | Aggregate | by Medical Home | x | |||
Medical Home Payables | 32A-SUMMARY OF ADIRONDACK MEDICAL HomeE PAYABLES - TOTAL PLA | All Government Programs | Aggregate | by Medical Home | x | |||
Enrollment | 1A-ENROLLMENT BY PRIMARY CARE SITE* | HARP | Aggregate | Primary Care Site (clinics/Outpatient and Medical Groups) and County | x | x | x | |
Enrollment | 1B-ENROLLMENT SUMMARY BY COUNTY | HARP | Aggregate | By County | x | |||
Enrollment | 2-ENROLLMENT SUMMARY BY PREMIUM GROUP | HARP | By Premium Group | By Premium Group | x | |||
Inpatient Delivery | 2B & C-ACCRUED MATERNITY DELIVERIES | HARP | Aggregate | By Deliveries | x | x | ||
Enrollment | 2D- HEALTH Home ENROLLMENT | HARP | Aggregate | Health Home | x | x | x | |
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Member Months | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Members | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | a. Capitation | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | b. Maternity Supplemental Kick Payments | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Premium Revenue | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | C.O.B. (Third Party Recoveries) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Reinsurance Recoveries | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Premium Revenue (inc. COB and Recoveries) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Net Investment Income | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Other Revenue | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | TOTAL HARP REVENUE | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | a. Inpatient Medical Surgical | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | b. Inp. Mental Health & SUD | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | c. Inpatient Maternity Delivery | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | d. Total Hospital Inpatient Care (a thru c) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Other Medical and Hospital: | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Primary Care | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Specialty Care | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Prenatal/Postpartum Maternity Services | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Ambulatory Surgery | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Outpatient Physical Rehab/Therapy | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Other Professional Services | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Emergency Room | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Outpatient Mental Health | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Outpatient SUD Treatment | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Behavioral Health HCBS Services | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Dental | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Pharmacy | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Home Health Care | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Nursing Facility | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Personal Care | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Personal Emergency Response Services | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Transportation - Emergent | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Transportation - Non-Emergent | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Diagnostic Test, Lab & X-Ray | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Family Planning | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Vision Care Inc. Eyeglasses | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Foot Care | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Other Medical | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Durable Medical Equipment | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Subtotal Medical & Hospital | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Global Capitation Surplus or (Loss) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Total Medical & Hospital (ln 30 + ln 06 + ln 56 + ln 29) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Compensation | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Occupancy, Depreciation & Amortization | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Marketing and Facilitated Enrollment | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Other | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Total Allowable Administration Expenses | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | TOTAL MEDICAL AND ADMINISTRATIVE EXPENSES | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | PREMIUM INCOME/(LOSS) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Nonallowable Administration Expense | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | OPERATING INCOME/(LOSS) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Aggregate Write-ins for Other Expenses | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Prior Period Revenue Adjustments and Extraordinary Items | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Federal and Foreign Income Taxes Incurred | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | Adjustments for prior period IBNR estimates | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE & EXPENSES | HARP | Aggregate | NET INCOME (LOSS) | x | x | ||
Revenue and Expense | 8A-INPATIENT MENTAL HEALTH/SUD COST | HARP | Aggregate | Cost by Type of Treatment | x | x | ||
Utilization | 8A-1-INPATIENT MENTAL HEALTH/SUD UTILIZATION DISCHARGES | HARP | Aggregate | Discharges by Type of Treatment | x | |||
Utilization | 8A-2-INPATIENT MENTAL HEALTH/SUD UTILIZATION DAYS | HARP | Aggregate | Days by Type of Treatment | x | |||
Pharmacy Costs | 8B-PHARMACY OUTPATIENT COST | HARP | Aggregate | by type of Outpatient Pharmacy | x | |||
Utilization | 8B-1 PHARMACY OUTPATIENT UTILIZATION SCRIPTS | HARP | Aggregate | by type of Outpatient Pharmacy | x | |||
Revenue and Expense | 8C-OUTPATIENT MENTAL HEALTH COST | HARP | Aggregate | Costs by Type of Treatment | x | x | ||
Utilization | 8C-1-Outpatient MENTAL HEALTH UTILIZATION VISITS | HARP | Aggregate | Visits by Type of Treatment | x | |||
Revenue and Expense | 8D-OUTPATIENT SUD SERVICES COST | HARP | Aggregate | Costs by Type of Treatment | x | |||
Utilization | 8D-1-OUTPATIENT SUD SERVICES UTILIZATION VISITS | HARP | Aggregate | Visits by Type of Treatment | x | |||
Revenue and Expense | 8E-HCBS & 1115 DEMO OUTPATIENT SERVICES COST | HARP | Aggregate | Costs by Type of Treatment | x | |||
Utilization | 8E-1-HCBS & 1115 DEMO OUTPATIENT SERVICES UTILIZATION VISITS | HARP | Aggregate | Visits by Type of Treatment | x | |||
Assessment and Care Management | 8F-ASSESSMENTS AND CARE MANAGEMENT | HARP | Aggregate | By Actual and Accrued | x | x | ||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | HARP | Aggregate | Inpatient | x | |||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | HARP | Aggregate | Primary Care | x | |||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | HARP | Aggregate | Physician Specialty Services | x | |||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | HARP | Aggregate | Emergency Room | x | |||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | HARP | Aggregate | All other medical services | x | |||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | HARP | Aggregate | Total Expenses Capitated | x | |||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | HARP | Aggregate | Totals Expenses FFS | x | |||
Claims | 9B-CLAIMS ANALYSIS CLAIMS UNPAID | HARP | Aggregate | Inpatient | x | |||
Claims | 9B-CLAIMS ANALYSIS CLAIMS UNPAID | HARP | Aggregate | Primary Care | x | |||
Claims | 9B-CLAIMS ANALYSIS CLAIMS UNPAID | HARP | Aggregate | Physician Specialty Services | x | |||
Claims | 9B-CLAIMS ANALYSIS CLAIMS UNPAID | HARP | Aggregate | Emergency Room | x | |||
Claims | 9B-CLAIMS ANALYSIS CLAIMS UNPAID | HARP | Aggregate | All other medical services | x | |||
IBNR | 9C-CLAIMS ANALYSIS RECONCILIATION OF PRIOR PERIOD IBNR | HARP | Aggregate | Inpatient | x | |||
IBNR | 9C-CLAIMS ANALYSIS RECONCILIATION OF PRIOR PERIOD IBNR | HARP | Aggregate | Primary Care | x | |||
IBNR | 9C-CLAIMS ANALYSIS RECONCILIATION OF PRIOR PERIOD IBNR | HARP | Aggregate | Physician Specialty Services | x | |||
IBNR | 9C-CLAIMS ANALYSIS RECONCILIATION OF PRIOR PERIOD IBNR | HARP | Aggregate | Emergency Room | x | |||
IBNR | 9C-CLAIMS ANALYSIS RECONCILIATION OF PRIOR PERIOD IBNR | HARP | Aggregate | All other medical services | x | |||
Global Capitation | 9D-GLOBAL CAPITATION SURPLUS OR (LOSS) | HARP | Aggregate | Member Months | x | |||
Utilization | 12-INPATIENT UTILIZATION DISCHARGES ACTUAL AND ACCRUED UTILIZATION | HARP | Aggregate | Actual and Accrued Discharges and Costs by Type of Admission | x | x | ||
Utilization | 12A-NURSING HOME UTILIZATION | HARP | Aggregate | Days and Discharges | x | |||
Utilization | 13-INPATIENT UTILIZATION DAYS ACTUAL UTILIZATION | HARP | Aggregate | Days by type of Admission | x | |||
Utilization | 14-UTILIZATION OF MEDICAL SERVICES AMBULATORY CARE | HARP | Aggregate | by Type of Service | x | x | ||
Utilization | 14A-PHARMACY UTILIZATION | HARP | Aggregate | by Type of Script | x | |||
Pharmacy Costs | 14A-1 PHARMACY COST (NET OF NYS SUGGESTED COPAYS) | HARP | Aggregate | by Type of Script | x | |||
Pharmacy CoPay | 14A-2 PHARMACY COPAY SCHEDULE | HARP | Aggregate | by type of Script | x | |||
Utilization | 14A-4 PHARMACY FAMILY PLANNING UTILIZATION | HARP | Aggregate | by Type of Script | x | |||
Pharmacy Costs | 14A-5 PHARMACY COSTS (NET OF NYS SUGGESTED COPAYS) FAMILY PLANNING | Harp | Aggregate | by Type of Script | x | |||
Utilization | 15A/B-HMO/HOSPITAL PAYMENTS | Harp | Aggregate | By Hospital and Type of Admission | x | x | ||
Utilization | 16A-MEDICAID UTILIZATION OF HHC SERVICES | HARP | Aggregate | By Hours and Visits | x | |||
Claims | 20-Claims ANALYSIS FOR ACTIVE MEBERS NON DUPLICATIVE CLAIMS | HARP | Aggregate | By paid and Denied | x | x | ||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HARP | Aggregate | Interest Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HARP | Aggregate | Dividend and Real Estate Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HARP | Aggregate | Net Realized Capital Gains or Losses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HARP | Aggregate | Investment Expenses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HARP | Aggregate | Interest Expenses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HARP | Aggregate | Interest on Claims paid after 45 days | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | HARP | Aggregate | Other Revenue and Expense | x | |||
Revenue and Expense | 26A-SCHEDULE OF AGGREGATE WRITEINS FOR OTHER EXPENSES | HARP | Aggregate | By Type of Write ins | x | |||
Revenue and Expense | 26B-SCHEDULE OF Extraordinary Items FOR OTHER EXPENSES | HARP | Aggregate | by Type of Item | x | |||
IBNR | 26C - SCHEDULE OF ADJUSTMENTS FOR PRIOR PERIOD IBNR | HARP | Aggregate | By Prior Year | x | |||
Revenue and Expense | 26D-DETAIL OF OTHER MEDICAL COST | HARP | Aggregate | by Other Medical Expenses | x | |||
Revenue and Expense | 26R-NEW REINSURANCE RECOVERIES | HARP | Aggregate | By Type of Reinsurance | x | |||
DRG | 27B-INPATIENT MATERNITY DELIVERY DRGs | HARP | Aggregate | by DRG | x | x | ||
APRDRG | 27B-1-INPATIENT MATERNITY DELIVERY APRDRGs | HARP | Aggregate | by APRDRG | x | x | ||
Non Adirondack Medical Home Provider | 30-NON ADIRONDACK MEDICAL Home | HARP | Aggregate | by NCQA Level | x | x | x | |
Adirondack Medical Home | 31-ADIRONDACK MEDICAL Home TOTAL | HARP | Aggregate | by Program | x | x | x | |
Enrollment | 1C-Enrollment Summary by County | Child Health Plus | Aggregate | By County | x | |||
Enrollment | 2-ENROLLMENT SUMMARY BY PREMIUM GROUP | Child Health Plus | Aggregate | By Premium Group | x | |||
Enrollment | 2A-DISENROLLMENT FROM PLAN | Child Health Plus | Aggregate | By Reason for Disenrollment | x | |||
Enrollment | 2B-DETAILS OF PRESUMPTIVELY ENROLLED CHILDREN WHO WERE FOUND INELLIGIBLE | Child Health Plus | Aggregate | By Reason for Disenrollment | x | |||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Members | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Child Health Plus Member Months | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Suscriber Premiums | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | NYS Premiums | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Newborn Supplemental Payments ("kick") | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Maternity Supplemental Payments | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | C.O.B. & Subrogation | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Reinsurance Recoveries | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Premium Revenue (inc. COB and Recoveries) | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Net Investment Income | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Other Revenue | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | a.) Inpatient Medical Surgical | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | b.) Inp. Mental Health & Substance Abuse | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | c.) Inp. Newborn Births (excluding Maternity) | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | d.) Inp. Maternity/Delivery | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Primary Care | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Specialty Care | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Prenatal/Postpartum Maternity Services | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Ambulatory Surgery | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Outpatient Physical Rehab/Therapy | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Other Professional Services | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Emergency Room | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Outpatient Mental Health | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Outpatient SUD Treatment | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Dental | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Pharmacy | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Durable Medical Equipment | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Home Health Care | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Nursing Facility | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Transportation - Emergent | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Diagnostic Test, Lab & X-Ray | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Family Planning | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Vision Care Inc. Eyeglasses | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Foot Care | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Other Medical | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Global Capitation Surplus or (Loss) | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Compensation | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Occupancy, Depreciation & Amortization | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Marketing and Facilitated Enrollment | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Other | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Total Allowable Administration Expenses | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | TOTAL MEDICAL AND ADMINISTRATIVE EXPENSES | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | PREMIUM INCOME/(LOSS) | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Nonallowable Administration Expense | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | OPERATING INCOME/(LOSS) | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Aggregate Write-ins for Other Expenses | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Prior Period Revenue Adjustments and Extraordinary Items | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Federal and Foreign Income Taxes Incurred | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | Adjustments for prior period IBNR Estimates | x | x | ||
Revenue and Expense | 6A-STATEMENT OF REVENUE & EXPENSES (ACCRUAL BASIS) | Child Health Plus | Aggregate | NET INCOME (LOSS) | x | x | ||
Claims | 9A-CLAIMS ANALYSIS Claims DURING THE CURRENT PERIOD | Child Health Plus | Aggregate | By Category of Service | x | |||
Claims | 9B-CLAIMS ANALYSIS CLAIMS UNPAID | Child Health Plus | Aggregate | By Category of Service | x | |||
IBNR | 9C-CLAIMS ANALYSIS RECONCILIATION OF PRIOR PERIOD IBNR | Child Health Plus | Aggregate | By Prior Year | x | |||
Global Capitation | 9D-GLOBAL CAPITATION SURPLUS OR (LOSS) | Child Health Plus | Aggregate | By category | x | x | x | |
User Rates of Service | 10-USER RATES OF SERVICE - Category OF SERVICE | Child Health Plus | Aggregate | By Age Group | x | x | ||
Utilization | 12-INPATIENT UTILIZATION DISCHARGES ACTUAL AND ACCRUED UTILIZATION | Child Health Plus | Aggregate | By Type of Admission and Age group | x | x | ||
Utilization | 12A-NURSING HOME UTILIZATION | Child Health Plus | Aggregate | By Age group | ||||
Utilization | 13-INPATIENT UTILIZATION DAYS ACTUAL UTILIZATION | Child Health Plus | Aggregate | By Type of Service and Age group | x | |||
Utilization | 14-UTILIZATION OF MEDICAL SERVICES - AMBULATORY CARE | Child Health Plus | Aggregate | By Type of Service and Age group | x | x | 0 | |
Utilization | 15A/B-HMO/HOSPITAL PAYMENTS | Child Health Plus | Aggregate | By Hospital and Type of Admission | x | x | ||
Utilization | 16-UTILIZATION OF HHC SERVICES | Child Health Plus | Aggregate | By Hours and Visits | x | x | ||
Claims | 20-Claims ANALYSIS FOR ACTIVE MEMBERS NON DUPLICATIVE CLAIMS | Child Health Plus | Aggregate | By paid and Denied and Age Group | x | x | ||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Child Health Plus | Aggregate | Interest Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Child Health Plus | Aggregate | Dividend and Real Estate Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Child Health Plus | Aggregate | Net Realized Capital Gains or Losses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Child Health Plus | Aggregate | Investment Expenses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Child Health Plus | Aggregate | Interest Expenses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Child Health Plus | Aggregate | Interest on Claims paid after 45 days | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Child Health Plus | Aggregate | Other Revenue and Expense | x | |||
Revenue and Expense | 26A-SCHEDULE OF AGGREGATE WRITEINS FOR OTHER EXPENSES | Child Health Plus | Aggregate | By Type of Write ins | x | |||
Revenue and Expense | 26B-SCHEDULE OF Extraordinary Items FOR OTHER EXPENSES | Child Health Plus | Aggregate | by Type of Item | x | |||
IBNR | 26C - SCHEDULE OF ADJUSTMENTS FOR PRIOR PERIOD IBNR | Child Health Plus | Aggregate | By Prior Year | x | |||
DRG | 27B-INPATIENT MATERNITY DELIVERY DRGs | Child Health Plus | Aggregate | by DRG | x | x | ||
APRDRG | 27B-1-INPATIENT MATERNITY DELIVERY APRDRGs | Child Health Plus | Aggregate | by APRDRG | x | x | ||
Non Adirondack Medical Home Provider | 30-NON ADIRONDACK MEDICAL Home | Child Health Plus | Aggregate | by NCQA Level | x | x | x | |
Adirondack Medical Home | 31-ADIRONDACK MEDICAL Home TOTAL | Child Health Plus | Aggregate | by Program | x | x | x | |
Revenue and Expense | 6D-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Dual Eligible Member Months | x | |||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Dual Eligible Members | x | |||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | a. Medicare Capitation | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | b. Medicaid Capitation | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Premium Revenue | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | C.O.B. (Third Party Recoveries) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Reinsurance Recoveries | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Net Investment Income | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Other Revenue | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | a. Inpatient Medical Surgical | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | b. Inp. Mental Health & Substance Abuse | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Primary Care | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Specialty Care | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Ambulatory Surgery | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Outpatient Physical Rehab/Therapy | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Other Professional Services | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Emergency Room | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Outpatient Mental Health | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Outpatient SUD Treatment | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Dental | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Pharmacy | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Home Health Care - Medicare | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Home Health Care - Non Medicare | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Nursing Facility | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Transportation - Emergent | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Transportation - Non Emergent | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Diagnostic Test, Lab & X-ray | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Family Planning | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Vision Care Inc. Eyeglasses | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Foot Care | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Other Medical | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Durable Medical Equipment | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Global Capitation Surplus or (Loss) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Other Medical | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Durable Medical Equipment | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Hearing Services | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Private Duty Nursing | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Foot Care | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Supplemental Benefits | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Reinsurance Premium Cost | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Provider and Quality Incentive Payments | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Compensation | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Occupancy, Depreciation & Amortization | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Marketing and Facilitated Enrollment | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Other | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Total Allowable Administration Expenses | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | TOTAL MEDICAL AND ADMINISTRATIVE EXPENSES | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | PREMIUM INCOME/(LOSS) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Nonallowable Administration Expense | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | OPERATING INCOME/(LOSS) | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Aggregate Write-ins for Other Expenses | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Prior Period Revenue Adjustments and Extraordinary Items | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Federal and Foreign Income Taxes Incurred | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | Adjustments for prior period IBNR Estimates | x | x | ||
Revenue and Expense | 6-STATEMENT OF REVENUE AND EXPENSES (ACCRUAL BASIS) SUMMARY OF ALL PREMIUM GROUPS ON CLAIMS INCURRED DURING THE CURRENT PERIOD | Medicaid Adv Dual | Aggregate | NET INCOME (LOSS) | x | x | ||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid Adv Dual | Aggregate | Interest Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid Adv Dual | Aggregate | Dividend and Real Estate Income | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid Adv Dual | Aggregate | Net Realized Capital Gains or Losses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid Adv Dual | Aggregate | Investment Expenses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid Adv Dual | Aggregate | Interest Expenses | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid Adv Dual | Aggregate | Interest on Claims paid after 45 days | x | |||
Revenue and Expense | 26-SCHEDULE OF NET INVESTMENT INCOME | Medicaid Adv Dual | Aggregate | Other Revenue and Expense | x | |||
Revenue and Expense | 26A-SCHEDULE OF AGGREGATE WRITEINS FOR OTHER EXPENSES | Medicaid Adv Dual | Aggregate | By Type of Write ins | x | |||
Revenue and Expense | 26B-SCHEDULE OF Extraordinary Items FOR OTHER EXPENSES | Medicaid Adv Dual | Aggregate | by Type of Item | x | |||
IBNR | 26C-SCHEDULE OF ADJUSTMENTS FOR PRIOR PERIOD IBNR | Medicaid Adv Dual | Aggregate | By Prior Year | x |
Here is a List of the Managed Long Term Care Tables from a recent Operational Report. Use the Filters or Search Bar to explore what data is captured in these reports.
(You can select multiple values in the select box, click outside the select box to activate)
Type of Data | Table# and Name | Program |
---|---|---|
Type of Data | Table# and Name | Program |
Enrollment | Exhibit A-1-Analysis of Enrolled Population | Total MLTC |
Enrollment | Exhibit A-2-Analysis of Enrolled Population By County | Total MLTC |
Utilization | Exhibit A-3-Hospital and Nursing Facility Utilization | Total MLTC |
Utilization | Exhibit A-4-Nursing Facility Discharges | Total MLTC |
Utilization | Exhibit A-5-Personal Care Hours YTD | Total MLTC |
Utilization | Exhibit A-6-Home Health Care and PCA Hours Year-to-Date | Total MLTC |
Utilization | Exhibit A-7-CDPAP Hours Year-to-Date | Total MLTC |
Utilization | Exhibit B-1-Utilization of Services | New Enrollees 21+ Previously MA FFS (Duals Only)/Nursing Home Permanent Placement |
Utilization | Exhibit B-1-Utilization of Services | Existing NHC Enrollees 18+ (Duals and Non-Duals)/Community |
Utilization | Exhibit B-2-Utilization of HHC Services | New Enrollees 21+ Previously MA FFS (Duals Only)/Nursing Home Permanent Placement |
Utilization | Exhibit B-2-Utilization of HHC Services | Existing NHC Enrollees 18+ (Duals and Non-Duals)/Community |
Utilization | Exhibit B-Utilization of Services | Total MLTC |
Utilization | Exhibit B-Utilization of Services | Existing NHC Enrollees 18+ (Duals and Non-Duals)/Community |
Utilization | Exhibit C-Number of Enrollees Utilizing Services | Total MLTC |
Plan Contact Information | Plan Information | Total MLTC |
Financial | Schedule A-1-Net Worth Reconciliation | All Programs |
Financial | Schedule A-Balance Sheet | All Programs |
Revenue and Expense | Schedule B-1-Medicaid Revenue and Expense Analysis | Existing NHC Enrollees 18+ (Duals and Non-Duals)/Community |
Revenue and Expense | Schedule B-1-Medicaid Revenue and Expense Analysis | New Enrollees 21+ Previously MA FFS (Duals Only)/Nursing Home Permanent Placement |
Revenue and Expense | Schedule B-Consolidated Revenue and Expense Summary All Lines of Business | All Programs |
Revenue and Expense | Schedule B-Revenue and Expense Statement - Total Line of Business | Total MLTC |
Care Management | Schedule D-2-Care Management | Total MLTC |
Administration | Schedule D-3A-Administration Expense - Contracted Services | Total MLTC |
Administration | Schedule D-3-Administration Expense - Total | Total MLTC |
Administration | Schedule D-3B-Administration Expense - Personnel Expense | Total MLTC |
Claims Analysis | Schedule D-6-Claims Analysis-B. Claims Unpaid | Total MLTC |
Claims Analysis | Schedule D-6-Claims Analysis-C. Summary of Prior Period IBNR | Total MLTC |
Claims Analysis | Schedule D-6-Claims Analysis-Claims Incurred During Current Period | Total MLTC |
Claims Analysis | Schedule D-6-Claims Analysis-D. Global Capitation Reconciliation (Total Plan) | Total MLTC |
Financial | Schedule D-7-Premium Receivables | Total MLTC |
Financial | Schedule F-IBNR Reserve Calculation | Total MLTC |
Financial | Schedule G-1-Schedule of Adjustments for Prior Period IBNR | Total MLTC |
Financial | Schedule G-2-Total Plan Schedule of Aggregate Write-ins for Other Expenses | Total MLTC |
Revenue and Expense | Schedule G-3-Total Plan Schedule of Prior Period Revenue Adjustments and Extraordinary Items | Total MLTC |
Financial | Schedule G-4-Schedule of Recovered Provider Payments For Services Provided in Prior Periods | Total MLTC |
Financial | Schedule G-Schedule of Net Investment Income | Total MLTC |
Claims Analysis | Schedule H-Claims Payable Aging Analysis of Unpaid Claims | Total MLTC |
Financial | Schedule I-Schedule of Plan's Transactions with Any Affiliate | Total MLTC |
Claims Analysis | Schedule J-Claims And Interest Penalties Paid During the Year | Total MLTC |