OTHER CLAIM RELATED FEE SUMMARY                                           
            Other Claim Related Fee Description/Incurred Date/Product/Sub Group-8 Digit/Payroll Location             

INVOICE NUMBER:     230110581479                                           PAGE:               1 of 3            
BILL ACCOUNT NUMBER:2401631001                                             PAID CLAIMS MONTH:  January 2023      
BILL ACCOUNT NAME:  Utz Quality Foods                                      CLAIMS PAID THRU:   01/06/2023        
CLIENT NUMBER:      240163                                                 BILL CYCLE:         1 of 4            
CLIENT NAME:        Utz Quality Foods                                      PREPARED DATE:      01/10/2023        

Other Claim Related Fee Description                                                                                Fee Amount                            
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
Claims Service Program: Non-Contracted Providers
  07/22
    Claims Service Program: Non-Contracted Providers
      025620-00
        INVIN                                                                                                          $24.40
      025620-00 Total                                                                                                  $24.40
    Claims Service Program: Non-Contracted Providers Total                                                             $24.40
  07/22 Total                                                                                                          $24.40
  08/22
    Claims Service Program: Non-Contracted Providers
      025620-01
        INVAZ                                                                                                           $2.49
      025620-01 Total                                                                                                   $2.49
    Claims Service Program: Non-Contracted Providers Total                                                              $2.49
  08/22 Total                                                                                                           $2.49
  12/22
    Claims Service Program: Non-Contracted Providers
      025620-01
          ADM                                                                                                         $101.25
      025620-01 Total                                                                                                 $101.25
      025620-02
          ADM                                                                                                         $143.64
      025620-02 Total                                                                                                 $143.64
    Claims Service Program: Non-Contracted Providers Total                                                            $244.89
  12/22 Total                                                                                                         $244.89
Claims Service Program: Non-Contracted Providers Total                                                                $271.78

                                                                                                                                                PAGE:2 of 3
                                                                                                                                                            
Other Claim Related Fee Description                                                                                Fee Amount                            
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
Claims Service Program: Participating
  12/22
    Claims Service Program: Participating
      025620-02
        SBSLS                                                                                                         $479.93
      025620-02 Total                                                                                                 $479.93
    Claims Service Program: Participating Total                                                                       $479.93
  12/22 Total                                                                                                         $479.93
Claims Service Program: Participating Total                                                                           $479.93
                                                                                                                                                            
Prepay Claims Savings Fee
  09/22
    Prepay Claims Savings Fee
      025620-01
         MKTG                                                                                                          $10.08
      025620-01 Total                                                                                                  $10.08
    Prepay Claims Savings Fee Total                                                                                    $10.08
  09/22 Total                                                                                                          $10.08
  12/22
    Prepay Claims Savings Fee
      025620-02
        CKPT2                                                                                                          $36.56
         PLT3                                                                                                           $3.36
      025620-02 Total                                                                                                  $39.92
    Prepay Claims Savings Fee Total                                                                                    $39.92
  12/22 Total                                                                                                          $39.92
  01/23
    Prepay Claims Savings Fee
      025620-01
        CHAMB                                                                                                           $1.21
      025620-01 Total                                                                                                   $1.21
    Prepay Claims Savings Fee Total                                                                                     $1.21

                                                                                                                                                PAGE:3 of 3
                                                                                                                                                            
Other Claim Related Fee Description                                                                                Fee Amount                            
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
  01/23 Total                                                                                                           $1.21
Prepay Claims Savings Fee Total                                                                                        $51.21
                                                                                                                                                            
Reprocessing Fee
  12/22
    Reprocessing Fee
      025620-01
         PLT3                                                                                                          $50.00
      025620-01 Total                                                                                                  $50.00
    Reprocessing Fee Total                                                                                             $50.00
  12/22 Total                                                                                                          $50.00
Reprocessing Fee Total                                                                                                 $50.00
                                                                                                                                                            
Other Claims Related Fee Summary Total                                                                                $852.92