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Semi Annual Delaware Prescription Assistance Program Report
January to June 2005


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Executive Summary

Overview

The Delaware Prescription Assistance Program (DPAP) began on January 14, 2000 through the passage of Senate Bill 6, during the 1999 legislative session. DPAP is paid for with tobacco settlement funds through the Delaware Health Fund. The program provides up to $2,500 per person, per State fiscal year for prescription assistance to qualified Delaware citizens who are over 65 years old and those under 65 years with disabilities. The Division of Medicaid & Medical Assistance (DMMA) contracts with Electronic Data Systems (EDS), the Delaware Medical Assistance Program (DMAP) fiscal agent, to conduct outreach, manage the application process, determine eligibility, and pay the prescription drug claims submitted from participating pharmacies.

DPAP leverages the existing Department of Health and Social Services (DHSS) pharmacy provider network. Pharmacy providers servicing other DHSS clients also submit claims for DPAP clients. All of the major chains and independent pharmacies in the state are enrolled as DHSS providers. The claims are submitted electronically in a real-time processing environment. Eligibility and medication coverage is verified and the pharmacies are notified within seconds of the claim status (paid or denied). These drug claims are also subject to all DMAP processing edits, audits, and Drug Utilization Review (DUR) alerts. See page 19 for more details.

As of June 30, 2005, the program had 7,369 members statewide, which includes 16% in Kent County, 54% in New Castle County, and 30% in Sussex County. These percentages remain consistent for the distribution of members over the last year. Of the 1,333 new applications received during the first half of 2005, approximately 71% were approved. Of the 29% that were denied coverage, 42% were because of incomplete applications and 37% were denied because they were Nemours eligible, above income, or were enrolled in Medicaid. The remaining 21% were denied because they had other prescription coverage, or were not yet 65 years of age or receiving Social Security Disability Income (SSDI).

There are clients enrolled in the program under the eligibility provision of having prescription costs that exceed 40% of their annual income. As these clients represent less than one-half of one percent of the population, these clients are not included in the program analysis.

From January to June 2005, DPAP provided 134,827 prescriptions at a total cost of $4,108,767. State DPAP funds were used to fill an average of 4.07 prescriptions per member, per month. There was an average monthly cost to the client for those 4.07 prescriptions of $55.29, representing their co-payment.

The percentage of members using their benefit has increased steadily over the life of the program, from 58% during the first six months of its inception, to its current level of 78%. This represents a 3% decrease over the prior six months. A total of $1,460,695 was received for DPAP in the last six months in drug rebate dollars from the drug manufacturers participating in the State Drug Rebate Program. A total of $5,985,026 has been received in DPAP drug rebate dollars since the program's inception.

The Drug Utilization Review process, mandated by the Federal government to ensure safe, appropriate, and efficient pharmaceutical coverage for DMAP clients, was applied both prospectively and retrospectively to all the DPAP prescriptions. DUR activities have included physician notifications and the addition of new drugs to prior authorization. The same clinical alerts generated under the Delaware Medical Assistance Program were applied to DPAP.

Enrollment Criteria

To be qualified for the Delaware Prescription Assistance Program, the applicant must meet all the following criteria:

  • Applicant must be a resident of the State of Delaware
  • Applicant must be at least 65 years of age, or qualify for SSDI benefits
  • Applicant must meet the income guidelines (200% of the federal poverty level) or have prescription costs that exceed 40% of his or her annual income
  • Must submit proof of income and/or SSDI benefits
  • Applicant must not have or be eligible for prescription coverage through Federal, State, or private sources regardless of any annual limitations to the benefits

There are several ways a client can enroll into DPAP: by phone (1-800-996-9969 option 2), by picking up an application (at any of the locations listed on page 10), or online at www.state.de.us/inscom/pillbill.htm .

During the Spring of 2005, the usual re-enrollment process was not conducted. In preparation for Medicare Part D and the changes that will be required of the DPAP program as a result, all DPAP clients were auto-enrolled for July-December of 2005 with a benefit limit of $2,500.

Benefit Coverage

The usual re-enrollment period that normally occurs during the months of April, May and June was changed this year to an auto enrollment for all clients who were eligible for benefits on 6-30-05. In order to align the DPAP enrollment period with the Medicare Prescription Drug Program, the DPAP benefit year was changed to a calendar year.

This was done in preparation for The Medicare Prescription Drug Program that will begin on January 1, 2006.

The Delaware Prescription Assistance Program has a full benefit coverage with a few limitations. Brand name drugs are covered only when there is no generic equivalent or in cases where verification of medical necessity for the brand name drug is provided by the prescribing practitioner.

The program covers medically necessary drugs manufactured by companies that agree to pay the State a rebate for the right to participate. Drug manufacturers provide a rebate to the State, based on the units of each drug that have been dispensed to DPAP clients. For each unit in which the DPAP program reimburses the pharmacy, the drug manufacturer pays a rebate to the State at a percentage of the drug cost or unit rebate amount. The rebate program assists the State in obtaining the best prices for the covered drugs, and is modeled after the federal drug rebate program operated by the Centers for Medicare and Medicaid Services (CMS). The EDS rebate analyst and the pharmacist consultant actively monitor rebate participation.

Effective April 1, 2005, the DMMA of Delaware began using a Preferred Drug List (PDL). The PDL must be used by doctors when prescribing medication.

This list is a selection of drugs that are therapeutically effective while at the same time less expensive. The list has been created through periodic meetings of the Pharmaceutical and Therapeutics Committee and will continue to grow until it is complete. Once the list has been completed, it will be reviewed annually in order to remain current with the latest research, national guidelines and changes in available medications.

DPAP does not pay for any of the drugs covered by Medicare, including diabetic supplies. Medicare currently covers these supplies for both insulin and non-insulin dependent patients. By encouraging the use of Medicare, DPAP dollars are saved for future use on non-Medicare covered pharmaceuticals.

Clients must make a co-pay of $5 or 25% of the cost of the prescription, whichever is greater. The co-pay is collected by the dispensing pharmacy. A total of $1,831,637 was collected in co-payment during January to June 2005.

The co-payments represent 45% of the State's drug expenditures for this period. The DPAP rebates collected for this program represented 36% of the drug cost for January to June 2005. These offsets saved the State a total of $3,292,332 for the first six months of 2005.

Details on the program's demographics, outreach, and financials follow.

Demographics

The Delaware Prescription Assistance Program enrollment began on January 14, 2000. As of June 30, 2005, there were 7,369 clients enrolled in the program. The program continues to add to its numbers each year.

Graph of report demographics

Enrollment by Eligibility Category

DPAP enrolls senior citizens who are 65 years of age or older, and individuals with disabilities who are receiving Social Security Disability benefits under Title II of the Social Security Act. Both eligible categories must have an income equal to or less than 200% of the Federal Poverty Level. The chart below shows the distribution of members by eligibility category. As of June 30, 2005, there were 3,639 seniors, 3,709 individuals with disabilities, and 21 individuals with income above 200% of the Federal Poverty Limit enrolled into the DPAP program. The chart below represents the average new enrollments across the previous six months.

Graph of open enrollment by category

County

As of June 30, 2005, 1,238 enrollees were from Kent County, 2,184 from Sussex County, and 3,947 from New Castle County. The percent of enrollees from each county is reflected in the adjacent chart. These percentages remain consistent with previous reporting periods.

Graph of open enrollment by county

Race

Reporting membership by race is complex because not all clients are willing to specify race and ethnicity. Based on those clients who selected a race category from the list provided, the racial composition of clients enrolled in the program is: 4,762 Caucasian, 1,213 African American, 863 Hispanic, 5 Native American, 18 Asian, and a total of 508 unspecified. The chart below shows the corresponding percentages of clients that have enrolled into the program in the past six months. Those who reported their race/ethnicity as either Native American or Asian represent less than 1% of the total population and are not represented below.

Graph of open enrollment by race

Gender

Since the start of the program, women have outnumbered men. Of the total clients enrolling in the program between January and June 2005, 592 were females and 347 were male. The total percentage of all enrollees is reflected in the adjacent chart.

Graph of open enrollment by gender

Applications Received

For State fiscal year 2005, 2,907 new applications were processed. This is an average of 242 applications reviewed per month. This is a decrease of 745 new applications over State fiscal year 2004. This trend shows the number of new applicants is leveling off. Although the number of applicants is leveling off, the program continues to grow. The continued growth of the program indicates that the it is retaining a large portion of its members through the annual re-enrollment process. The chart below reflects the comparison of applications processed for the last three State fiscal years.

Graph of applications received

Applications Approved

For the second half of State Fiscal Year 2005, DPAP approved 939 applications. The graph below details the number of applications approved over the last three State Fiscal years. The number of applications approved from January to June of 2005 remains consistent with the number of applications approved in previous years.

Graph of applications approved

Applications Denied

The primary purpose of the program is to provide prescription coverage to lower income seniors, age 65 and older, and individuals with disabilities, or those who are receiving Social Security Disability Income (SSDI) benefits. Therefore, those applicants who are not receiving SSDI or are not over 65 years of age, and whose income is not within the program guidelines, are denied coverage. For the last six months of State Fiscal Year 2005, 29% of the applications received were denied. Of those, 42% were denied due to incomplete applications and 37% were denied because they were Nemours eligible, above income, or were enrolled in Medicaid. The chart below details the application denials and the number of applications denied for each reason. There were 4 applications denied, as their prescription costs were less than 40% of their income. This represents less than one percent of the denials and is not included in the chart below.

Graph of applications denied

Phone Lines

Monthly Phone Calls

The Delaware Prescription Assistance Program successfully handled a monthly average of 1,769 incoming calls between January and June of 2005. Calls were answered in an average of 20 seconds with an average abandoned call rate of 4 percent. Calls focused on enrollment, re-enrollment, and eligibility questions. Call volume increases started in January due to the implementation of DUR+ and continued due to the unique re-enrollment activities. Calls also increased due to the emergence of information about Medicare Part D. Call volume is expected to be higher than average for the remainder of 2005 as DPAP clients are further exposed to the Medicare Part D program.

Graph of phone lines

The DPAP program received a total of 10,614 calls during the January to June 2005 time period. During the previous six-month period, July to December 2004, 5,391 calls were received. For the same period last year, January 2004 to June 2004, the call volume was 6,816. Compared to the January to June period last year, the call volume increased by 3,798 calls. This was due to the implementation of several clinical initiatives and the cancellation (or automation) of the re-enrollment process for the first half of the fiscal year.

Outreach Activities

DPAP outreach activities have engaged government, public, and medical professionals throughout Delaware. Outreach channels have consisted of advertising, information dissemination, special events, and application assistance opportunities. Continuous areas of focus have included senior citizen centers, State Service Centers, community mental health facilities, and all pharmacies in the state. There was special attention given to Kent County between January and June of 2005. Kent County continues to have the lowest participation rate of all counties. Large, colorful, informational posters with the DPAP toll free number were delivered to various appropriate sites for display.

Application Distribution

From January to June 2005, over 4,500 applications were distributed through community contacts and training sessions. Applications were distributed to all of the pharmacies in the state, State Service Centers, hospitals, and other locations. (A list of community locations where applications can be obtained is on page 10). The pharmacy community has been supportive in identifying potential clients for the program. Clients in the program use 195 pharmacies across Delaware to obtain their prescriptions.

The chart below shows applicants' responses regarding how they heard about DPAP from January to June 2005.

Graph of how applications were distributed

*Grapevine is noted as a referral source when a caller identifies that they have heard about the program through a friend, family member, the phone book, the Internet, or when the client has previously applied.

Special Events

The Delaware Prescription Assistance Program leveraged several well-publicized health care events to promote the program. Hundreds of individuals were introduced to the program at these events. The DPAP team participated in joint programs with other agencies and their clients throughout the last six months. Some of these special events are summarized below. At these events, 217 applications were distributed.

Special Events Summary
Event Number of Attendees Date
Claymore Senior Center Fitness Health Fair 45 April 2005
Christian Growth Ministries Health Fair 60 May 2005
Claymont Community Health Fair 50 May 2005
National Women's Health Fair 100 May 2005
Brandywine School District Fair 200 June 2005
Modern Maturity Center Medicare Road Show 50 June 2005
Georgetown Community Center Medicare Road Show 40 June 2005

Additional locations where presentations were made on DPAP eligibility and enrollment:

  • People's Settlement - Enterprise Community
  • Delaware Helpline
  • ELDERinfo

DPAP Information Distributed January - June 2005

The list below shows many of the diverse locations where DPAP information and applications were distributed in the past six months. Over 4,350 applications were distributed to these facilities.

Provider/Hospital/RX

  • Riverside Medical Complex
  • Christiana Care

Community Centers and Residential Locations

  • Hope 6 Program/Wilmington Housing Authority
  • Catholic Charities
  • Silver Lake Center
  • Westminster Village
  • Green Meadows Center
  • Milford Senior Center

Businesses

  • Home Health Corporation of America
  • Alzheimer's Association
  • Acme Information Center
  • Super Fresh Information Center

State/Government Agencies

  • State office of Volunteerism
  • State Service Centers-Statewide

Financials

From January 1 to June 30, 2005, the Delaware Prescription Assistance Program provided 134,827 prescriptions for an average of 7,086* clients at a cost of $4,108,767.

It is important to note that there is a small percentage of clients enrolled in DPAP under the eligibility provision of having prescription costs that exceed 40% of their annual income. They are less than 1% of the total program and are therefore not represented in the following financial analyses.

Paid Amount

Between January and June of 2005, the average monthly amount paid in DPAP prescriptions was $684,794. For the same time period last year (January to June 2004), the average amount paid per month in prescriptions was $635,190. This is an average monthly increase of $49,604 or 8%.

The aged and disabled, since the start of the program, continue to remain close in the dollars spent. This graph represents the actual dollars spent by month for the first half of 2005.

Graph of paid amount

*For a complete breakdown by month refer to Appendix A.

Program Expenditures

The following chart depicts the growth in monthly expenditures since the program's inception. It should be noted that the statistics for SFY 2000 are based on six months worth of expenditures. There has been a steady increase in the annual cost of the program, attributed to the increase in the cost of prescription drugs, the increase in enrolled clients, and an increase in the usage of the benefit. There has been a 14.0% increase in expenditures over the last State Fiscal Year while the number of clients enrolled has increased by 11.7%.

Graph of program expenditures

Number of Prescriptions

From January to June 2005, the average number of prescriptions filled in a month was 22,471, an average increase of 2834 prescriptions per month compared to the same period last year.

Graph of number of prescriptions

Overall, the number of prescriptions filled by eligibility category was very similar between the individuals with disabilities and the elderly. This has been a consistent trend over the life of the program. The graph below illustrates the individual monthly counts by aid category.

Graph #2 of number of prescriptions

Percentage of Clients Using Benefits

On a monthly average, between January and June, 78%* of the clients used their benefit during the month. This average has decreased over the previous six-month period by 2%. The average number of clients using their benefits in the past six months is almost identical to the prior six-month period.

Graph of number of clients using benefits
See Appendix A.

Average Number of Prescriptions Per Client Per Month

The number of prescriptions filled per member per month has decreased slightly over the past six-month period. From January to June 2005, the average number of prescriptions for each DPAP member was 4.07 per month compared with 4.13 in the previous six months. The average number of prescriptions per month, by eligibility category, is noted in the chart below. While slightly more aged clients use their benefit, the disabled population on average receives a greater number of prescriptions each month.

Graph of number of average number of prescriptions

filled per client per month

Average Cost Per Prescription

The following statistics are calculated on the number of clients that sued their benefit in the month indicated. In general, the average cost per prescription was consistent between the elderly and the individuals with disabilities. During this period, the average cost to the program per prescription was $30.45. There was an average decrease of $5.19 per prescription compared to the previous six months, and a $3.26 decrease this year compared to the same time last year (January to June 2004). The DSS cost per prescription decreases as clients exhaust their $2,500 benefit. When the full $2,500 is expended, the remaining balance of the cost of the prescription is added to the client's co-payment. As a the population of clients above 200% of FPL relatively small, changes in their usage translates into a dramatic change as represented in the graph below.

Graph of number of average cost per prescription

Per Member Per Month Cost

The average cost per member per month for the program remains similar between the two eligibility categories. The calculation per member per month uses all eligible clients as a denominator. From January to June, the average cost was $96.97 per member per month. This is a $0.51 a month increase in costs per member in comparison to last year at this same time (January to June 2004). The per member per month cost is consistently higher in the second half of the calendar year over the first half. The chart below shows the monthly average cost per member by eligibility category. These costs represent the State's dollars and do not include the clients' co-payments.

Graph of cost per member per month

The overall amount paid per member per month has increased 1.7% over the previous State Fiscal Year. Therefore, the program has seen an overall increase in prescription expenditures of $1,108,068 this year compared to the amount spent during State Fiscal Year 2004. This is due to the increase in members over the past year. The chart below is a summary of expenditures during life of the program.

table of cost per member per month

*Annualized 12 month average of enrolled clients.

Member Expenditure

Benefit Dollars Spent

The $2,500 annual limit accommodates most members as noted in the benefit expenditure chart below. Compared to the same period last year, there was little change in how much of their benefit dollars clients used.

Out of the 7,369 clients enrolled in DPAP during the past 12 months:

  • 99.4% of clients have used some portion of their benefits.
  • 13.4% of the clients used all their benefit dollars.
  • 51.2% of the clients used up to half of their benefit dollars.
  • 42.1% of the clients used between $100 and $1000.
  • 0.6% have not used any of the DPAP benefits.
Graph of benefit dollars spent

Drug Expenditure by Category

DPAP spent 82% of the prescription drug dollars on the ten categories listed below. This percentage increased by 1% over the previous six months and the same period last year. Most categories represent treatment for chronic illnesses that would be expected with either the elderly or individuals with disabilities.

Graph of drug expenditure by category

Number of Prescriptions by Category

The top ten therapeutic classes account for 74% of the drugs that are filled through DPAP. This represents a 4% increase in use of the top ten drugs over the previous six-month period.

Graph of number of prescriptions by category

Drug Utilization Review

All prescriptions that are filled for DPAP clients are automatically reviewed for clinical appropriateness. This process is called Drug Utilization Review (DUR). There are two types of DUR: prospective and retrospective. Prospective DUR alerts the dispensing pharmacist before the prescription is filled. Retrospective analysis looks at prescription use over a long period of time. The DUR processes optimize medical and pharmaceutical care by reviewing the therapy of its recipients who are using prescription drugs. The DUR Board identifies criteria used. The Board consists of physicians, pharmacists, and an advanced practice nurse.

Prospective Drug Utilization Review

Pharmacists submit claims electronically in a real-time environment, called the Point Of Service (POS) system. Eligibility and medication coverage is verified and the pharmacies are notified within seconds of the claim status.

Graph of prospective drug utilization (POS)

Between January and June of 2005, 90% of all prescription claims submitted were filled. Twenty-seven percent or 33,417 generated a clinical concern or an alert as depicted in the chart below. Of the alerts, 33% were not filled, and 67% were overridden and filled, as depicted in the chart to the left. When faced with a clinical concern from the POS system, pharmacists take appropriate action, which can entail using their professional judgment, contacting the physician, or simply talking to the patient. The prescriptions that were not filled may be related to a minor issue, such as it being too early for a refill. Major issues also arise, and are carefully screened by the appropriate medical professionals. The chart on the preceding page details the number of prescriptions filled during the past 6 months as well as the number of prescriptions that were flagged for clinical concern and how many of those prescriptions were filled.

Graph of prospective drug utilization

Retrospective Drug Utilization Review

A retrospective drug utilization review allows for an evaluation of drug usage over a long span of time, generally six months to a year. EDS contracts with Heritage Information Systems, Inc. for the retrospective drug utilization review. This type of review can alert practitioners to problems that may not be apparent at client pharmacy visits or upon renewal of a prescription. Exceptions are identified when a patient's therapy falls outside established guidelines.

The Retrospective Drug Utilization Review for the State Fiscal Year 2005, concentrated on Underutilization of Lipid Lowering Agents. The purpose of this review was to analyze medical and prescription claim data to determine opportunities for improving coronary heart disease (CHD) prevention with lifestyle modifications and lipid lowering drug therapies, following NCEP guidelines and cost considerations.

Patients , males 45 and older and females 55 and older, were selected with CHD or CHD risk equivalent factors, including myocardial infraction, angina, coronary artery bypass graft, and diabetes, with a positive smoking history, and diagnosis of hypertension.

The intervention included a cover letter, individual patient profiles, and NCEP guidelines regarding the underutilization of lipid lowering agents. A six-month outcome assessment was performed in May 2005. The DMMA Retrospective Drug Utilization Review Intervention Outcome involved the data collected through the Underutilization of Lipid Lowering Agents Intervention. Letters were mailed in October, 2004 to 261 prescribers, and addressed an adjusted target population of 228 clients. These clients were continuously enrolled in a DMMA program and had prescription claims during the last 90 days of the last 6 months. The intervention dealt with primary prevention only and involved patients with two risk factors for cardiovascular disease. The patients were not receiving lipid lowering agents in the last year prior to the mailing. Patients were excluded if they had a lipid panel performed in the last year or if they had a contraindication to an HMG CoA Reductase Inhibitor. There was approximately a 4% difference in underutilization of the target group and control group which resulted in an increase in expenditures of $2, 311 over the 6 month intervention period. At the time of the intervention, 91 clients were enrolled in the DPAP.

In Summary

The January to June time period continued to show an increase in the number of applications made to the program. This resulted in a rise in the eligible population and in program utilization.

Program expenditures continued to increase as seen in the chart on page 13. Since January of 2001, per member per month costs, average cost of prescription, and total program expenditures were higher in the first half of the fiscal year. In part, this may be attributed to a new benefit year where clients are not reaching their benefit limit. Delaware Health and Social Services continues to review cost containment policies.

In January, 2005 DMMA implemented DUR+, an automated prior authorization/drug utilization review program that included four different initiatives: dose optimization, step therapy, duplicate therapy and quantity limitations. The dose optimization initiative involved over 60 different medications. The duplicate therapy initiative involved six different classes of medications. The Step therapy initiative involved two different classes of medications. The quantity limit initiative involved eight classes of medications and set an allowed amount of fifteen different medications per client without the restriction of prior authorization.

Effective April 1, 2005, a preferred drug list (PDL) was put into effect. A PDL includes selected brand name drugs that are considered preferred because of their overall ability to meet patient needs. The Pharmaceutical & Therapeutics Committee (P&T Committee), consisting of Delaware clinicians, reviews information on each drug and makes recommendations regarding what drugs to place on the PDL. The final decision for determination of the PDL remains with the State Division of Medicaid and Medical Assistance (DMMA). Non-Preferred drugs are available with prior authorization. Physicians must provide documentation supporting why the preferred product can not be used.

Client enrollment has almost tripled in the four years since DPAP's inception. The program continues to be successful, helping Delawareans in need and without prescription coverage, as evidenced by the continued increase in client interest and enrollments. This program provides assistance to part of our most vulnerable population, the elderly and the disabled. It provides important and necessary medications that might not otherwise be utilized. As much of the program expenditures represent treatment for chronic illnesses expected with this population, the quality and quantity of life is improved and healthcare costs related to these illnesses are reduced.

Appendix A

Summary of Expenditures During the Life of the Program
Month Total Eligible Clients Who Used Benefit % of Clients Using Benefit Claim Count Claim Paid Amount Claim Dollar By Total Eligible Average $ Per Prescription Average Number Of Prescription Per Client
July 5,481 4,550 83.00% 16,857 $581,988.14 $106.45 $34.56 3.72
August 5,854 4,957 84.70% 22,996 $827,439.33 $414.83 $36.03 4.66
September 6,122 4,890 79.82% 18,830 $680,601.00 $111.41 $36.15 3.87
October 6,292 5,036 80.05% 20,306 $761,212.96 $121.20 $37.50 4.05
November 6,458 5,203 80.58% 23,331 $821,550.53 $127.46 $35.22 4.50
December 6,594 5,182 78.60% 20,713 $711,733.44 $108.09 $34.37 4.01
January 6,757 5,454 80.71% 25,307 $849,331.42 $125.69 $33.56 4.64
February 6,890 5,241 76.06% 20,396 $643,552.83 $93.40 $31.54 3.89
March 7,025 5,435 77.36% 21,120 $658,362.31 $93.71 $31.17 3.88
April 7,183 5,512 76.73% 21,305 $652,741.51 $90.87 $30.63 3.86
May 7,289 5,840 80.12% 25,551 $727,468.65 $99.80 $28.47 4.37
June 7,369 5,606 76.07% 21,146 $577,310.20 $78.34 $27.30 3.77
Annual Totals 79,314 62,906 953.78% 257,860 $8,493,292.32 $1,298.25 $396.50 49.21
Annualized Monthly Average 6,610 5,242 79.48% 21,488 $707,774.36 $108.19 $33.04 4.10

The date for Appendix A is reported from the DURR290V in the MMIS

Contact Information

Please direct any questions or comments about this report to the EDS Claims Manager who is available at 302-454-7622 or at:

EDS Claims Manager
248 Chapman Road, Suite 100
Newark, Delaware 19702



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