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Operating expenses totaled $18.7 billion, an increase of $1.6 billion (9%) over 2022, reflecting increases in medical claims ($364 million or 51%, related to the increase in Health Plan membership), wages ($543 million or 8%, including market adjustments for certain employees and ongoing use of temporary staffing), costs and use of clinical ($127 million or 14%) and pharmaceutical ($320 million or 26%) supplies, and depreciation and interest ($9 million, 1%)