CCS Statewide CY2012 Fee for Service Expenditures by Claim Type and Diagnosis Duplicate CIN Count Claim Type Code Desc DX Group DX SubGroup Sum of

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1 CCS Statewide CY2012 Fee for Service Expenditures by Claim Type and Diagnosis Duplicate CIN Count Claim Type Code Desc DX Group DX SubGroup Sum of Medi-Cal Reimbursement * Outpatient Supplementary V Codes Malignancies $336, * Inpatient Supplementary V Codes Malignancies $243, * Medical/Physician Supplementary V Codes Malignancies $32, * Pharmacy Supplementary V Codes Malignancies $29, * Inpatient Conditions in the Perinatal Period Other $141, Pharmacy Conditions in the Perinatal Period Other $2, Inpatient Digestive System Gastroesophageal Reflux $247, Inpatient Genitourinary System Renal Failure $852, Inpatient Complications of Pregnancy, Childbirth and Puerperium Other $1,316, Medical/Physician Conditions in the Perinatal Period Other $39, Pharmacy Digestive System Gastroesophageal Reflux $77, Pharmacy Complications of Pregnancy, Childbirth and Puerperium Other $41, Pharmacy Genitourinary System Renal Failure $185, Inpatient Mental Disorders Other $622, Outpatient Conditions in the Perinatal Period Other $26, Inpatient Respiratory System Asthma $559, Medical/Physician Digestive System Gastroesophageal Reflux $69, Inpatient Congenital Anomalies Diaphragmetic - Anomalies $2,838, Outpatient Genitourinary System Renal Failure $281, Medical/Physician Genitourinary System Renal Failure $123, Outpatient Digestive System Gastroesophageal Reflux $74, Outpatient Complications of Pregnancy, Childbirth and Puerperium Other $90, Medical/Physician Complications of Pregnancy, Childbirth and Puerperium Other $93, Pharmacy Supplementary E Codes Other $55, Pharmacy Congenital Anomalies Diaphragmetic - Anomalies $192, Inpatient Unknown Other $1,641, Inpatient Endoctrine, Nutritional and Metabolic, Immunity Pituitary Disorders $1,101, Inpatient Skin and Subcutaneous Tissue Other $1,968, Inpatient Endoctrine, Nutritional and Metabolic, Immunity Immune Disorders $6,181, Inpatient Nervous System and Sense Organs Ear, Nose, Throat $849, Inpatient Congenital Anomalies Biliary Atresca $3,339, Pharmacy Respiratory System Asthma $266, Medical/Physician Congenital Anomalies Diaphragmetic - Anomalies $378, Inpatient Digestive System Malocclusion $1,901, Outpatient Congenital Anomalies Diaphragmetic - Anomalies $365, Pharmacy Unknown Other $86, Medical/Physician Respiratory System Asthma $148, Inpatient Supplementary E Codes Other $2,503, Outpatient Respiratory System Asthma $537, Inpatient Neoplasms Other $10,595, Inpatient Congenital Anomalies Congenital Hydrocephalus $3,133, Outpatient Supplementary E Codes Other $74, Inpatient Blood and Blood-Forming Organs Coagulation Disorders $4,629, Pharmacy Mental Disorders Other $113, Inpatient Neoplasms Brain Tumors $10,120,946.01

2 136 Medical/Physician Supplementary E Codes Other $235, Inpatient Infectious Diseases Other $7,361, Inpatient Nervous System and Sense Organs Hydrocephalus $8,317, Inpatient Endoctrine, Nutritional and Metabolic, Immunity Thyroid Disorders $3,817, Medical/Physician Unknown Other $156, Inpatient Blood and Blood-Forming Organs Anemias $7,852, Inpatient Nervous System and Sense Organs Myopathies $10,769, Inpatient Congenital Anomalies Anomalies of Abdominal Wall $18,478, Medical/Physician Mental Disorders Other $141, Outpatient Unknown Other $137, Inpatient Nervous System and Sense Organs Degenerative Disease of CNS $9,783, Pharmacy Congenital Anomalies Biliary Atresca $1,431, Pharmacy Skin and Subcutaneous Tissue Other $929, Pharmacy Neoplasms Other $837, Pharmacy Nervous System and Sense Organs Ear, Nose, Throat $195, Medical/Physician Congenital Anomalies Biliary Atresca $845, Pharmacy Digestive System Malocclusion $130, Pharmacy Injury and Poisoning Head Injury/Skull Fracture $298, Outpatient Congenital Anomalies Biliary Atresca $901, Inpatient Supplementary V Codes Prematurity/Live Birth $7,240, Pharmacy Congenital Anomalies Anomalies of Abdominal Wall $1,192, Pharmacy Congenital Anomalies Congenital Hydrocephalus $697, Inpatient Neoplasms Benign Neoplasms $5,452, Pharmacy Blood and Blood-Forming Organs Anemias $1,631, Inpatient Blood and Blood-Forming Organs Other $8,906, Inpatient Congenital Anomalies Spina Bifida $5,657, Pharmacy Neoplasms Brain Tumors $2,003, Outpatient Mental Disorders Other $291, Inpatient Musculoskeletal System and Connective Tissue Scoliosis $9,058, Pharmacy Nervous System and Sense Organs Hydrocephalus $748, Inpatient Endoctrine, Nutritional and Metabolic, Immunity Cystic Fibrosis $17,955, Pharmacy Blood and Blood-Forming Organs Other $3,094, Pharmacy Supplementary V Codes Prematurity/Live Birth $210, Inpatient Nervous System and Sense Organs Hearing Loss $9,871, Medical/Physician Skin and Subcutaneous Tissue Other $485, Medical/Physician Neoplasms Other $1,295, Pharmacy Infectious Diseases Other $4,805, Pharmacy Endoctrine, Nutritional and Metabolic, Immunity Immune Disorders $8,645, Outpatient Neoplasms Other $1,817, Outpatient Skin and Subcutaneous Tissue Other $628, Medical/Physician Congenital Anomalies Anomalies of Abdominal Wall $2,371, Outpatient Congenital Anomalies Anomalies of Abdominal Wall $1,097, Medical/Physician Endoctrine, Nutritional and Metabolic, Immunity Immune Disorders $981, Inpatient Respiratory System Other $15,877, Inpatient Nervous System and Sense Organs Ophthalmology $20,357, Inpatient Endoctrine, Nutritional and Metabolic, Immunity Other $12,570,748.58

3 384 Pharmacy Neoplasms Benign Neoplasms $721, Outpatient Endoctrine, Nutritional and Metabolic, Immunity Immune Disorders $2,129, Pharmacy Respiratory System Respiratory Failure $2,146, Inpatient Injury and Poisoning Head Injury/Skull Fracture $7,889, Medical/Physician Digestive System Malocclusion $296, Medical/Physician Neoplasms Brain Tumors $2,349, Outpatient Neoplasms Brain Tumors $3,393, Pharmacy Musculoskeletal System and Connective Tissue Scoliosis $906, Inpatient Supplementary V Codes Other $25,026, Inpatient Respiratory System Respiratory Failure $24,868, Medical/Physician Congenital Anomalies Congenital Hydrocephalus $1,287, Outpatient Supplementary V Codes Prematurity/Live Birth $234, Outpatient Congenital Anomalies Congenital Hydrocephalus $1,659, Outpatient Infectious Diseases Other $1,085, Inpatient Blood and Blood-Forming Organs Hemoglobinopathies $15,214, Medical/Physician Infectious Diseases Other $902, Inpatient Genitourinary System Renal $13,406, Pharmacy Nervous System and Sense Organs Myopathies $1,805, Inpatient Symptoms Signs and Ill-Defined Conditions Other $14,363, Medical/Physician Nervous System and Sense Organs Hydrocephalus $1,678, Inpatient Genitourinary System Other $9,449, Pharmacy Respiratory System Other $2,392, Outpatient Nervous System and Sense Organs Hydrocephalus $1,942, Inpatient Circulatory System Other $19,843, Medical/Physician Blood and Blood-Forming Organs Anemias $1,139, Pharmacy Nervous System and Sense Organs Degenerative Disease of CNS $3,107, Outpatient Respiratory System Respiratory Failure $10,686, Pharmacy Congenital Anomalies Spina Bifida $1,212, Outpatient Blood and Blood-Forming Organs Anemias $3,154, Pharmacy Circulatory System Other $1,940, Medical/Physician Supplementary V Codes Prematurity/Live Birth $736, Inpatient Circulatory System Cardiac - Medical Conditions $23,593, Medical/Physician Respiratory System Respiratory Failure $4,898, Medical/Physician Injury and Poisoning Head Injury/Skull Fracture $1,132, Medical/Physician Blood and Blood-Forming Organs Other $1,015, Pharmacy Endoctrine, Nutritional and Metabolic, Immunity Cystic Fibrosis $24,562, Inpatient Supplementary V Codes Screening for developmental handicaps in $55,674, Outpatient Injury and Poisoning Head Injury/Skull Fracture $769, Medical/Physician Nervous System and Sense Organs Ear, Nose, Throat $550, Pharmacy Endoctrine, Nutritional and Metabolic, Immunity Pituitary Disorders $12,273, Medical/Physician Endoctrine, Nutritional and Metabolic, Immunity Cystic Fibrosis $3,500, Outpatient Endoctrine, Nutritional and Metabolic, Immunity Cystic Fibrosis $1,741, Outpatient Blood and Blood-Forming Organs Other $2,211, Pharmacy Genitourinary System Other $706, Inpatient Nervous System and Sense Organs Other $47,233, Inpatient Nervous System and Sense Organs Epilepsy $16,414,284.84

4 709 Outpatient Endoctrine, Nutritional and Metabolic, Immunity Pituitary Disorders $1,797, Outpatient Nervous System and Sense Organs Ear, Nose, Throat $612, Medical/Physician Endoctrine, Nutritional and Metabolic, Immunity Pituitary Disorders $861, Inpatient Digestive System Other $33,797, Pharmacy Blood and Blood-Forming Organs Hemoglobinopathies $8,012, Inpatient Congenital Anomalies Cleft Palate/Lip $10,105, Pharmacy Blood and Blood-Forming Organs Coagulation Disorders $129,225, Medical/Physician Respiratory System Other $2,414, Pharmacy Supplementary V Codes Screening for developmental handicaps in $970, Medical/Physician Nervous System and Sense Organs Degenerative Disease of CNS $6,153, Medical/Physician Congenital Anomalies Spina Bifida $6,429, Outpatient Congenital Anomalies Spina Bifida $5,049, Outpatient Respiratory System Other $4,350, Medical/Physician Nervous System and Sense Organs Myopathies $7,523, Inpatient Musculoskeletal System and Connective Tissue Other $25,991, Medical/Physician Blood and Blood-Forming Organs Coagulation Disorders $2,220, Outpatient Nervous System and Sense Organs Degenerative Disease of CNS $12,961, Outpatient Blood and Blood-Forming Organs Coagulation Disorders $27,041, Outpatient Nervous System and Sense Organs Myopathies $11,511, Medical/Physician Neoplasms Benign Neoplasms $1,484, Pharmacy Injury and Poisoning Fractures $875, Outpatient Neoplasms Benign Neoplasms $1,547, Pharmacy Genitourinary System Renal $9,069, Pharmacy Supplementary V Codes Other $7,361, Pharmacy Injury and Poisoning Other $2,016, Outpatient Digestive System Malocclusion $639, Pharmacy Digestive System Other $8,180, Medical/Physician Circulatory System Other $3,160, Medical/Physician Blood and Blood-Forming Organs Hemoglobinopathies $1,696, Outpatient Blood and Blood-Forming Organs Hemoglobinopathies $3,345, Outpatient Circulatory System Other $4,459, Pharmacy Congenital Anomalies Cleft Palate/Lip $2,029, Pharmacy Circulatory System Cardiac - Medical Conditions $7,286, Medical/Physician Genitourinary System Renal $3,507, Pharmacy Nervous System and Sense Organs Other $10,025, Outpatient Genitourinary System Renal $8,066, Pharmacy Symptoms Signs and Ill-Defined Conditions Other $6,179, Inpatient Endoctrine, Nutritional and Metabolic, Immunity Diabetes $19,981, Inpatient Neoplasms Malignancies $118,080, Pharmacy Endoctrine, Nutritional and Metabolic, Immunity Other $17,013, Inpatient Nervous System and Sense Organs Cerebral Palsy $70,900, Outpatient Musculoskeletal System and Connective Tissue Scoliosis $2,688, Pharmacy Nervous System and Sense Organs Ophthalmology $2,683, Medical/Physician Supplementary V Codes Other $4,608, Medical/Physician Supplementary V Codes Screening for developmental handicaps in $4,447, Inpatient Injury and Poisoning Other $54,287,350.14

5 1834 Medical/Physician Digestive System Other $5,559, Pharmacy Nervous System and Sense Organs Epilepsy $10,781, Medical/Physician Musculoskeletal System and Connective Tissue Scoliosis $2,495, Inpatient Injury and Poisoning Fractures $26,933, Pharmacy Endoctrine, Nutritional and Metabolic, Immunity Thyroid Disorders $2,385, Outpatient Digestive System Other $7,751, Inpatient Congenital Anomalies Cardiac - Congenital Anomalies $85,851, Pharmacy Musculoskeletal System and Connective Tissue Other $10,015, Outpatient Supplementary V Codes Screening for developmental handicaps in $2,020, Outpatient Supplementary V Codes Other $9,267, Medical/Physician Nervous System and Sense Organs Epilepsy $4,768, Medical/Physician Endoctrine, Nutritional and Metabolic, Immunity Other $3,691, Medical/Physician Genitourinary System Other $2,125, Inpatient Congenital Anomalies Other $65,502, Outpatient Endoctrine, Nutritional and Metabolic, Immunity Other $13,353, Outpatient Nervous System and Sense Organs Epilepsy $9,821, Medical/Physician Nervous System and Sense Organs Other $11,558, Outpatient Genitourinary System Other $2,335, Medical/Physician Symptoms Signs and Ill-Defined Conditions Other $3,812, Pharmacy Neoplasms Malignancies $14,947, Outpatient Nervous System and Sense Organs Other $23,802, Pharmacy Nervous System and Sense Organs Hearing Loss $4,268, Outpatient Symptoms Signs and Ill-Defined Conditions Other $8,781, Outpatient Circulatory System Cardiac - Medical Conditions $5,794, Medical/Physician Circulatory System Cardiac - Medical Conditions $5,835, Medical/Physician Injury and Poisoning Other $7,127, Inpatient Conditions in the Perinatal Period Prematurity/Live Birth $193,501, Outpatient Injury and Poisoning Other $7,631, Medical/Physician Congenital Anomalies Cleft Palate/Lip $5,417, Outpatient Endoctrine, Nutritional and Metabolic, Immunity Thyroid Disorders $2,831, Medical/Physician Endoctrine, Nutritional and Metabolic, Immunity Thyroid Disorders $1,354, Outpatient Congenital Anomalies Cleft Palate/Lip $6,465, Medical/Physician Musculoskeletal System and Connective Tissue Other $5,959, Pharmacy Conditions in the Perinatal Period Prematurity/Live Birth $6,539, Outpatient Musculoskeletal System and Connective Tissue Other $10,678, Pharmacy Congenital Anomalies Other $12,260, Pharmacy Congenital Anomalies Cardiac - Congenital Anomalies $15,257, Medical/Physician Injury and Poisoning Fractures $4,164, Medical/Physician Neoplasms Malignancies $18,577, Outpatient Nervous System and Sense Organs Ophthalmology $5,728, Outpatient Neoplasms Malignancies $28,116, Outpatient Injury and Poisoning Fractures $3,100, Pharmacy Nervous System and Sense Organs Cerebral Palsy $30,610, Medical/Physician Nervous System and Sense Organs Ophthalmology $5,812, Outpatient Endoctrine, Nutritional and Metabolic, Immunity Diabetes $6,042, Pharmacy Endoctrine, Nutritional and Metabolic, Immunity Diabetes $35,041,913.22

6 6560 Medical/Physician Endoctrine, Nutritional and Metabolic, Immunity Diabetes $7,616, Medical/Physician Conditions in the Perinatal Period Prematurity/Live Birth $19,090, Outpatient Conditions in the Perinatal Period Prematurity/Live Birth $14,914, Medical/Physician Nervous System and Sense Organs Hearing Loss $8,777, Medical/Physician Nervous System and Sense Organs Cerebral Palsy $43,376, Outpatient Nervous System and Sense Organs Hearing Loss $17,448, Outpatient Nervous System and Sense Organs Cerebral Palsy $91,278, Outpatient Congenital Anomalies Cardiac - Congenital Anomalies $23,825, Medical/Physician Congenital Anomalies Cardiac - Congenital Anomalies $25,483, Medical/Physician Congenital Anomalies Other $26,369, Outpatient Congenital Anomalies Other $30,180,450.66

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