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

INVOICE NUMBER:     230131587845                                           PAGE:               1 of 3            
BILL ACCOUNT NUMBER:2401631001                                             PAID CLAIMS MONTH:  January 2023      
BILL ACCOUNT NAME:  Utz Quality Foods                                      CLAIMS PAID THRU:   01/27/2023        
CLIENT NUMBER:      240163                                                 BILL CYCLE:         4 of 4            
CLIENT NAME:        Utz Quality Foods                                      PREPARED DATE:      01/31/2023        

Other Claim Related Fee Description                                                                                Fee Amount                            
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
Claims Service Program: Non-Contracted Providers
  01/23
    Claims Service Program: Non-Contracted Providers
      025620-00
          ADM                                                                                                         $264.19
      025620-00 Total                                                                                                 $264.19
      025620-01
          NEW                                                                                                         $417.15
      025620-01 Total                                                                                                 $417.15
    Claims Service Program: Non-Contracted Providers Total                                                            $681.34
  01/23 Total                                                                                                         $681.34
Claims Service Program: Non-Contracted Providers Total                                                                $681.34
                                                                                                                                                            
Pre Pay Coding Validation
  01/23
    Pre Pay Coding Validation
      025620-01
        FLEET                                                                                                          $12.49
      025620-01 Total                                                                                                  $12.49
      025620-02
         PLT1                                                                                                          $17.59
      025620-02 Total                                                                                                  $17.59
    Pre Pay Coding Validation Total                                                                                    $30.08
  01/23 Total                                                                                                          $30.08
Pre Pay Coding Validation Total                                                                                        $30.08
                                                                                                                                                            
Prepay Claims Savings Fee

                                                                                                                                                PAGE:2 of 3
                                                                                                                                                            
Other Claim Related Fee Description                                                                                Fee Amount                            
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
  10/22
    Prepay Claims Savings Fee
      025620-01
         PLT4                                                                                                           $5.88
        SBUNB                                                                                                          $98.53
      025620-01 Total                                                                                                 $104.41
    Prepay Claims Savings Fee Total                                                                                   $104.41
  10/22 Total                                                                                                         $104.41
  12/22
    Prepay Claims Savings Fee
      025620-01
         PLT3                                                                                                          $58.52
      025620-01 Total                                                                                                  $58.52
    Prepay Claims Savings Fee Total                                                                                    $58.52
  12/22 Total                                                                                                          $58.52
  01/23
    Prepay Claims Savings Fee
      025620-01
         PLT3                                                                                                          $35.59
      025620-01 Total                                                                                                  $35.59
      025620-02
         PLT1                                                                                                           $8.90
      025620-02 Total                                                                                                   $8.90
    Prepay Claims Savings Fee Total                                                                                    $44.49
  01/23 Total                                                                                                          $44.49
Prepay Claims Savings Fee Total                                                                                       $207.42
                                                                                                                                                            
Reprocessing Fee
  01/23
    Reprocessing Fee
      025620-01
         MKTG                                                                                                          $25.00

                                                                                                                                                PAGE:3 of 3
                                                                                                                                                            
Other Claim Related Fee Description                                                                                Fee Amount                            
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
         PLT5                                                                                                          $25.00
      025620-01 Total                                                                                                  $50.00
    Reprocessing Fee Total                                                                                             $50.00
  01/23 Total                                                                                                          $50.00
Reprocessing Fee Total                                                                                                 $50.00
                                                                                                                                                            
Other Claims Related Fee Summary Total                                                                                $968.84