HRF_601_1_3: Statistical Data - by State - QLD
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Effective date: 1 January 2024
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Australian Business Number
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Institution Name
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Reporting Period
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Scale Factor
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Quarterly
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Whole dollars to two decimal places
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Reporting Consolidation
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Health Benefits Fund
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Part 1 Policies and insured persons
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Single
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Family
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Single parent
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Couple
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2+ persons no adults
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3+ adults
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Total
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(1)
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(2)
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(3)
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(4)
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(5)
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(6)
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(7)
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1. Total hospital treatment (includes hospital treatment only and
hospital treatment and general treatment combined)
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1.1. Policies
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1.1.1. Exclusionary policies
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1.1.1.1. Excess & co-payments
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1.1.1.2. No excess & no co-payments
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1.1.1.3. Total exclusionary policies
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1.1.2. Non-exclusionary policies
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1.1.2.1. Excess & co-payments
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1.1.2.2. No excess & no co-payments
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1.1.2.3. Total non-exclusionary policies
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1.2. Total policies
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1.3. Insured persons
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1.3.1. Exclusionary policies
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1.3.1.1. Excess & co-payments
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1.3.1.2. No excess & no co-payments
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1.3.1.3. Total exclusionary policies
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1.3.2. Non-exclusionary policies
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1.3.2.1. Excess & co-payments
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1.3.2.2. No excess & no co-payments
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1.3.2.3. Total non-exclusionary policies
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1.4. Total insured persons
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2. Hospital treatment only
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2.1. Policies
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2.1.1. Exclusionary policies
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2.1.1.1. Excess & co-payments
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2.1.1.2. No excess & no co-payments
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2.1.1.3. Total exclusionary policies
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2.1.2. Non-exclusionary policies
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2.1.2.1. Excess & co-payments
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2.1.2.2. No excess & no co-payments
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2.1.2.3. Total non-exclusionary policies
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2.2. Total policies
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2.3. Insured persons
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2.3.1. Exclusionary policies
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2.3.1.1. Excess & co-payments
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2.3.1.2. No excess & no co-payments
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2.3.1.3. Total exclusionary policies
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2.3.2. Non-exclusionary policies
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2.3.2.1. Excess & co-payments
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2.3.2.2. No excess & no co-payments
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2.3.2.3. Total non-exclusionary policies
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2.4. Total insured persons
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3. Hospital treatment and general treatment combined
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3.1. Policies
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3.1.1. Exclusionary policies
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3.1.1.1. Excess & co-payments
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3.1.1.2. No excess & no co-payments
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3.1.1.3. Total exclusionary policies
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3.1.2. Non-exclusionary policies
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3.1.2.1. Excess & co-payments
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3.1.2.2. No excess & no co-payments
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3.1.2.3. Total non-exclusionary policies
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3.2. Total policies
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3.3. Insured persons
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3.3.1. Exclusionary policies
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3.3.1.1. Excess & co-payments
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3.3.1.2. No excess & no co-payments
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3.3.1.3. Total exclusionary policies
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3.3.2. Non-exclusionary policies
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3.3.2.1. Excess & co-payments
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3.3.2.2. No excess & no co-payments
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3.3.2.3. Total non-exclusionary policies
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3.4. Total insured persons
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4. General treatment ambulance only
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4.1.1. Policies
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4.1.2. Insured persons
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5. Total general treatment only
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5.1.1. Policies
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5.1.2. Insured persons
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6. General treatment excluding hospital-substitute, CDMP and
hospital-linked ambulance treatment
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6.1.1. Policies
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6.1.2. Insured persons
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7. Total general treatment
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7.1.1. Policies
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7.1.2. Insured persons
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Changes during the quarter
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Hospital treatment only
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Hospital treatment and general treatment
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General treatment only
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Policies
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Insured persons
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Policies
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Insured persons
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Policies
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Insured persons
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(1)
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(2)
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(3)
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(4)
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(5)
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(6)
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8. Start of quarter
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9. New policies/persons
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10. Transferring from another state
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11. Transferring to another state
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12.
Transferring from another
fund
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13. Transferring from another policy
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14. Transferring to another policy
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15. Discontinued
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16. End of quarter
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Part 2 Total benefits paid for hospital treatment and
hospital-substitute treatment
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Total benefits for hospital treatment and hospital-substitute
treatment
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Episodes
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Days
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Benefits paid
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(1)
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(2)
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(3)
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17. Day hospital
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18. Public hospitals
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18.1. Day only
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18.2. Overnight
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19. Private hospitals
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19.1. Day only
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19.2. Overnight
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20. Hospital-substitute day only
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21. Treatment greater than one day
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22. Total
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23. Nursing home type patients
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23.1. Public hospitals
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23.2. Private hospitals
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23.3. Total nursing home type patients
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Number
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Benefits paid
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(1)
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(2)
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24. Medical benefits
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25. Medical devices or human tissue products benefits
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26. Total Chronic Disease Management Programs
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Benefits paid
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27. Total benefits paid for general treatment
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28. Ineligible hospital benefits
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29. Total benefits paid for hospital treatment and general treatment
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High Cost Claimants Pool
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30. Number of HCCP claimants (current quarter)
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31. Gross benefits for current and preceding 3 quarters (for current
quarter HCCP claimants)
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32. Net benefits for current and preceding 3 quarters for HCCP
claimants - after ABP
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33. Net benefits above threshold for current and preceding 3 quarters
(for current quarter HCCP claimants)
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34. Total benefits to be included in HCCP (current quarter)
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Part 3 Hospital treatment by age category
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Hospital treatment by age category
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35. Males
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Age group
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Insured persons
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Episodes
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Days
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Other HT benefits
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Medical benefits
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Medical devices or human tissue products benefits
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Fees excluding medicare benefit
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(1)
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(2)
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(3)
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(4)
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(5)
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(6)
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(7)
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(8)
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0-4
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5-9
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10-14
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15-19
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20-24
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25-29
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30-34
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35-39
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40-44
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45-49
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50-54
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55-59
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60-64
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65-69
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70-74
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75-79
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80-84
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85-89
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90-94
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95+
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35.1. Total males
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36. Females
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Age group
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Insured persons
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Episodes
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Days
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Other HT benefits
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Medical benefits
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Medical devices or human tissue products benefits
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Fees excluding medicare benefit
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(1)
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(2)
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(3)
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(4)
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(5)
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(6)
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(7)
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(8)
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0-4
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5-9
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10-14
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15-19
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20-24
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25-29
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30-34
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35-39
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40-44
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45-49
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50-54
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55-59
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60-64
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65-69
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70-74
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75-79
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80-84
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85-89
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90-94
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95+
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36.1. Total females
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Part 4 Hospital-substitute treatment by age category
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Hospital-substitute treatment by age category
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37. Males
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Age group
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Insured persons
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Episodes
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Days
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Other H-ST benefits
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Medical benefits
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Medical devices or human tissue products benefits
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Fees excluding medicare benefit
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(1)
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(2)
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(3)
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(4)
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(5)
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(6)
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(7)
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(8)
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0-4
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5-9
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10-14
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15-19
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20-24
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25-29
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30-34
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35-39
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40-44
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45-49
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50-54
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55-59
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60-64
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65-69
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70-74
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75-79
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80-84
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85-89
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90-94
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95+
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37.1. Total males
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38. Females
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Age group
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Insured persons
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Episodes
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Days
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Other H-ST benefits
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Medical benefits
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Medical devices or human tissue products benefits
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Fees excluding medicare benefit
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(1)
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(2)
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(3)
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(4)
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(5)
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(6)
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(7)
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(8)
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0-4
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5-9
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10-14
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15-19
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20-24
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25-29
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30-34
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35-39
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40-44
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45-49
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50-54
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55-59
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60-64
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65-69
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70-74
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75-79
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80-84
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85-89
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90-94
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95+
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38.1. Total females
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Part 5 Chronic Disease Management Program by age category
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Chronic Disease Management Program by age category
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39. Males
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Age group
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Insured persons
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Programs
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Eligible benefits
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Ineligible benefits
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Total benefits
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Fees excluding medicare benefit
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(1)
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(2)
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(3)
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(4)
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(5)
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(6)
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(7)
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0-4
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5-9
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10-14
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15-19
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20-24
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25-29
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30-34
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35-39
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40-44
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45-49
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50-54
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|
|
|
|
|
|
55-59
|
|
|
|
|
|
|
|
60-64
|
|
|
|
|
|
|
|
65-69
|
|
|
|
|
|
|
|
70-74
|
|
|
|
|
|
|
|
75-79
|
|
|
|
|
|
|
|
80-84
|
|
|
|
|
|
|
|
85-89
|
|
|
|
|
|
|
|
90-94
|
|
|
|
|
|
|
|
95+
|
|
|
|
|
|
|
|
|
|
39.1. Total males
|
|
|
|
|
|
|
|
|
|
40. Females
|
|
|
|
Age group
|
Insured persons
|
Programs
|
Eligible benefits
|
Ineligible benefits
|
Total benefits
|
Fees excluding medicare benefit
|
|
(1)
|
(2)
|
(3)
|
(4)
|
(5)
|
(6)
|
(7)
|
|
|
|
|
|
|
|
|
|
0-4
|
|
|
|
|
|
|
|
5-9
|
|
|
|
|
|
|
|
10-14
|
|
|
|
|
|
|
|
15-19
|
|
|
|
|
|
|
|
20-24
|
|
|
|
|
|
|
|
25-29
|
|
|
|
|
|
|
|
30-34
|
|
|
|
|
|
|
|
35-39
|
|
|
|
|
|
|
|
40-44
|
|
|
|
|
|
|
|
45-49
|
|
|
|
|
|
|
|
50-54
|
|
|
|
|
|
|
|
55-59
|
|
|
|
|
|
|
|
60-64
|
|
|
|
|
|
|
|
65-69
|
|
|
|
|
|
|
|
70-74
|
|
|
|
|
|
|
|
75-79
|
|
|
|
|
|
|
|
80-84
|
|
|
|
|
|
|
|
85-89
|
|
|
|
|
|
|
|
90-94
|
|
|
|
|
|
|
|
95+
|
|
|
|
|
|
|
|
|
|
40.1. Total females
|
|
|
|
|
|
|
|
|
|
Part 6 General treatment excluding hospital-substitute, CDMP and
hospital-linked ambulance treatment
|
|
|
|
General treatment by age category
|
|
|
|
41. Males
|
|
|
|
Age group
|
Insured persons
|
Services
|
Benefits
|
Fees charged
|
|
(1)
|
(2)
|
(3)
|
(4)
|
(5)
|
|
|
|
|
|
|
|
0-4
|
|
|
|
|
|
5-9
|
|
|
|
|
|
10-14
|
|
|
|
|
|
15-19
|
|
|
|
|
|
20-24
|
|
|
|
|
|
25-29
|
|
|
|
|
|
30-34
|
|
|
|
|
|
35-39
|
|
|
|
|
|
40-44
|
|
|
|
|
|
45-49
|
|
|
|
|
|
50-54
|
|
|
|
|
|
55-59
|
|
|
|
|
|
60-64
|
|
|
|
|
|
65-69
|
|
|
|
|
|
70-74
|
|
|
|
|
|
75-79
|
|
|
|
|
|
80-84
|
|
|
|
|
|
85-89
|
|
|
|
|
|
90-94
|
|
|
|
|
|
95+
|
|
|
|
|
|
|
|
41.1. Total males
|
|
|
|
|
|
|
|
42. Females
|
|
|
|
Age group
|
Insured persons
|
Services
|
Benefits
|
Fees charged
|
|
(1)
|
(2)
|
(3)
|
(4)
|
(5)
|
|
|
|
|
|
|
|
0-4
|
|
|
|
|
|
5-9
|
|
|
|
|
|
10-14
|
|
|
|
|
|
15-19
|
|
|
|
|
|
20-24
|
|
|
|
|
|
25-29
|
|
|
|
|
|
30-34
|
|
|
|
|
|
35-39
|
|
|
|
|
|
40-44
|
|
|
|
|
|
45-49
|
|
|
|
|
|
50-54
|
|
|
|
|
|
55-59
|
|
|
|
|
|
60-64
|
|
|
|
|
|
65-69
|
|
|
|
|
|
70-74
|
|
|
|
|
|
75-79
|
|
|
|
|
|
80-84
|
|
|
|
|
|
85-89
|
|
|
|
|
|
90-94
|
|
|
|
|
|
95+
|
|
|
|
|
|
|
|
42.1. Total females
|
|
|
|
|
|
|
|
Part 7 Total hospital treatment policies by type of cover
|
|
|
|
Total hospital treatment policies
|
|
|
|
43. Number of policies
|
|
|
|
|
Full cover
|
Reduced cover but no lifetime exclusions
|
Reduced cover and some lifetime exclusions
|
Some lifetime exclusions but no reduced cover
|
Total
|
|
|
(1)
|
(2)
|
(3)
|
(4)
|
(5)
|
|
43.1. Excess & co-payments
|
|
|
|
|
|
|
NIL
|
|
|
|
|
|
|
<= $500/$1,000 (*)
|
|
|
|
|
|
|
> $500/$1,000 (**)
|
|
|
|
|
|
|
43.2. Total
|
|
|
|
|
|
|
|
|
(*) Excess <= $500 per policy covering only one person and excess
<=$1,000 for all other policies
|
|
(**) Excess > $500 per policy covering only one person and excess
> $1,000 for all other policies
|
|
|
|
|
|
General treatment claims processing for the state (excluding
hospital-substitute treatment and CDMP)
|
|
|
|
44. Percent of claims processed within five working days
|
|
|
|
|
National retention index - hospital treatment policy holders
|
|
|
|
45. Percent of policies existing two years or more that are still in
force
|
|
|
|
|
Part 8 Benefits paid for Chronic Disease Management Programs
|
|
|
|
46. Benefits paid for CDMPs
|
|
|
|
CDMP deliverables
|
Services
|
Benefits
|
Fees charged
|
|
(1)
|
(2)
|
(3)
|
(4)
|
|
|
|
|
|
|
Planning
|
|
|
|
|
Coordination
|
|
|
|
|
Allied Health Services
|
|
|
|
|
Other
|
|
|
|
|
|
|
46.1. Total CDMPs
|
|
|
|
|
|
|
47. Benefits paid by program type
|
|
|
|
Type of CDMP
|
Programs
|
Benefits
|
Fees charged
|
|
(1)
|
(2)
|
(3)
|
(4)
|
|
|
|
|
|
|
Risk factors for chronic disease
|
|
|
|
|
Cardiovascular
|
|
|
|
|
Diabetes
|
|
|
|
|
Mental Health
|
|
|
|
|
Other (specify)
|
|
|
|
|
|
|
47.1. Total by program type
|
|
|
|
|
|
|
Part 9 Benefits paid for general treatment (excluding
hospital-substitute treatment and CDMP)
|
|
|
|
48. Type of treatment by service type
|
|
|
|
Service type
|
Services
|
Benefits
|
Fees charged
|
|
(1)
|
(2)
|
(3)
|
(4)
|
|
|
|
|
|
|
Accidental Death / Funeral Expenses
|
|
|
|
|
Acupuncture / Acupressure
|
|
|
|
|
Ambulance
|
|
|
|
|
Chiropractic
|
|
|
|
|
Community, Home, District Nursing
|
|
|
|
|
Dental
|
|
|
|
|
Dietetics
|
|
|
|
|
Domestic Assistance
|
|
|
|
|
Ex gratia Payments
|
|
|
|
|
Preventative Health Products/Health Management Program
|
|
|
|
|
Hearing Aids and Audiology
|
|
|
|
|
Hypnotherapy
|
|
|
|
|
Maternity Services
|
|
|
|
|
Natural Therapies
|
|
|
|
|
Occupational Therapy
|
|
|
|
|
Optical
|
|
|
|
|
Orthoptics (Eye Therapy)
|
|
|
|
|
Osteopathic Services
|
|
|
|
|
Overseas
|
|
|
|
|
Pharmacy
|
|
|
|
|
Physiotherapy
|
|
|
|
|
Podiatry (Chiropody)
|
|
|
|
|
Medical devices or human
tissue products, Aids and Appliances
|
|
|
|
|
Psych/Group Therapy
|
|
|
|
|
School
|
|
|
|
|
Sickness and Accident
|
|
|
|
|
Speech Therapy
|
|
|
|
|
Theatre Fees
|
|
|
|
|
Travel and Accommodation
|
|
|
|
|
|
|
48.1. Other (please specify)
|
|
|
|
|
Description
|
Services
|
Benefits
|
Fees charged
|
|
(1)
|
(2)
|
(3)
|
(4)
|
|
|
|
|
|
|
|
|
48.2. Total general treatment
|
|
|
|
|
|
|
Part 10 Lifetime Health Cover
|
|
|
|
49. Number of adults with hospital cover
|
|
|
|
Certified age at entry
|
Male
|
Female
|
Male LHC loading removed
|
Female LHC loading removed
|
LHC Loading %
|
|
|
(1)
|
(2)
|
(3)
|
(4)
|
|
|
30
|
|
|
|
|
0%
|
|
31
|
|
|
|
|
2%
|
|
32
|
|
|
|
|
4%
|
|
33
|
|
|
|
|
6%
|
|
34
|
|
|
|
|
8%
|
|
35
|
|
|
|
|
10%
|
|
36
|
|
|
|
|
12%
|
|
37
|
|
|
|
|
14%
|
|
38
|
|
|
|
|
16%
|
|
39
|
|
|
|
|
18%
|
|
40
|
|
|
|
|
20%
|
|
41
|
|
|
|
|
22%
|
|
42
|
|
|
|
|
24%
|
|
43
|
|
|
|
|
26%
|
|
44
|
|
|
|
|
28%
|
|
45
|
|
|
|
|
30%
|
|
46
|
|
|
|
|
32%
|
|
47
|
|
|
|
|
34%
|
|
48
|
|
|
|
|
36%
|
|
49
|
|
|
|
|
38%
|
|
50
|
|
|
|
|
40%
|
|
51
|
|
|
|
|
42%
|
|
52
|
|
|
|
|
44%
|
|
53
|
|
|
|
|
46%
|
|
54
|
|
|
|
|
48%
|
|
55
|
|
|
|
|
50%
|
|
56
|
|
|
|
|
52%
|
|
57
|
|
|
|
|
54%
|
|
58
|
|
|
|
|
56%
|
|
59
|
|
|
|
|
58%
|
|
60
|
|
|
|
|
60%
|
|
61
|
|
|
|
|
62%
|
|
62
|
|
|
|
|
64%
|
|
63
|
|
|
|
|
66%
|
|
64
|
|
|
|
|
68%
|
|
65
|
|
|
|
|
70%
|
|
Total
|
|
|
|
|
0%
|
|
|
|
Part 11 Total hospital treatment medical services statistics
|
|
|
|
|
Amount charged
|
Medicare benefit
|
Fund benefit
|
Gap
|
Number of services
|
% of services
|
Amount charged % of MBS
|
|
(1)
|
(2)
|
(3)
|
(4)
|
(5)
|
(6)
|
(7)
|
50. No-gap agreement
|
|
|
|
|
|
|
|
<= MBS fee
|
|
|
|
|
|
|
|
>MBS to 125% MBS fee
|
|
|
|
|
|
|
|
>125% to 150% MBS fee
|
|
|
|
|
|
|
|
>150% to 200% MBS fee
|
|
|
|
|
|
|
|
>200% MBS fee
|
|
|
|
|
|
|
|
50.1. Total no-gap agreement
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
51. Known gap agreement
|
|
|
|
|
|
|
|
>MBS to 125% MBS fee
|
|
|
|
|
|
|
|
>125% to 150% MBS fee
|
|
|
|
|
|
|
|
>150% to 200% MBS fee
|
|
|
|
|
|
|
|
>200% MBS fee
|
|
|
|
|
|
|
|
51.1. Total known gap agreement
|
|
|
|
|
|
|
|
52. Total agreement
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
53. No agreement
|
|
|
|
|
|
|
|
<= MBS fee
|
|
|
|
|
|
|
|
>MBS to 125% MBS fee
|
|
|
|
|
|
|
|
>125% to 150% MBS fee
|
|
|
|
|
|
|
|
>150% to 200% MBS fee
|
|
|
|
|
|
|
|
>200% MBS fee
|
|
|
|
|
|
|
|
54. Total no agreement
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
55. Grand total
|
|
|
|
|
|
|
|
55.1. Total services with no gap
|
|
|
|
|
|
|
|
55.2. Total services with no or known gap
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|