From: Pharmaceutical cost management in an ambulatory setting using a risk adjustment tool
ACGR3 | N | %N | Average expenditure | Total expenditure | Average age | St. Dv. age | |
---|---|---|---|---|---|---|---|
1. Healthy | |||||||
10 | Healthy | 1,633,686 | 35.10% | 42.63 | 69,644,034 | 28.56 | 19.05 |
11 | Healthy Non-User | 784,168 | 16.85% | 0.00 | 0 | 36.21 | 16.99 |
12 | Delivery without Other Significant Illness | 28,921 | 0.62% | 49.30 | 1,425,805 | 30.56 | 8.41 |
14 | Pregnancy without Other Significant Illness | 19,451 | 0.42% | 35.92 | 698,680 | 31.26 | 6.93 |
15 | Evidence of Significant Chronic or Acute Diagnosis without Other Significant Illness | 152,488 | 3.28% | 190.76 | 29,088,611 | 40.35 | 23.00 |
2. History of significant acute disease | |||||||
20 | History Of Significant Acute Disease | 193,19 | 4.15% | 95.96 | 1,853,851 | 33.23 | 19.65 |
22 | Delivery with History of Significant Acute Illness | 15,875 | 0.34% | 209.51 | 3,325,971 | 33.87 | 10.84 |
24 | Pregnancy with History of Significant Acute Illness | 7,108 | 0.15% | 64.70 | 459,888 | 31.83 | 5.99 |
25 | Evidence of Significant Chronic or Acute Diagnosis with History of Significant Acute Illness | 44,836 | 0.96% | 166.72 | 7,475,058 | 38.06 | 21.98 |
3. Single minor chronic disease | |||||||
31 | Single Minor Chronic Disease Level - 1 | 403,148 | 8.66% | 190.25 | 76,698,907 | 45.58 | 18.58 |
32 | Single Minor Chronic Disease Level - 2 | 41,173 | 0.88% | 258.48 | 10,642,397 | 43.19 | 19.23 |
4. Minor chronic disease in multiple Organ Systems | |||||||
41 | Minor Chronic Disease In Multiple Organ Systems Level - 1 | 90,903 | 1.95% | 339.85 | 30,893,385 | 55.72 | 15.69 |
42 | Minor Chronic Disease In Multiple Organ Systems Level - 2 | 25,3 | 0.54% | 515.28 | 130,366 | 61.58 | 13.52 |
43 | Minor Chronic Disease In Multiple Organ Systems Level - 3 | 34,801 | 0.75% | 520.02 | 18,097,216 | 57.91 | 15.38 |
44 | Minor Chronic Disease In Multiple Organ Systems Level - 4 | 5,204 | 0.11% | 704.89 | 3,668,248 | 59.07 | 14.99 |
5. Single dominant or moderate chronic disease | |||||||
51 | Single Dominant Or Moderate Chronic Disease Level - 1 | 484,232 | 10.40% | 528.68 | 256,003,774 | 54.76 | 21.09 |
52 | Single Dominant Or Moderate Chronic Disease Level - 2 | 135,731 | 2.92% | 739.94 | 100,432,796 | 54.37 | 22.66 |
53 | Single Dominant Or Moderate Chronic Disease Level - 3 | 39,795 | 0.86% | 1108.05 | 44,094,850 | 59.30 | 19.73 |
54 | Single Dominant Or Moderate Chronic Disease Level - 4 | 5,133 | 0.11% | 1061.65 | 5,449,449 | 63.83 | 21.39 |
55 | Single Dominant Or Moderate Chronic Disease Level - 5 | 9,556 | 0.21% | 1348.04 | 12,881,870 | 66.70 | 17.46 |
56 | Single Dominant Or Moderate Chronic Disease Level - 6 | 761 | 0.02% | 1961.34 | 1,492,580 | 51.56 | 18.79 |
6. Chronic disease in 2 or more Organ Systems | |||||||
61 | Significant Chronic Disease In Multiple Organ Systems Level - 1 | 217,363 | 4.67% | 994.26 | 216,115,336 | 66.93 | 15.42 |
62 | Significant Chronic Disease In Multiple Organ Systems Level - 2 | 93,125 | 2.00% | 1362.09 | 126,844,631 | 69.14 | 14.57 |
63 | Significant Chronic Disease In Multiple Organ Systems Level - 3 | 62,212 | 1.34% | 1567.73 | 97,531,619 | 70.90 | 13.95 |
64 | Significant Chronic Disease In Multiple Organ Systems Level - 4 | 40,647 | 0.87% | 1835.01 | 74,587,651 | 72.87 | 13.26 |
65 | Significant Chronic Disease In Multiple Organ Systems Level - 5 | 19,282 | 0.41% | 2074.03 | 39,991,446 | 75.06 | 13.02 |
66 | Significant Chronic Disease In Multiple Organ Systems Level - 6 | 2,259 | 0.05% | 2087.73 | 4,716,182 | 75.24 | 13.40 |
7. Dominant Chronic Disease in 3 or more Organ Systems | |||||||
71 | Dominant Chronic Disease In Three Or More Organ Systems Level - 1 | 7,202 | 0.15% | 1861.56 | 13,406,955 | 73.70 | 10.35 |
72 | Dominant Chronic Disease In Three Or More Organ Systems Level - 2 | 5,913 | 0.13% | 2159.61 | 12,769,774 | 74.88 | 10.54 |
73 | Dominant Chronic Disease In Three Or More Organ Systems Level - 3 | 12,577 | 0.27% | 2420.64 | 30,444,389 | 76.04 | 10.33 |
74 | Dominant Chronic Disease In Three Or More Organ Systems Level - 4 | 3,587 | 0.08% | 2677.64 | 9,604,695 | 77.33 | 9.95 |
75 | Dominant Chronic Disease In Three Or More Organ Systems Level - 5 | 2,694 | 0.06% | 2784.93 | 7,502,601 | 77.07 | 10.08 |
76 | Dominant Chronic Disease In Three Or More Organ Systems Level - 6 | 1,076 | 0.02% | 2528.73 | 2,720,913 | 76.05 | 10.06 |
8. Dominant and Metastatic Malignancies | |||||||
81 | Dominant, Metastatic, And Complicated Malignancies Level - 1 | 1,677 | 0.04% | 800.04 | 1,341,667 | 61.41 | 16.28 |
82 | Dominant, Metastatic, And Complicated Malignancies Level - 2 | 5,692 | 0.12% | 1223.61 | 6,964,788 | 62.59 | 16.67 |
83 | Dominant, Metastatic, And Complicated Malignancies Level - 3 | 6,419 | 0.14% | 1649.05 | 10,585,252 | 66.99 | 14.72 |
84 | Dominant, Metastatic, And Complicated Malignancies Level - 4 | 4,878 | 0.10% | 2021.68 | 9,861,755 | 69.61 | 13.66 |
85 | Dominant, Metastatic, And Complicated Malignancies Level - 5 | 1,389 | 0.03% | 2131.74 | 2,960,987 | 70.86 | 12.19 |
9. Catastrophic conditions | |||||||
91 | Catastrophic Conditions Level - 1 | 1,895 | 0.04% | 1632.93 | 3,094,402 | 44.83 | 22.15 |
92 | Catastrophic Conditions Level - 2 | 3,647 | 0.08% | 1164.40 | 4,246,567 | 46.30 | 16.97 |
93 | Catastrophic Conditions Level - 3 | 1,857 | 0.04% | 1944.29 | 3,610,547 | 53.82 | 19.86 |
94 | Catastrophic Conditions Level - 4 | 2,02 | 0.04% | 1949.96 | 393,892 | 52.68 | 16.77 |
95 | Catastrophic Conditions Level - 5 | 976 | 0.02% | 2244.09 | 2,190,232 | 63.49 | 16.67 |
96 | Catastrophic Conditions Level - 6 | 515 | 0.01% | 2368.46 | 1,219,757 | 65.04 | 16.37 |
Total | 4, 654, 362 | 100% | 298.71 | 1, 301, 898, 793 | 41. 32 | 23.07 |