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{"sheet":"Instructions","index":0,"n_rows":18,"n_cols":2,"rows_kept":18,"cut":false,"hidden":false,"merged":[]}
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[null,"Instructions"]
[null,"Enter proper information for yourself and dependent(s) in the yellow input boxes. Start with the top input of coverage tier then put your best estimate for amount of services for the upcoming medical year. "]
[null,"Although most services are within the general categories of this calculator, some services may be charged at a different amount. Please consult your Explanation of Benefits for more detailed information."]
[null,"If a certain input is unknown, you may leave it blank. However, an educated guess is better than an empty input."]
[]
[null,"Assumptions"]
[null,"All claims are assumed to be in-network. "]
[null,"Costs for services and prescriptions are based on an averages, actual prices of services and prescriptions will vary."]
[]
[null,"Disclaimers"]
[null,"1. This calculator does not capture the tax savings employees typically realize by paying for premiums on a pre-tax basis. The total costs to employees may be lower than reflected when such tax savings are taken into account. "]
[null,"2. This tool is designed to provide an estimate and comparison of out-of-pocket costs, including premiums, that you may expect to experience under each of the medical plans offered by CZ-USA. This information is an estimate only and does not guarantee the total costs you will incur or the charges for any particular service. Your actual expenses may be either lower or higher, depending on the provider(s) you select, their treatment choices, your particular healthcare needs and other factors.  \n\nThe estimates provided regarding the costs you may expect to incur under the different plans are based on the information you entered into the spreadsheet regarding the healthcare services you expect in the coming plan year. Your actual out-of-pocket expenses may vary. You will be responsible for the actual amounts owed, as determined after services are rendered.  "]

{"sheet":"Calculator","index":1,"n_rows":65,"n_cols":8,"rows_kept":65,"cut":false,"hidden":false,"merged":[[9,6,9,9],[31,1,33,1],[36,1,38,1],[41,1,43,1],[11,6,13,6],[16,6,18,6],[21,6,23,6],[41,6,43,6],[34,6,37,6],[26,6,31,6],[11,1,13,1],[16,1,18,1],[21,1,23,1],[26,1,28,1],[46,4,46,5],[4,1,4,2],[9,1,9,4]]}
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[null,"Step 1: Select who will be covered"]
[]
[null,"Coverage Tier: ",null,"Employee Only",null,null,"Utilization Level (optional):","N/A"]
[]
[]
[null,"Step 2: Insert / Change Inputs Based on Anticipated Needs"]
[]
[null,"Services",null,null,null,null,"Prescriptions"]
[null,"Primary Care Doctor Visits",null,null,null,null,"Tier 1 Prescriptions"]
[null,"Do not include preventive care or primary care for children under 19 years old.\n$175 per visit used for calculation","Employee",null,null,null,"Enter the total amount of annual prescriptions expected.\n$50 per month used for calculation","Employee"]
[null,null,{"$f":"IF($D$5=\"Employee + Spouse\",\"Spouse\",IF($D$5=\"Employee + Child\",\"Child\",IF($D$5=\"Family\",\"Spouse\",\"\")))","v":""},null,null,null,null,{"$f":"IF($D$5=\"Employee + Spouse\",\"Spouse\",IF($D$5=\"Employee + Child\",\"Child\",IF($D$5=\"Family\",\"Spouse\",\"\")))","v":""}]
[null,null,{"$f":"IF($D$5=\"Employee + Child\",\"Child(ren)\",IF($D$5=\"Family\",\"Child(ren)\",\"\"))","v":""},null,null,null,null,{"$f":"IF($D$5=\"Employee + Child\",\"Child(ren)\",IF($D$5=\"Family\",\"Child(ren)\",\"\"))","v":""}]
[]
[null,"Specialist Doctor Visits",null,null,null,null,"Tier 2 Prescriptions"]
[null,"Do not include preventive care. Copay is half as much per visit within Designated Network\n$250 per visit used for calculation","Employee",null,null,null,"Enter the total amount of annual prescriptions expected.\n$300 per month used for calculation","Employee"]
[null,null,{"$f":"IF($D$5=\"Employee + Spouse\",\"Spouse\",IF($D$5=\"Employee + Child\",\"Child\",IF($D$5=\"Family\",\"Spouse\",\"\")))","v":""},null,null,null,null,{"$f":"IF($D$5=\"Employee + Spouse\",\"Spouse\",IF($D$5=\"Employee + Child\",\"Child\",IF($D$5=\"Family\",\"Spouse\",\"\")))","v":""}]
[null,null,{"$f":"IF($D$5=\"Employee + Child\",\"Child(ren)\",IF($D$5=\"Family\",\"Child(ren)\",\"\"))","v":""},null,null,null,null,{"$f":"IF($D$5=\"Employee + Child\",\"Child(ren)\",IF($D$5=\"Family\",\"Child(ren)\",\"\"))","v":""}]
[]
[null,"Major Diagnostic and Imaging",null,null,null,null,"Tier 3 Prescriptions"]
[null,"Do not include Lab Testing, X-ray services, or screenings.\n$600 per test used for calculation","Employee",null,null,null,"Enter the total amount of annual prescriptions expected.\n$400 per month used for calculation","Employee"]
[null,null,{"$f":"IF($D$5=\"Employee + Spouse\",\"Spouse\",IF($D$5=\"Employee + Child\",\"Child\",IF($D$5=\"Family\",\"Spouse\",\"\")))","v":""},null,null,null,null,{"$f":"IF($D$5=\"Employee + Spouse\",\"Spouse\",IF($D$5=\"Employee + Child\",\"Child\",IF($D$5=\"Family\",\"Spouse\",\"\")))","v":""}]
[null,null,{"$f":"IF($D$5=\"Employee + Child\",\"Child(ren)\",IF($D$5=\"Family\",\"Child(ren)\",\"\"))","v":""},null,null,null,null,{"$f":"IF($D$5=\"Employee + Child\",\"Child(ren)\",IF($D$5=\"Family\",\"Child(ren)\",\"\"))","v":""}]
[]
[null,"Urgent Care Visits",null,null,null,null,"Tier 4 Prescriptions"]
[null,"Additional copays, deductible, or co-insurance may apply if other services are received at urgent care facility.\n$500 per visit used for calculation","Employee",null,null,null,"Enter the total amount of annual prescriptions expected. \nNote: Tier 4 Prescriptions vary greatly in cost, consider adding additional cost if you anticipate a high cost prescription\n$1,000 per month used for calculation","Employee"]
[null,null,{"$f":"IF($D$5=\"Employee + Spouse\",\"Spouse\",IF($D$5=\"Employee + Child\",\"Child\",IF($D$5=\"Family\",\"Spouse\",\"\")))","v":""},null,null,null,null,{"$f":"IF($D$5=\"Employee + Spouse\",\"Spouse\",IF($D$5=\"Employee + Child\",\"Child\",IF($D$5=\"Family\",\"Spouse\",\"\")))","v":""}]
[null,null,{"$f":"IF($D$5=\"Employee + Child\",\"Child(ren)\",IF($D$5=\"Family\",\"Child(ren)\",\"\"))","v":""},null,null,null,null,{"$f":"IF($D$5=\"Employee + Child\",\"Child(ren)\",IF($D$5=\"Family\",\"Child(ren)\",\"\"))","v":""}]
[]
[null,"Hospitalization Days"]
[null,"Please enter as an amount of days in hospital\n$6,000 a day used for calculation","Employee"]
[null,null,{"$f":"IF($D$5=\"Employee + Spouse\",\"Spouse\",IF($D$5=\"Employee + Child\",\"Child\",IF($D$5=\"Family\",\"Spouse\",\"\")))","v":""}]
[null,null,{"$f":"IF($D$5=\"Employee + Child\",\"Child(ren)\",IF($D$5=\"Family\",\"Child(ren)\",\"\"))","v":""},null,null,null,"Mailed Prescriptions"]
[null,null,null,null,null,null,"Enter yes if you anticipate having your prescriptions mailed. \nEnter no if you anticipate filling prescriptions at a pharmacy."]
[null,"Emergency Room Visits"]
[null,"Additional copays, deductible, or co-insurance may apply if other services are received at Emergency Room.\n$2,500 a visit used for calculation","Employee"]
[null,null,{"$f":"IF($D$5=\"Employee + Spouse\",\"Spouse\",IF($D$5=\"Employee + Child\",\"Child\",IF($D$5=\"Family\",\"Spouse\",\"\")))","v":""}]
[null,null,{"$f":"IF($D$5=\"Employee + Child\",\"Child(ren)\",IF($D$5=\"Family\",\"Child(ren)\",\"\"))","v":""}]
[]
[null,"Outpatient Surgeries",null,null,null,null,"Additional Costs (Optional)"]
[null,"Note: Surgeries vary greatly in cost, consider adding additional cost if you anticipate a high cost surgery\n$5,000 per surgery used for calculation","Employee",null,null,null,"Enter any additional costs you anticipate incurring and/or costs for unexpected incidents","Employee"]
[null,null,{"$f":"IF($D$5=\"Employee + Spouse\",\"Spouse\",IF($D$5=\"Employee + Child\",\"Child\",IF($D$5=\"Family\",\"Spouse\",\"\")))","v":""},null,null,null,null,{"$f":"IF($D$5=\"Employee + Spouse\",\"Spouse\",IF($D$5=\"Employee + Child\",\"Child\",IF($D$5=\"Family\",\"Spouse\",\"\")))","v":""}]
[null,null,{"$f":"IF($D$5=\"Employee + Child\",\"Child(ren)\",IF($D$5=\"Family\",\"Child(ren)\",\"\"))","v":""},null,null,null,null,{"$f":"IF($D$5=\"Employee + Child\",\"Child(ren)\",IF($D$5=\"Family\",\"Child(ren)\",\"\"))","v":""}]
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[null,"Step 3: Compare Costs"]
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[null,"*HSA Balance is not deducted from Plan Comparison Chart"]
[null,"*Employer Funded HSA is only available if enrolled in the HDHP HSA plan"]

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[null,null,"Mission"]
[null,null,"We provide Business and Personal Insurance, Surety Bonds, Employee Benefits and HR Consulting\nto protect the assets of our clients and their families."]
[]
[]
[null,null,"Values"]
[null,null,"We place God, family and community first. | We care. | We take ownership."]
[]
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[null,null,"millercares.com"]

{"sheet":"Inputs","index":3,"n_rows":39,"n_cols":28,"rows_kept":39,"cut":false,"hidden":true,"merged":[]}
["Average Costs",null,null,null,"Benefits","PPO $1,000","PPO $2,000","HDHP HSA",null,null,null,{"$f":"F1","v":"PPO $1,000"},{"$f":"G1","v":"PPO $2,000"},"HDHP HSA",null,null,null,null,"N/A",null,"Low","Medium","High",null,1,2,3,4]
["Primary Care Visit",175,{"$f":"B2*1.1","v":192.50000000000003},null,"Employee Only",181.46,90.72,0,null,null,"Primary Care",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Calculator!E12,IF(Calculator!$D$5=Inputs!$E$3,Calculator!E12+Calculator!E13,IF(Calculator!$D$5=Inputs!$E$4,Calculator!E12+Calculator!E13+Calculator!E14,IF(Calculator!$D$5=Inputs!$E$5,Calculator!E12+Calculator!E13+Calculator!E14,0))))","v":0},null,null,null,1,"Employee Only","Yes","Low","Primary Care",1,3,6,null,"Employee","Employee","Employee","Employee"]
["Specialists Office Visit",250,{"$f":"B3*1.1","v":275},null,"Employee + Spouse",544.38,362.92,181.46,null,null,null,{"$f":"IF(F12=\"Yes\",IF(F11<>0,($L$2*F11)+$L$2*($B$2*F8),$L$2*($B$2*F8)),$L$2*F11)","v":0},{"$f":"IF(G12=\"Yes\",IF(G11<>0,($L$2*G11)+$L$2*($B$2*G8),$L$2*($B$2*G8)),$L$2*G11)","v":0},{"$f":"IF(H12=\"Yes\",IF(H11<>0,($L$2*H11)+$L$2*($B$2*H8),$L$2*($B$2*H8)),$L$2*H11)","v":0},null,2,"Employee + Spouse","No","Medium","Specialists",1,2,4,null,null,"Spouse","Child","Spouse"]
["Labs or Imaging - Hospital or Outpatient Facility",600,660,null,"Employee + Child",453.64,272.18,136.08000000000001,null,null,"Specialists",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Calculator!E17,IF(Calculator!$D$5=Inputs!$E$3,Calculator!E17+Calculator!E18,IF(Calculator!$D$5=Inputs!$E$4,Calculator!E17+Calculator!E18+Calculator!E19,IF(Calculator!$D$5=Inputs!$E$5,Calculator!E17+Calculator!E18+Calculator!E19,0))))","v":0},null,null,null,3,"Employee + Child",null,"High","Imaging",1,2,8,null,null,null,"Child","Child(ren)"]
[null,null,0,null,"Family",635.1,453.64,272.18,null,null,null,{"$f":"IF(F14=\"Yes\",IF(F13<>0,($L$4*F13)+$L$4*($B$3*F8),$L$4*($B$3*F8)),$L$4*F13)","v":0},{"$f":"IF(G14=\"Yes\",IF(G13<>0,($L$4*G13)+$L$4*($B$3*G8),$L$4*($B$3*G8)),$L$4*G13)","v":0},{"$f":"IF(H14=\"Yes\",IF(H13<>0,($L$4*H13)+$L$4*($B$3*H8),$L$4*($B$3*H8)),$L$4*H13)","v":0},null,4,"Family",null,null,"Hospitalization",0,0,0]
[null,null,0,null,"Deductible",1000,2000,3000,null,null,"Imaging",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Calculator!E22,IF(Calculator!$D$5=Inputs!$E$3,Calculator!E22+Calculator!E23,IF(Calculator!$D$5=Inputs!$E$4,Calculator!E22+Calculator!E23+Calculator!E24,IF(Calculator!$D$5=Inputs!$E$5,Calculator!E22+Calculator!E23+Calculator!E24,0))))","v":0},null,null,null,5,null,null,null,"Urgent Care",0,0,2]
["Hospitalization / Inpatient Services",5700,6270.0000000000009,null,"Deductible Family",2000,6000,6000,null,null,null,{"$f":"IF(F16=\"Yes\",IF(F15<>0,($L$6*F15)+$L$6*($B$4*F8),$L$6*($B$4*F8)),$L$6*F15)","v":0},{"$f":"IF(G16=\"Yes\",IF(G15<>0,($L$6*G15)+$L$6*($B$4*G8),$L$6*($B$4*G8)),$L$6*G15)","v":0},{"$f":"IF(H16=\"Yes\",IF(H15<>0,($L$6*H15)+$L$6*($B$4*H8),$L$6*($B$4*H8)),$L$6*H15)","v":0},null,6,null,null,null,"ER ",0,0,0]
["Outpatient Surgery",5000,5500,null,"Member Coinsurance",0.2,0.2,0.3,0.5,null,"Hospitalization",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Calculator!E32,IF(Calculator!$D$5=Inputs!$E$3,Calculator!E32+Calculator!E33,IF(Calculator!$D$5=Inputs!$E$4,Calculator!E32+Calculator!E33+Calculator!E34,IF(Calculator!$D$5=Inputs!$E$5,Calculator!E32+Calculator!E33+Calculator!E34,0))))","v":0},null,null,null,7,null,null,null,"Surgeries",0,0,1]
["Emergency Room Visit",2500,2750,null,"Out-of-Pocket Max",2500,5000,5000,null,null,null,{"$f":"IF(F22=\"Yes\",IF(F21<>0,($L$8*F21)+$L$8*($B$7*F8),$L$8*($B$7*F8)),$L$8*F21)","v":0},{"$f":"IF(G22=\"Yes\",IF(G21<>0,($L$8*G21)+$L$8*($B$7*G8),$L$8*($B$7*G8)),$L$8*G21)","v":0},{"$f":"IF(H22=\"Yes\",IF(H21<>0,($L$8*H21)+$L$8*($B$7*H8),$L$8*($B$7*H8)),$L$8*H21)","v":0},null,8,null,null,null,"Mailed"]
["Urgent Care Visit",500,550,null,"Out-of-Pocket Max Family",5000,10000,10000,null,null,"Urgent Care",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Calculator!E27,IF(Calculator!$D$5=Inputs!$E$3,Calculator!E27+Calculator!E28,IF(Calculator!$D$5=Inputs!$E$4,Calculator!E27+Calculator!E28+Calculator!E29,IF(Calculator!$D$5=Inputs!$E$5,Calculator!E27+Calculator!E28+Calculator!E29,0))))","v":0},null,null,null,9,null,null,null,"Tier 1",3,6,12]
["Generic Rx",50,55.000000000000007,null,"Primary Care Copay",25,40,null,null,null,null,{"$f":"IF(F18=\"Yes\",IF(F17<>0,($L$10*F17)+$L$10*($B$10*F8),$L$10*($B$10*F8)),$L$10*F17)","v":0},{"$f":"IF(G18=\"Yes\",IF(G17<>0,($L$10*G17)+$L$10*($B$10*G8),$L$10*($B$10*G8)),$L$10*G17)","v":0},{"$f":"IF(H18=\"Yes\",IF(H17<>0,($L$10*H17)+$L$10*($B$10*H8),$L$10*($B$10*H8)),$L$10*H17)","v":0},null,10,null,null,null,"Tier 2",2,4,8]
["High Generic Rx",300,330,null,"Primary Care Coinsurance",null,null,"Yes",null,null,"ER ",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Calculator!E37,IF(Calculator!$D$5=Inputs!$E$3,Calculator!E37+Calculator!E38,IF(Calculator!$D$5=Inputs!$E$4,Calculator!E37+Calculator!E38+Calculator!E39,IF(Calculator!$D$5=Inputs!$E$5,Calculator!E37+Calculator!E38+Calculator!E39,0))))","v":0},null,null,null,11,null,null,null,"Tier 3",0,0,2]
[" Brand Rx",400,440.00000000000006,null,"Specialist Copay",50,80,null,null,null,null,{"$f":"IF(F20=\"Yes\",IF(F19<>0,($L$12*F19)+$L$12*($B$9*F8),$L$12*($B$9*F8)),$L$12*F19)","v":0},{"$f":"IF(G20=\"Yes\",IF(G19<>0,($L$12*G19)+$L$12*($B$9*G8),$L$12*($B$9*G8)),$L$12*G19)","v":0},{"$f":"IF(H20=\"Yes\",IF(H19<>0,($L$12*H19)+$L$12*($B$9*I8),$L$12*($B$9*I8)),$L$12*H19)","v":0},null,12,null,null,null,"Tier 4",0,0,1]
["High Brand Rx",1000,1100,null,"Specialist Coinsurance",null,null,"Yes",null,null,"Surgeries",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Calculator!E42,IF(Calculator!$D$5=Inputs!$E$3,Calculator!E42+Calculator!E43,IF(Calculator!$D$5=Inputs!$E$4,Calculator!E42+Calculator!E43+Calculator!E44,IF(Calculator!$D$5=Inputs!$E$5,Calculator!E42+Calculator!E43+Calculator!E44,0))))","v":0},null,null,null,13]
[null,null,0,null,"Imaging Copay",null,null,null,null,null,null,{"$f":"IF(F22=\"Yes\",IF(F21<>0,($L$14*F21)+$L$14*($B$8*F8),$L$14*($B$8*F8)),$L$14*F21)","v":0},{"$f":"IF(G22=\"Yes\",IF(G21<>0,($L$14*G21)+$L$14*($B$8*G8),$L$14*($B$8*G8)),$L$14*G21)","v":0},{"$f":"IF(H22=\"Yes\",IF(H21<>0,($L$14*H21)+$L$14*($B$8*H8),$L$14*($B$8*H8)),$L$14*H21)","v":0},null,14]
[null,null,0,null,"Imaging Coinsurance","Yes","Yes","Yes",null,null,"Mailed",{"$f":"Calculator!H34","v":0},null,null,null,15]
["MRI",775,852.50000000000011,null,"Urgent Care Copay",25,40,null,null,null,"Tier 1",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Calculator!J12,IF(Calculator!$D$5=Inputs!$E$3,Calculator!J12+Calculator!J13,IF(Calculator!$D$5=Inputs!$E$4,Calculator!J12+Calculator!J13+Calculator!J14,IF(Calculator!$D$5=Inputs!$E$5,Calculator!J12+Calculator!J13+Calculator!J14,0))))","v":0},null,null,null,16]
["X-Ray",75,82.5,null,"Urgent Care Coinsurance",null,null,"Yes",null,null,null,{"$f":"IF(F26=\"Yes\",IF(F25<>0,($L$17*F25)+$L$17*($B$11*F8),$L$17*($B$11*F8)),$L$17*F25)*IF(L16=\"Yes\",F33,1)","v":0},{"$f":"IF(G26=\"Yes\",IF(G25<>0,($L$17*G25)+$L$17*($B$11*G8),$L$17*($B$11*G8)),$L$17*G25)*IF($L$16=\"Yes\",G33,1)","v":0},{"$f":"IF(H26=\"Yes\",IF(H25<>0,($L$17*H25)+$L$17*($B$11*H8),$L$17*($B$11*H8)),$L$17*H25)*IF($L$16=\"Yes\",H33,1)","v":0},null,17]
["Mammogram",265,291.5,null,"Emergency Care Copay",100,100,null,null,null,"Tier 2",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Calculator!J17,IF(Calculator!$D$5=Inputs!$E$3,Calculator!J17+Calculator!J18,IF(Calculator!$D$5=Inputs!$E$4,Calculator!J17+Calculator!J18+Calculator!J19,IF(Calculator!$D$5=Inputs!$E$5,Calculator!J17+Calculator!J18+Calculator!J19,0))))","v":0},null,null,null,18]
["CT",1000,1100,null,"Emergency Care Coinsurance","Yes","Yes","Yes",null,null,null,{"$f":"IF(F28=\"Yes\",IF(F27<>0,($L$19*F27)+$L$19*($B$12*F8),$L$19*($B$12*F8)),$L$19*F27)*IF($L$16=\"Yes\",F33,1)","v":0},{"$f":"IF(G28=\"Yes\",IF(G27<>0,($L$19*G27)+$L$19*($B$12*G8),$L$19*($B$12*G8)),$L$19*G27)*IF($L$16=\"Yes\",G33,1)","v":0},{"$f":"IF(H28=\"Yes\",IF(H27<>0,($L$19*H27)+$L$19*($B$12*H8),$L$19*($B$12*H8)),$L$19*H27)*IF($L$16=\"Yes\",H33,1)","v":0},null,19]
["Ultrasound",200,220.00000000000003,null,"Outpatient Hospital Copay",null,null,null,null,null,"Tier 3",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Calculator!J22,IF(Calculator!$D$5=Inputs!$E$3,Calculator!J22+Calculator!J23,IF(Calculator!$D$5=Inputs!$E$4,Calculator!J22+Calculator!J23+Calculator!J24,IF(Calculator!$D$5=Inputs!$E$5,Calculator!J22+Calculator!J23+Calculator!J24,0))))","v":0},null,null,null,20]
["Endoscope",100,110.00000000000001,null,"Outpatient Hospital Coinsurance","Yes","Yes","Yes",null,null,null,{"$f":"IF(F30=\"Yes\",IF(F29<>0,($L$21*F29)+$L$21*($B$13*F8),$L$21*($B$13*F8)),$L$21*F29)","v":0},{"$f":"IF(G30=\"Yes\",IF(G29<>0,($L$21*G29)+$L$21*($B$13*G8),$L$21*($B$13*G8)),$L$21*G29)","v":0},{"$f":"IF(H30=\"Yes\",IF(H29<>0,($L$21*H29)+$L$21*($B$13*H8),$L$21*($B$13*H8)),$L$21*H29)","v":0},null,21]
["Angiograph",415,456.50000000000006,null,"Inpatient Hospital Copay",null,null,null,null,null,"Tier 4",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Calculator!J27,IF(Calculator!$D$5=Inputs!$E$3,Calculator!J27+Calculator!J28,IF(Calculator!$D$5=Inputs!$E$4,Calculator!J27+Calculator!J28+Calculator!J29,IF(Calculator!$D$5=Inputs!$E$5,Calculator!J27+Calculator!J28+Calculator!J29,0))))","v":0},null,null,null,22]
["KU Outpatient Avg",{"$f":"143021305/105032","v":1361.6926746134511},1497.8619420747964,null,"Inpatient Hospital Coinsurance","Yes","Yes","Yes",null,null,null,{"$f":"IF(F32=\"Yes\",IF(F31<>0,($L$23*F31)+$L$23*($B$14*F8),$L$23*($B$14*F8)),$L$23*F31)*IF($L$16=\"Yes\",F33,1)","v":0},{"$f":"IF(G32=\"Yes\",IF(G31<>0,($L$23*G31)+$L$23*($B$14*G8),$L$23*($B$14*G8)),$L$23*G31)*IF($L$16=\"Yes\",G33,1)","v":0},{"$f":"IF(H32=\"Yes\",IF(H31<>0,($L$23*H31)+$L$23*($B$14*H8),$L$23*($B$14*H8)),$L$23*H31)*IF($L$16=\"Yes\",H33,1)","v":0},null,23]
[null,null,0,null,"Prescription Drugs Tier 1 Copay",15,15,10,null,null,"Add'l Costs",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Calculator!J42,IF(Calculator!$D$5=Inputs!$E$3,Calculator!J42+Calculator!J43,IF(Calculator!$D$5=Inputs!$E$4,Calculator!J42+Calculator!J43+Calculator!J44,IF(Calculator!$D$5=Inputs!$E$5,Calculator!J42+Calculator!J43+Calculator!J44,0))))","v":0},{"$f":"L25","v":0},{"$f":"L25","v":0},null,24]
["Tier 4 Pain Meds",600,660,null,"Prescription Drugs Tier 1 Coinsurance",null,null,null,null,null,"Premium",{"$f":"VLOOKUP(Calculator!D5,E2:F5,2,FALSE)*12","v":2177.52},{"$f":"VLOOKUP(Calculator!D5,E2:G5,3,FALSE)*12","v":1088.6399999999999},{"$f":"VLOOKUP(Calculator!D5,E2:H5,4,FALSE)*12","v":0},null,25]
["Tier 4 Pain & Inflammation",2000,2200,null,"Prescription Drugs Tier 2 Copay",45,45,35,null,null,"Deductible",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Inputs!F6,Inputs!F7)","v":1000},{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Inputs!G6,Inputs!G7)","v":2000},{"$f":"IF(Calculator!$D$5=Inputs!$E$2,Inputs!H6,Inputs!H7)","v":3000},null,26]
["Tier 4 Addiction",500,550,null,"Prescription Drugs Tier 2 Coinsurance",null,null,null,null,null,"Adding Ded",{"$f":"MIN(L27,SUM(L3,L5,L7,L9,L13,L15,L18,L20,L22,L24,L25))","v":0},{"$f":"MIN(M27,SUM(M3,M5,M7,M9,M13,M15,M18,M20,M22,M24,M25))","v":0},{"$f":"MIN(N27,SUM(N3,N5,N7,N9,N13,N15,N18,N20,N22,N24,N25))","v":0},null,27]
["Tier 4 Antibacterial",300,330,null,"Prescription Drugs Tier 3 Copay",85,85,60,null,null,"Copays/Coins",{"$f":"IF(L28<L27,0,MIN(SUM(L3,L5,L7,L9,L11,L13,L15,L18,L20,L22,L24,L25)-L28,L30-L27))","v":0},{"$f":"IF(M28<M27,0,MIN(SUM(M3,M5,M7,M9,M11,M13,M15,M18,M20,M22,M24,M25)-M28,M30-M27))","v":0},{"$f":"IF(N28<N27,0,MIN(SUM(N3,N5,N7,N9,N11,N13,N15,N18,N20,N22,N24,N25)-N28,N30-N27))","v":0},null,28]
["Tier 4 Seizures",1200,1320,null,"Prescription Drugs Tier 3 Coinsurance",null,null,null,null,null,"OOP Max",{"$f":"IF(Calculator!$D$5=Inputs!$E$2,F9,F10)","v":2500},{"$f":"IF(Calculator!$D$5=Inputs!$E$2,G9,G10)","v":5000},{"$f":"IF(Calculator!$D$5=Inputs!$E$2,H9,H10)","v":5000},null,29]
["Tier 4 Depression",300,330,null,"Prescription Drugs Tier 4 Copay",200,200,60,null,null,"HSA Contribution",null,null,{"$f":"60*12","v":720},null,30]
["Tier 4 Gout",900,990.00000000000011,null,"Prescription Drugs Tier 4 Coinsurance",null,null,null,null,null,"HSA Used",null,null,{"$f":"MIN(SUM(N3,N5,N7,N9,N11,N13,N15,N18,N20,N22,N24,N25),N31)","v":0}]
["Tier 4 Cancer",1400,1540.0000000000002,null,"Mailed Drug Multiplier",2.5,2.5,2.5,null,null,"HSA Balance",null,null,{"$f":"N31-N32","v":720}]
["Tier 4 Parkinsons",700,770.00000000000011]
["Tier 4 Mood Disorders",2000,2200]
["Tier 4 Heart",400,440.00000000000006]
["Tier 4 ADD",1400,1540.0000000000002]
["Tier 4 MS",10000,11000]
[null,{"$f":"AVERAGE(B26:B38)","v":1669.2307692307693},1836.1538461538464]