Indian Health Program Summary of Drug Spend

April 21, 2015 Indian Health Program Summary of Drug Spend Monthly Summary of Claims and Member Utilization

Count of Sum of Claim Sum of Paid Year/Month Member ID Count Amt Pd/User Pd/Clm $ 2014 5774 10028 $ 210.00 $ 120.91 1,212,527.74 $ 1 400 719 $ 190.15 $ 105.79 76,061.71 $ 2 409 634 $ 166.94 $ 107.69 68,277.72 $ 3 469 763 $ 162.10 $ 99.64 76,026.19 $ 4 455 792 $ 169.72 $ 97.51 77,223.98 $ 5 482 864 $ 179.12 $ 99.92 86,333.83 $ 6 476 824 $ 263.66 $ 152.31 125,503.30 $ 7 491 906 $ 199.78 $ 108.27 98,089.81 $ 8 501 900 $ 392.82 $ 218.67 196,800.41 $ 9 540 915 $ 279.65 $ 165.04 151,011.91 $ 10 525 952 $ 183.25 $ 101.06 96,208.68 $ 11 490 849 $ 180.66 $ 104.27 88,522.20 $ 12 536 910 $ 135.20 $ 79.64 72,468.00 $ Grand Total 5774 10028 $ 210.00 $ 120.91 1,212,527.74 Top 25 Drugs by Claim Count

Drug Name Sum of Claim Count Sum of Amount Paid HYDROCODONE/ACETAMINOPHEN 1585 $31,842.79 OXYCODONE/ACETAMINOPHEN 766 $36,106.76 TRAMADOL HCL 359 $2,950.13 IBUPROFEN 344 $2,283.54 AMOXICILLIN 316 $2,590.75 GABAPENTIN 283 $5,630.82 OXYCODONE HCL 247 $10,330.37 ALPRAZOLAM 238 $1,582.64 AZITHROMYCIN 236 $3,974.75 ZOLPIDEM TARTRATE 207 $1,118.51 CYCLOBENZAPRINE HCL 200 $1,452.45 LISINOPRIL 196 $1,241.06 PREDNISONE 194 $1,132.02 MORPHINE SULFATE ER 191 $6,894.70 LORAZEPAM 184 $1,334.00 PROAIR HFA 173 $8,497.58 ONDANSETRON ODT 161 $2,428.33 TRAZODONE HCL 160 $1,021.64 LEVOTHYROXINE SODIUM 152 $1,628.32 MONTELUKAST SODIUM 141 $4,249.45 CLONAZEPAM 135 $763.09 CEPHALEXIN 132 $1,457.63 ONDANSETRON HCL 128 $1,928.47 METFORMIN HCL 124 $1,056.83 FLUOXETINE HCL 119 $782.06 Grand Total 6971 $134,278.69 Top 25 Drugs by Pharmacy Paid Amount

Drug Name Sum of Claim Count Sum of Amount Paid NEXAVAR 11 $120,556.74 SOVALDI 4 $114,259.04 OLYSIO 3 $67,701.48 AVONEX PEN 13 $61,203.74 ENBREL SURECLICK 18 $49,258.44 SABRIL 7 $47,461.14 ABILIFY 63 $46,583.27 OXYCODONE/ACETAMINOPHEN 766 $36,106.76 HYDROCODONE/ACETAMINOPHEN 1585 $31,842.79 ORENCIA 11 $29,294.00 LYRICA 85 $27,265.90 ABILIFY MAINTENA 14 $21,805.21 INTUNIV 48 $19,656.82 MODAFINIL 23 $19,309.56 LATUDA 29 $19,288.27 NOVOLOG FLEXPEN 43 $18,762.85 HUMIRA 9 $17,909.14 RISPERDAL CONSTA 14 $17,495.44 NEXIUM 69 $16,755.80 VYVANSE 74 $15,577.25 LANTUS SOLOSTAR 45 $12,954.21 LIDOCAINE 68 $12,554.03 DULOXETINE HCL 112 $12,494.86 ADVAIR DISKUS 43 $11,582.36 LANTUS 26 $11,506.91 Grand Total 3183 $859,186.01 Top 25 Drug Classes by Claim Count

Drug Class Sum of Claim Count Sum of Amount Paid ANALGESICS, NARCOTICS 3411 $112,012.82 ANTICONVULSANTS 977 $133,917.88 NSAIDS, CYCLOOXYGENASE INHIBITOR - TYPE 610 $6,074.98 ANTI-ANXIETY DRUGS 538 $3,741.09 PENICILLINS 480 $7,457.95 SKELETAL MUSCLE RELAXANTS 470 $7,961.04 SELECTIVE SEROTONIN REUPTAKE INHIBITOR (SSRIS) 409 $3,504.54 BETA-ADRENERGIC AGENTS 367 $16,944.70 ANTIEMETIC/ANTIVERTIGO AGENTS 332 $6,144.29 GLUCOCORTICOIDS 314 $2,847.48 INSULINS 280 $93,003.82 SEDATIVE-HYPNOTICS,NON-BARBITURATE 261 $2,743.90 MACROLIDES 252 $4,694.27 ANTIPSYCHOTICS,ATYPICAL,DOPAMINE,& SEROTONIN ANTAG 233 $53,284.94 ANTIHYPERLIPIDEMIC - HMG COA REDUCTASE INHIBITORS 219 $2,033.32 ANTIHYPERTENSIVES, ACE INHIBITORS 211 $1,304.15 ANTIHISTAMINES - 1ST GENERATION 205 $2,610.52 CALCIUM CHANNEL BLOCKING AGENTS 195 $2,481.71 BETA-ADRENERGIC BLOCKING AGENTS 194 $2,466.07 SEROTONIN-NOREPINEPHRINE REUPTAKE-INHIB (SNRIS) 171 $21,752.83 ANTIHYPERTENSIVES, SYMPATHOLYTIC 170 $1,671.10 THYROID HORMONES 162 $1,896.28 CONTRACEPTIVES,ORAL 161 $7,892.10 SEROTONIN-2 ANTAGONIST/REUPTAKE INHIBITORS (SARIS) 160 $1,021.64 ANTIHISTAMINES - 2ND GENERATION 156 $1,022.68 Grand Total 10938 $500,486.10 Top 25 Drug Classes by Pharmacy Paid Amount

Drug Class Sum of Claim Count Sum of Amount Paid ANTICONVULSANTS 977 $133,917.88 ANTINEOPLASTIC SYSTEMIC ENZYME INHIBITORS 11 $120,556.74 HEP C VIRUS,NUCLEOTIDE ANALOG NS5B POLYMERASE INH 4 $114,259.04 ANALGESICS, NARCOTICS 3411 $112,012.82 INSULINS 280 $93,003.82 ANTI-INFLAMMATORY TUMOR NECROSIS FACTOR INHIBITOR 45 $92,123.84 ANTIPSYCHOTICS, ATYP, D2 PARTIAL AGONIST/5HT MIXED 77 $68,388.48 HEPATITIS C VIRUS NS3/4A SERINE PROTEASE INHIB. 3 $67,701.48 AGENTS TO TREAT MULTIPLE SCLEROSIS 13 $61,203.74 ANTIPSYCHOTICS,ATYPICAL,DOPAMINE,& SEROTONIN ANTAG 233 $53,284.94 ANTINFLAMMATORY, SEL.COSTIM.MOD.,T-CELL INHIBITOR 11 $29,294.00 ADRENERGICS, AROMATIC, NON-CATECHOLAMINE 130 $23,237.86 SEROTONIN-NOREPINEPHRINE REUPTAKE-INHIB (SNRIS) 171 $21,752.83 PROTON-PUMP INHIBITORS 143 $20,264.22 TX FOR ADHD - SELECTIVE ALPHA-2 RECEPTOR AGONIST 48 $19,656.82 NARCOLEPSY AND SLEEP DISORDER THERAPY AGENTS 23 $19,309.56 BETA-ADRENERGIC AND GLUCOCORTICOID COMBINATIONS 70 $18,908.38 ANTIMIGRAINE PREPARATIONS 103 $18,041.13 BETA-ADRENERGIC AGENTS 367 $16,944.70 TX FOR ATTENTION DEFICIT-HYPERACT(ADHD)/NARCOLEPSY 91 $15,290.61 GENERAL BRONCHODILATOR AGENTS 58 $15,238.95 GLUCOCORTICOIDS, ORALLY INHALED 72 $12,583.71 TOPICAL LOCAL ANESTHETICS 71 $12,581.05 RIFAMYCINS AND RELATED DERIVATIVE ANTIBIOTICS 8 $10,183.52 IMMUNOSUPPRESSIVES 51 $10,140.11 Grand Total 6471 $1,179,880.23