EPIC Program Annual Data Tables 2003-2004: Tables IV-A and IV-B

Table IV-A
Claims, Expenditures and Revenue by Program Year^*

Description	Category	Fifthteenth (2001-2002)	Sixteenth (2002-2003)	Seventeenth (2003-2004)
Net State Cost= (Expenditures-Revenue)		$325,049,682	$398,450,931	$486,550,971
Number of Claims	Co-payment	7,920,399	9,131,797	9,919,891
	Deductible	638,208	810,150	854,094
	Total Claims	8,558,607	9,941,947	10,773,985
Expenditures	Total Cost of Drugs	$588,817,853	$734,758,484	$892,398,354
	less Third Party Payments**	$0	$0	$28,001,001
	less Participant Co-payments	$93,838,144	$110,315,610	$119,881,862
	less Deductible Payments	$34,575,600	$44,520,955	$49,573,370
	Total EPIC Expenditures	$460,404,109	$579,921,919	$694,942,121
Less Revenue	Manufacturers' Rebates***	$116,396,192	$159,650,887	$184,095,071
	plus Participant Fees	$18,958,235	$21,820,101	$22,117,521
	plus Claim Recovery****	$0	$0	$2,178,558
	Total Revenue	$135,354,427	$181,470,988	$208,391,150

^* Table IV-A represents Claims, Expenditures and Revenue by Program Year up to October 2003-September 2004.

^** Total Third Party Payments from Medicare drug discount cards and other insurers.

^*** Manufacturers' rebates were calculated on an accrual basis from April 1991-September 2003 and on a cash basis from October 2003-present.

^**** Retroactive Third Party Claim recoveries from Medicare and other insurers.

Table IV-B
Payment and Utilization by Program Year^*

Paid Claims	Fifthteenth (2001-2002)	Sixteenth (2002-2003)	Seventeenth (2003-2004)
Average EPIC Payment per Claim	$53.79	$58.33	$64.50
Average Deductible Payment per Claim	$54.18	$54.95	$58.04
Average Participant Co-payment per Claim	$11.85	$12.08	$12.09
Average Third Party Payment** per Claim	$0	$0	$2.60
Average Total Cost per Claim	$68.80	$73.90	$82.83
Number of Participants Reaching Deductible	$33,038	47,528	59,981
Number of Participants Reaching Copay limit	$26,788	30,566	37,813

^* Table IV-B represents Payment and Utilization by program year up to October 2003-September 2004.

^** Total Third Party Payments from Medicare drug discount cards and other insurers.