Calculating Patient Responsibility

1. Order Total: $928.20 OOP: $2,000.00

Coverage: 90% OOP Met: $0.00
Deductible: $600.00
Deductible Met: $0.00 Answer: __________
OOP: $1,200.00
OOP Met: $0.00 7. Order Total: $863.00
Coverage: 90%
Answer: __________ Deductible: $2,000.00
Deductible Met: $2,000.00
2. Order Total: $1,619.10 OOP: $5,000.00
Coverage: 85% OOP Met: $4,925.00
Deductible: $1,000.00
Deductible Met: $900.00 Answer: ___________
OOP: $2,000.00
OOP Met: $900.00 8. Order Total: $612.08
Coverage: 90%
Answer: __________ Deductible: $300.00
Deductible Met: $177.30
3. Order Total: $460.00 OOP: $1,000.00
Coverage: 100% OOP Met: $677.30
Copay: $10.00
OOP: $1,000.00 Answer: ___________
OOP Met: $1,000.00
9. Order Total: $311.64
Answer: _________ Coverage: 80%
Deductible: $2,000.00
4. Order Total: $823.00 Deductible Met: $0.00
Coverage: 75% OOP: $4,000.00
Deductible: $350.00 OOP Met: $0.00
Deductible Met: $275.00
OOP: $2,000.00 Answer: __________
OOP Met: $275.00
10. Order Total: $309.40
Answer: ________ Coverage: 95%
Deductible: $1,000.00
5. Order Total: $3,085.00 Deductible Met: $1,000.00
Coverage: 50% OOP: $5,000.00
Deductible: $1,000.00 OOP Met: $5,000.00
Deductible Met: $0.00
OOP: $5,000.00 Answer: __________
OOP Met: $0.00
11. Order Total: $1300.00
Answer: _________ Coverage: 95%
Deductible: $3000.00
6. Order Total: $599.00 Deductible Met: $1500.00
Coverage: 80% OOP: $7000.00
Deductible: $1,000.00 OOP Met: $2750.00
Deductible Met: $0.00
 Calculating Patient Responsibility
Answer: __________ 17. Order Total: $550.00
Coverage: 75%
12. Order Total: $251.11 Deductible: $800.00
Coverage: 80% Deductible Met: $250.00
Deductible: $200.00 OOP: $1800.00
Deductible Met: $180.00 OOP Met: $1350.00
OOP: $2000.00
OOP Met: $1800.00 Answer: __________

Answer: __________ 18. Order Total: $875.00

Coverage: 75%
13. Order Total: $753.33 Deductible: $900.00
Coverage: 50% Deductible Met: $835.00
Deductible: $1500.00 OOP: $2100.00
Deductible Met: $1230.00 OOP Met: $1890.00
OOP: $3000.00
OOP Met: $1230.00 Answer: __________

Answer: __________ 19. Order Total: $990.00

Coverage: 85%
14. Order Total: $1550.00 Deductible: $1300.00
Coverage: 100% Deductible Met: $975.00
Copay: $100.00 OOP: $3500.00
Deductible: $3000.00 OOP Met: $2350.00
Deductible Met: $2275.00
OOP: $5000.00 Answer: __________
OOP Met: $3125.00
20. Order Total: $1100.00
Answer: __________ Coverage: 95%
Deductible: $1500.00
15. Order Total: $900.00 Deductible Met: $50.00
Coverage: 80% OOP: $3500.00
Deductible: $1500.00 OOP Met: $50.00
Deductible Met: $1500.00
OOP: $3000.00 Answer: __________
OOP Met: $2750.00

Answer: __________

16. Order Total: $680.00

Coverage: 50%
Deductible: $300.00
Deductible Met: $300.00
OOP: $1500.00
OOP Met: $1425.00

Answer: __________