The attributable costs and damages approach was estimated using a literature-based attributable cost ceiling model. The approach is a typical attributable cost or damages approach, with necessary adjustments for state and local share of attributable costs, opioids sourced from the healthcare system and fixed versus variable costs. The total ten-year extrapolated NPV-adjusted attributable costs across all three categories would be $16,377.81 million nationally. When apportioned to the two Ohio counties featured in an opioid MDL abatement order, the amounts derived from the cost ceiling model are less than 1% of those claimed by plaintiffs in the two Ohio counties. The plaintiff amounts are based on estimated abatement costs, rather than attributable costs, and that difference may explain part of the difference. This will be explored in the next chapter, where an abatement cost model is developed, more broadly consistent with the general approach taken by plaintiffs in the MDL.