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Medicaid Financial Management Report - Net CHIP Expenditures FY 1998

Alabama National

FMR M-CHIP

Service Category Total Computable Federal Share State ShareC-Premiums: Up To 150% - Gross Premiums Paid 249,218 195,686 53,532C-Premiums: Up To 150% - Cost Sharing Offset 0 0 0C-Premiums: Over 150% - Gross Premiums Paid 1 1 0C-Premiums: Over 150% - Cost Sharing Offset 0 0 0C-Inpatient Hospital Services - Reg. Payments 768,811 603,670 165,141

C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 81,444 63,950 17,494C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 326,350 256,250 70,100C-Outpatient Hospital Services 187,754 147,425 40,329C-Outpatient Mental Health 0 0 0C-Prescribed Drugs 342,147 268,654 73,493C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 215,208 168,981 46,227C-Vision Sevices 76,064 59,726 16,338C-Other Practitioners 11,262 8,843 2,419C-Clinic Services 140,820 110,572 30,248


Alabama National

FMR M-CHIP

Service Category Total Computable Federal Share State ShareC-Therapy Services 0 0 0

C-Laboratory/Radiological Services 107,072 84,073 22,999C-Medical Equipment 8,702 6,833 1,869C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 63,787 50,085 13,702C-Home Health 3,135 2,462 673C-Medicare Payments 0 0 0C-Home And Community 0 0 0C-Hospice 0 0 0C-Medical Transport 16,105 12,645 3,460C-Case Management 141,534 111,133 30,401C-Other Services 49,498 38,866 10,632C-Balance 2,788,912 2,189,855 599,057C-Collections 0 0 0C-Total Net 2,788,912 2,189,855 599,057

Created On: Wednesday, April 3, 2013 at 9:17 AM

Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Alaska

National

FMR M-CHIP

Service Category Total Computable Federal Share State ShareC-Premiums: Up To 150% - Gross Premiums Paid 0 0 0C-Premiums: Up To 150% - Cost Sharing Offset 0 0 0C-Premiums: Over 150% - Gross Premiums Paid 0 0 0C-Premiums: Over 150% - Cost Sharing Offset 0 0 0C-Inpatient Hospital Services - Reg. Payments 0 0 0

C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 0 0 0C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 0 0 0C-Outpatient Hospital Services 0 0 0C-Outpatient Mental Health 0 0 0C-Prescribed Drugs 0 0 0C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 0 0 0C-Vision Sevices 0 0 0C-Other Practitioners 0 0 0C-Clinic Services 0 0 0


National

FMR M-CHIP


C-Laboratory/Radiological Services 0 0 0C-Medical Equipment 0 0 0C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 0 0 0C-Home Health 0 0 0C-Medicare Payments 0 0 0C-Home And Community 0 0 0C-Hospice 0 0 0C-Medical Transport 0 0 0C-Case Management 0 0 0C-Other Services 0 0 0C-Balance 0 0 0C-Collections 0 0 0C-Total Net 0 0 0



Amer. Samoa National

FMR M-CHIP





FMR M-CHIP




Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Arizona National

FMR M-CHIP




FMR M-CHIP





Arkansas National

FMR M-CHIP




California National

FMR M-CHIP

Service Category Total Computable Federal Share State ShareC-Premiums: Up To 150% - Gross Premiums Paid 0 0 0C-Premiums: Up To 150% - Cost Sharing Offset 0 0 0C-Premiums: Over 150% - Gross Premiums Paid 0 0 0C-Premiums: Over 150% - Cost Sharing Offset 0 0 0C-Inpatient Hospital Services - Reg. Payments 424,445 279,539 144,906

C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 27,655 18,214 9,441C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 202,310 133,241 69,069C-Outpatient Hospital Services 89,379 58,865 30,514C-Outpatient Mental Health 0 0 0C-Prescribed Drugs 182,679 120,313 62,366C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 100,577 66,240 34,337C-Vision Sevices 0 0 0C-Other Practitioners 1,199 789 410C-Clinic Services 7,984 5,258 2,726


California National

FMR M-CHIP


C-Laboratory/Radiological Services 43,509 28,655 14,854C-Medical Equipment 0 0 0C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 9,813 6,463 3,350C-Home Health 86,944 57,261 29,683C-Medicare Payments 0 0 0C-Home And Community 0 0 0C-Hospice 0 0 0C-Medical Transport 0 0 0C-Case Management 0 0 0C-Other Services 10,469 6,895 3,574C-Balance 1,186,963 781,733 405,230C-Collections 0 0 0C-Total Net 1,186,963 781,733 405,230



Colorado National

FMR M-CHIP




Connecticut National

FMR M-CHIP





FMR M-CHIP





Delaware National

FMR M-CHIP




Dist. Of Col. National

FMR M-CHIP





FMR M-CHIP




Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Florida

National

FMR M-CHIP


C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 0 0 0C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 501,233 345,650 155,583C-Outpatient Hospital Services 600,353 414,004 186,349C-Outpatient Mental Health 149,865 103,347 46,518C-Prescribed Drugs 275,185 189,768 85,417C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 513,278 353,956 159,322C-Vision Sevices 0 0 0C-Other Practitioners 48,136 33,195 14,941C-Clinic Services 130,799 90,199 40,600


National

FMR M-CHIP


C-Laboratory/Radiological Services 51,909 35,796 16,113C-Medical Equipment 0 0 0C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 37,962 26,179 11,783C-Home Health 21,780 15,019 6,761C-Medicare Payments 0 0 0C-Home And Community 0 0 0C-Hospice 0 0 0C-Medical Transport 0 0 0C-Case Management 25,729 17,742 7,987C-Other Services 3,170,667 2,186,492 984,175C-Balance 6,454,111 4,450,754 2,003,357C-Collections 0 0 0C-Total Net 6,454,111 4,450,754 2,003,357


Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Georgia National

FMR M-CHIP




FMR M-CHIP




Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Guam

National

FMR M-CHIP




National

FMR M-CHIP




Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Hawaii

National

FMR M-CHIP




National

FMR M-CHIP




Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Idaho

National

FMR M-CHIP


C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 0 0 0C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 303,068 238,545 64,523C-Outpatient Hospital Services 106,337 83,698 22,639C-Outpatient Mental Health 0 0 0C-Prescribed Drugs 171,797 135,222 36,575C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 345,717 272,114 73,603C-Vision Sevices 0 0 0C-Other Practitioners 50,596 39,824 10,772C-Clinic Services 72,010 56,679 15,331


National

FMR M-CHIP


C-Laboratory/Radiological Services 38,201 30,068 8,133C-Medical Equipment 0 0 0C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 17,775 13,991 3,784C-Home Health 1,031 812 219C-Medicare Payments 0 0 0C-Home And Community 6,965 5,482 1,483C-Hospice 0 0 0C-Medical Transport 13,826 10,882 2,944C-Case Management 10,784 8,488 2,296C-Other Services 52,377 41,226 11,151C-Balance 1,562,098 1,229,528 332,570C-Collections 0 0 0C-Total Net 1,562,098 1,229,528 332,570


Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Illinois

National

FMR M-CHIP

Service Category Total Computable Federal Share State ShareC-Premiums: Up To 150% - Gross Premiums Paid 200,860 130,559 70,301C-Premiums: Up To 150% - Cost Sharing Offset 0 0 0C-Premiums: Over 150% - Gross Premiums Paid 0 0 0C-Premiums: Over 150% - Cost Sharing Offset 0 0 0C-Inpatient Hospital Services - Reg. Payments 3,507,219 2,279,692 1,227,527

C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 434,522 282,440 152,082C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 140 91 49C-Physician/Surgical 807,503 524,877 282,626C-Outpatient Hospital Services 852,510 554,132 298,378C-Outpatient Mental Health 0 0 0C-Prescribed Drugs 1,221,686 794,095 427,591C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 155,388 101,002 54,386C-Vision Sevices 15,265 9,923 5,342C-Other Practitioners 1,105,980 718,888 387,092C-Clinic Services 362,063 235,341 126,722


National

FMR M-CHIP

Service Category Total Computable Federal Share State ShareC-Therapy Services 4,865 3,162 1,703

C-Laboratory/Radiological Services 170,427 110,778 59,649C-Medical Equipment 95,398 62,009 33,389C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 336,146 218,495 117,651C-Home Health 6,600 4,290 2,310C-Medicare Payments 2,528 1,643 885C-Home And Community 0 0 0C-Hospice 1,304 848 456C-Medical Transport 54,535 35,448 19,087C-Case Management 15,905 10,339 5,566C-Other Services 5,548 3,606 1,942C-Balance 9,356,392 6,081,658 3,274,734C-Collections 0 0 0C-Total Net 9,356,392 6,081,658 3,274,734


Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Indiana National

FMR M-CHIP




FMR M-CHIP





Iowa National

FMR M-CHIP


C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 0 0 0C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 40,912 30,533 10,379C-Outpatient Hospital Services 40,388 30,142 10,246C-Outpatient Mental Health 0 0 0C-Prescribed Drugs 50,383 37,601 12,782C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 29,144 21,750 7,394C-Vision Sevices 10,191 7,606 2,585C-Other Practitioners 1,861 1,389 472C-Clinic Services 6,584 4,914 1,670


Iowa National

FMR M-CHIP


C-Laboratory/Radiological Services 923 689 234C-Medical Equipment 0 0 0C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 15,876 11,848 4,028C-Home Health 99 74 25C-Medicare Payments 0 0 0C-Home And Community 0 0 0C-Hospice 0 0 0C-Medical Transport 0 0 0C-Case Management 0 0 0C-Other Services 2,479 1,850 629C-Balance 339,491 253,364 86,127C-Collections 0 0 0C-Total Net 339,491 253,364 86,127


Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Kansas

National

FMR M-CHIP




National

FMR M-CHIP





Kentucky National

FMR M-CHIP




Louisiana National

FMR M-CHIP



Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Maine

National

FMR M-CHIP




National

FMR M-CHIP





Maryland National

FMR M-CHIP


C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 4,999 3,249 1,750C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 9,987 6,492 3,495C-Outpatient Hospital Services 52,285 33,985 18,300C-Outpatient Mental Health 0 0 0C-Prescribed Drugs 19,450 12,643 6,807C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 535 348 187C-Vision Sevices 332 216 116C-Other Practitioners 91 59 32C-Clinic Services 1,489 968 521


Maryland National

FMR M-CHIP


C-Laboratory/Radiological Services 4,972 3,232 1,740C-Medical Equipment 922 599 323C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 2,645 1,719 926C-Home Health 0 0 0C-Medicare Payments 0 0 0C-Home And Community 0 0 0C-Hospice 0 0 0C-Medical Transport 575 374 201C-Case Management 0 0 0C-Other Services (6,043) (3,928) (2,115)C-Balance 969,704 630,308 339,396C-Collections 0 0 0C-Total Net 969,704 630,308 339,396



Mass. Blind National

FMR M-CHIP





FMR M-CHIP





Massachusetts National

FMR M-CHIP





FMR M-CHIP





Michigan National

FMR M-CHIP

Service Category Total Computable Federal Share State ShareC-Premiums: Up To 150% - Gross Premiums Paid 274,292 185,175 89,117C-Premiums: Up To 150% - Cost Sharing Offset 0 0 0C-Premiums: Over 150% - Gross Premiums Paid 0 0 0C-Premiums: Over 150% - Cost Sharing Offset 0 0 0C-Inpatient Hospital Services - Reg. Payments 0 0 0

C-Inpatient Hospital Services - DSH 183,574 123,931 59,643C-Inpatient Mental Health - Reg. Payment 0 0 0C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 121,147 81,786 39,361C-Outpatient Hospital Services 105,129 70,973 34,156C-Outpatient Mental Health 37,594 25,380 12,214C-Prescribed Drugs 124,085 83,770 40,315C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 33,567 22,661 10,906C-Vision Sevices 6,888 4,650 2,238C-Other Practitioners 3,242 2,189 1,053C-Clinic Services 60,331 40,729 19,602


Michigan National

FMR M-CHIP


C-Laboratory/Radiological Services 3,944 2,663 1,281C-Medical Equipment 2,408 1,626 782C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 0 0 0C-Home Health 9,441 6,374 3,067C-Medicare Payments 0 0 0C-Home And Community 0 0 0C-Hospice 0 0 0C-Medical Transport 8,542 5,767 2,775C-Case Management 0 0 0C-Other Services 0 0 0C-Balance 974,415 657,830 316,585C-Collections 0 0 0C-Total Net 974,415 657,830 316,585



Minnesota National

FMR M-CHIP




Mississippi National

FMR M-CHIP





FMR M-CHIP





Missouri National

FMR M-CHIP




Montana National

FMR M-CHIP




N. Mariana Islands National

FMR M-CHIP





FMR M-CHIP


C-Laboratory/Radiological Services 0 0 0C-Medical Equipment 0 0 0C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 0 0 0C-Home Health 0 0 0C-Medicare Payments 0 0 0C-Home And Community 0 0 0C-Hospice 0 0 0C-Medical Transport 0 0 0C-Case Management 0 0 0C-Other Services 910,050 591,533 318,517C-Balance 910,050 591,533 318,517C-Collections 0 0 0C-Total Net 910,050 591,533 318,517



Nebraska National

FMR M-CHIP


C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 0 0 0C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 765 472 293C-Outpatient Hospital Services 2,314 1,415 899C-Outpatient Mental Health 0 0 0C-Prescribed Drugs 3,052 1,901 1,151C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 386 247 139C-Vision Sevices 0 0 0C-Other Practitioners 2 1 1C-Clinic Services 0 0 0


Nebraska National

FMR M-CHIP


C-Laboratory/Radiological Services 90 55 35C-Medical Equipment 0 0 0C-Family Planning 14 9 5C-Abortions 0 0 0C-Screening Services 0 0 0C-Home Health 0 0 0C-Medicare Payments 0 0 0C-Home And Community 0 0 0C-Hospice 0 0 0C-Medical Transport 0 0 0C-Case Management 0 0 0C-Other Services 0 0 0C-Balance 6,623 4,100 2,523C-Collections 0 0 0C-Total Net 6,623 4,100 2,523


Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Nevada National

FMR M-CHIP




FMR M-CHIP





New Hampshire National

FMR M-CHIP





FMR M-CHIP





New Jersey National

FMR M-CHIP

Service Category Total Computable Federal Share State ShareC-Premiums: Up To 150% - Gross Premiums Paid 3,141,381 2,041,898 1,099,483C-Premiums: Up To 150% - Cost Sharing Offset 0 0 0C-Premiums: Over 150% - Gross Premiums Paid 0 0 0C-Premiums: Over 150% - Cost Sharing Offset 0 0 0C-Inpatient Hospital Services - Reg. Payments 348,167 226,308 121,859

C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 48,123 31,280 16,843C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 61,137 39,739 21,398C-Outpatient Hospital Services 406,169 264,010 142,159C-Outpatient Mental Health 0 0 0C-Prescribed Drugs 200,730 130,474 70,256C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 78,798 51,219 27,579C-Vision Sevices 30,683 19,944 10,739C-Other Practitioners 16,862 10,960 5,902C-Clinic Services 103,204 67,083 36,121


New Jersey National

FMR M-CHIP


C-Laboratory/Radiological Services 24,625 16,007 8,618C-Medical Equipment 2,636 1,714 922C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 0 0 0C-Home Health 8,133 5,287 2,846C-Medicare Payments 0 0 0C-Home And Community 4,278 2,781 1,497C-Hospice 0 0 0C-Medical Transport 3,101 2,016 1,085C-Case Management 0 0 0C-Other Services 54,452 35,394 19,058C-Balance 4,532,479 2,946,114 1,586,365C-Collections 0 0 0C-Total Net 4,532,479 2,946,114 1,586,365



New Mexico National

FMR M-CHIP




New York National

FMR M-CHIP




North Carolina National

FMR M-CHIP





FMR M-CHIP





North Dakota National

FMR M-CHIP





FMR M-CHIP





Ohio National

FMR M-CHIP

Service Category Total Computable Federal Share State ShareC-Premiums: Up To 150% - Gross Premiums Paid 1,377,493 973,887 403,606C-Premiums: Up To 150% - Cost Sharing Offset 0 0 0C-Premiums: Over 150% - Gross Premiums Paid 79,622 56,293 23,329C-Premiums: Over 150% - Cost Sharing Offset 0 0 0C-Inpatient Hospital Services - Reg. Payments 3,371,122 2,383,384 987,738

C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 729,431 515,708 213,723C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 1,564,861 1,106,357 458,504C-Outpatient Hospital Services 1,165,508 824,014 341,494C-Outpatient Mental Health 0 0 0C-Prescribed Drugs 1,351,186 955,288 395,898C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 755,347 534,030 221,317C-Vision Sevices 0 0 0C-Other Practitioners 235,358 166,398 68,960C-Clinic Services 850,515 601,314 249,201


Ohio National

FMR M-CHIP


C-Laboratory/Radiological Services 41,820 29,567 12,253C-Medical Equipment 0 0 0C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 0 0 0C-Home Health 38,053 26,903 11,150C-Medicare Payments 0 0 0C-Home And Community 11,512 8,139 3,373C-Hospice 9,096 6,431 2,665C-Medical Transport 56,563 39,990 16,573C-Case Management 193,172 136,573 56,599C-Other Services 387,344 273,852 113,492C-Balance 12,218,003 8,638,128 3,579,875C-Collections 0 0 0C-Total Net 12,218,003 8,638,128 3,579,875



Oklahoma National

FMR M-CHIP



Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Oregon National

FMR M-CHIP




FMR M-CHIP





Pennsylvania National

FMR M-CHIP





FMR M-CHIP





Puerto Rico National

FMR M-CHIP





FMR M-CHIP





Rhode Island National

FMR M-CHIP





FMR M-CHIP





South Carolina National

FMR M-CHIP

Service Category Total Computable Federal Share State ShareC-Premiums: Up To 150% - Gross Premiums Paid 120,855 95,670 25,185C-Premiums: Up To 150% - Cost Sharing Offset 0 0 0C-Premiums: Over 150% - Gross Premiums Paid 0 0 0C-Premiums: Over 150% - Cost Sharing Offset 0 0 0C-Inpatient Hospital Services - Reg. Payments 4,238,507 3,355,202 883,305

C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 5,367,907 4,249,235 1,118,672C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 3,398,729 2,690,435 708,294C-Outpatient Hospital Services 1,847,950 1,462,837 385,113C-Outpatient Mental Health 516 408 108C-Prescribed Drugs 2,192,299 1,735,425 456,874C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 2,251,893 1,782,599 469,294C-Vision Sevices 81,860 64,800 17,060C-Other Practitioners 444,374 351,767 92,607C-Clinic Services 3,225,816 2,553,556 672,260



FMR M-CHIP


C-Laboratory/Radiological Services 335,607 265,666 69,941C-Medical Equipment 182,537 144,496 38,041C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 325,202 257,430 67,772C-Home Health 68,915 54,554 14,361C-Medicare Payments 569 451 118C-Home And Community 19,564 15,487 4,077C-Hospice 0 0 0C-Medical Transport 111,932 88,606 23,326C-Case Management 2,294,047 1,815,968 478,079C-Other Services 5,321,514 4,212,510 1,109,004C-Balance 31,846,762 25,209,902 6,636,860C-Collections 0 0 0C-Total Net 31,846,762 25,209,902 6,636,860



South Dakota National

FMR M-CHIP

Service Category Total Computable Federal Share State ShareC-Premiums: Up To 150% - Gross Premiums Paid 0 0 0C-Premiums: Up To 150% - Cost Sharing Offset 0 0 0C-Premiums: Over 150% - Gross Premiums Paid 0 0 0C-Premiums: Over 150% - Cost Sharing Offset 0 0 0C-Inpatient Hospital Services - Reg. Payments 3,053 2,364 689

C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 0 0 0C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 11,526 8,925 2,601C-Outpatient Hospital Services 7,627 5,906 1,721C-Outpatient Mental Health 0 0 0C-Prescribed Drugs 16,928 13,107 3,821C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 0 0 0C-Vision Sevices 1,996 1,546 450C-Other Practitioners 12,010 9,299 2,711C-Clinic Services 1,912 1,480 432



FMR M-CHIP


C-Laboratory/Radiological Services 601 465 136C-Medical Equipment 0 0 0C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 463 359 104C-Home Health 9 7 2C-Medicare Payments 0 0 0C-Home And Community 0 0 0C-Hospice 0 0 0C-Medical Transport 211 163 48C-Case Management 2,274 1,761 513C-Other Services 1,869 1,447 422C-Balance 60,479 46,829 13,650C-Collections 0 0 0C-Total Net 60,479 46,829 13,650



Tennessee National

FMR M-CHIP



Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Texas

National

FMR M-CHIP

Service Category Total Computable Federal Share State ShareC-Premiums: Up To 150% - Gross Premiums Paid 1,395,320 1,026,955 368,365C-Premiums: Up To 150% - Cost Sharing Offset 0 0 0C-Premiums: Over 150% - Gross Premiums Paid 0 0 0C-Premiums: Over 150% - Cost Sharing Offset 0 0 0C-Inpatient Hospital Services - Reg. Payments 0 0 0

C-Inpatient Hospital Services - DSH 0 0 0C-Inpatient Mental Health - Reg. Payment 0 0 0C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 0 0 0C-Physician/Surgical 0 0 0C-Outpatient Hospital Services 0 0 0C-Outpatient Mental Health 0 0 0C-Prescribed Drugs 336,362 247,562 88,800C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 0 0 0C-Vision Sevices 0 0 0C-Other Practitioners 0 0 0C-Clinic Services 0 0 0


National

FMR M-CHIP


C-Laboratory/Radiological Services 0 0 0C-Medical Equipment 0 0 0C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 0 0 0C-Home Health 0 0 0C-Medicare Payments 0 0 0C-Home And Community 0 0 0C-Hospice 0 0 0C-Medical Transport 0 0 0C-Case Management 1,200 883 317C-Other Services 0 0 0C-Balance 1,732,882 1,275,400 457,482C-Collections 0 0 0C-Total Net 1,732,882 1,275,400 457,482



Utah National

FMR M-CHIP




Vermont National

FMR M-CHIP




Virgin Islands National

FMR M-CHIP





FMR M-CHIP




Medicaid Financial Management Report - Net CHIP Expenditures FY 1998 Virginia National

FMR M-CHIP




FMR M-CHIP





Washington National

FMR M-CHIP




West Virginia National

FMR M-CHIP





FMR M-CHIP


C-Laboratory/Radiological Services 0 0 0C-Medical Equipment 0 0 0C-Family Planning 0 0 0C-Abortions 0 0 0C-Screening Services 706 576 130C-Home Health 0 0 0C-Medicare Payments 0 0 0C-Home And Community 0 0 0C-Hospice 0 0 0C-Medical Transport 0 0 0C-Case Management 0 0 0C-Other Services 2,051 1,673 378C-Balance 4,222 3,444 778C-Collections 0 0 0C-Total Net 4,222 3,444 778



Wisconsin National

FMR M-CHIP




Wyoming National

FMR M-CHIP




National Totals National

FMR M-CHIP

Service Category Total Computable Federal Share State ShareC-Premiums: Up To 150% - Gross Premiums Paid 7,703,923 5,274,389 2,429,534C-Premiums: Up To 150% - Cost Sharing Offset 0 0 0C-Premiums: Over 150% - Gross Premiums Paid 79,623 56,294 23,329C-Premiums: Over 150% - Cost Sharing Offset 0 0 0C-Inpatient Hospital Services - Reg. Payments 14,033,765 10,112,824 3,920,941

C-Inpatient Hospital Services - DSH 183,574 123,931 59,643C-Inpatient Mental Health - Reg. Payment 6,694,081 5,164,076 1,530,005C-Inpatient Mental Health - DSH 0 0 0C-Nursing Care Services 140 91 49C-Physician/Surgical 7,349,878 5,463,587 1,886,291C-Outpatient Hospital Services 5,463,871 3,951,543 1,512,328C-Outpatient Mental Health 187,975 129,135 58,840C-Prescribed Drugs 6,488,773 4,726,479 1,762,294C-Drug Rebate - National 0 0 0C-Drug Rebate - State 0 0 0C-Dental Services 4,479,981 3,375,264 1,104,717C-Vision Sevices 223,279 168,411 54,868C-Other Practitioners 1,930,973 1,343,601 587,372C-Clinic Services 4,963,527 3,768,093 1,195,434



FMR M-CHIP


C-Laboratory/Radiological Services 823,700 607,714 215,986C-Medical Equipment 292,603 217,277 75,326C-Family Planning 14 9 5C-Abortions 0 0 0C-Screening Services 810,375 587,145 223,230C-Home Health 244,140 173,043 71,097C-Medicare Payments 3,097 2,094 1,003C-Home And Community 42,319 31,889 10,430C-Hospice 10,400 7,279 3,121C-Medical Transport 265,390 195,891 69,499C-Case Management 2,684,645 2,102,887 581,758C-Other Services 9,962,275 7,391,416 2,570,859C-Balance 74,943,586 54,990,480 19,953,106C-Collections 0 0 0C-Total Net 74,943,586 54,990,480 19,953,106



National

FMR T-CHIP

Service Category Total Computable Federal Share State ShareNo Data Found



Alabama National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 298,962 269,066 29,896MMIS - Inhouse Activities 193,489 174,142 19,347MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 2,745,055 2,058,792 686,263Approved MMIS: Inhouse 5,876,909 4,407,682 1,469,227Approved MMIS: Private 5,031,476 3,773,607 1,257,869Mechanized Systems - In-House 948 475 473

Mechanized Systems: Private Sector 3,472,735 1,736,368 1,736,367Peer Review Organizations 0 0 0TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 2,190,354 1,095,178 1,095,176Preadmission Screening 594,565 445,924 148,641Resident Review 0 0 0Drug Use Review 78,261 39,131 39,130Outstationed Eligibility 4,761,634 2,864,152 1,897,482TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 28,476,932 14,238,467 14,238,465Balance 53,721,320 31,102,984 22,618,336


Alabama National

FMR CHIP

Service Category Total Computable Federal Share State ShareCollections (63,125) (33,590) (29,535)Total Net Expenditures 53,658,195 31,069,394 22,588,801CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 0 0 0Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 0 0 0Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0


Alabama National

FMR CHIP

Service Category Total Computable Federal Share State ShareAbortions 0 0 0Screening Services 0 0 0Home Health 0 0 0Reserved 0 0 0Home and Community 0 0 0Hospice 0 0 0Medical Transportation 0 0 0Case Management 0 0 0Other Services 0 0 0Outreach 6,259 4,915 1,344Administration 303,620 238,402 65,218Balance 309,879 243,317 66,562Less: Collections 0 0 0Total 309,879 243,317 66,562



National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 372 336 36MMIS - Inhouse Activities (1,266) (1,139) (127)MMIS - Private Sector 718,512 539,559 178,953MMIS - Drug Claims 0 0 0Skilled Professional 3,756,605 2,817,455 939,150Approved MMIS: Inhouse 1,351,102 1,013,326 337,776Approved MMIS: Private 5,589,625 4,192,219 1,397,406Mechanized Systems - In-House 517,968 258,984 258,984

Mechanized Systems: Private Sector 416,730 208,365 208,365Peer Review Organizations 561,367 421,025 140,342TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 192,195 144,147 48,048Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 21,540,681 10,770,341 10,770,340Balance 34,643,891 20,364,618 14,279,273


National

FMR CHIP

Service Category Total Computable Federal Share State ShareCollections 0 0 0Total Net Expenditures 34,643,891 20,364,618 14,279,273CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 0 0 0Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 0 0 0Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0


National

FMR CHIP

Service Category Total Computable Federal Share State ShareAbortions 0 0 0Screening Services 0 0 0Home Health 0 0 0Reserved 0 0 0Home and Community 0 0 0Hospice 0 0 0Medical Transportation 0 0 0Case Management 0 0 0Other Services 0 0 0Outreach 0 0 0Administration 0 0 0Balance 0 0 0Less: Collections 0 0 0Total 0 0 0




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 0 0 0Approved MMIS: Inhouse 0 0 0Approved MMIS: Private 0 0 0Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 0 0 0TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 0 0 0Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 0 0 0Balance 0 0 0



FMR CHIP

Service Category Total Computable Federal Share State ShareCollections 0 0 0Total Net Expenditures 0 0 0CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 0 0 0Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 0 0 0Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0



FMR CHIP




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 24,552 22,096 2,456MMIS - Inhouse Activities 10,839 9,755 1,084MMIS - Private Sector 18,085 16,277 1,808MMIS - Drug Claims 0 0 0Skilled Professional 8,490,091 6,367,569 2,122,522Approved MMIS: Inhouse 8,941,093 6,705,820 2,235,273Approved MMIS: Private 1,078,066 808,549 269,517Mechanized Systems - In-House 1,331,739 665,871 665,868

Mechanized Systems: Private Sector 899,080 449,541 449,539Peer Review Organizations 584,540 438,406 146,134TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 82,138 82,138 0Nurse Aide Training Costs 171,544 85,773 85,771Preadmission Screening 4,980,663 3,735,497 1,245,166Resident Review 317,451 238,088 79,363Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 111,103,184 55,551,593 55,551,591Balance 138,033,065 75,176,973 62,856,092


FMR CHIP



Arkansas National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 1,294,315 1,164,884 129,431MMIS - Drug Claims 0 0 0Skilled Professional 7,434,234 5,575,677 1,858,557Approved MMIS: Inhouse 553,982 415,486 138,496Approved MMIS: Private 17,203,399 12,902,549 4,300,850Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 4,549,557 3,412,168 1,137,389TPL - Recovery 33,646 16,824 16,822TPL - Assignment Of Rights 15,671 7,836 7,835Immigration Status 0 0 0Nurse Aide Training Costs 1,448,532 724,267 724,265Preadmission Screening 310,245 232,683 77,562Resident Review 71,945 53,960 17,985Drug Use Review 243,232 121,618 121,614Outstationed Eligibility 1,073,541 536,772 536,769TANF Base 1,541,346 1,387,211 154,135TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 50,455,458 25,227,730 25,227,728Balance 86,229,103 51,779,665 34,449,438


Arkansas National

FMR CHIP



California National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 11,307,095 10,176,385 1,130,710MMIS - Private Sector 1,784,245 1,605,821 178,424MMIS - Drug Claims 0 0 0Skilled Professional 79,101,067 59,325,801 19,775,266Approved MMIS: Inhouse 31,990,933 23,993,202 7,997,731Approved MMIS: Private 105,094,248 78,820,686 26,273,562Mechanized Systems - In-House 17,322,585 8,661,295 8,661,290

Mechanized Systems: Private Sector 19,183,569 9,591,787 9,591,782Peer Review Organizations 0 0 0TPL - Recovery 501,226 250,614 250,612TPL - Assignment Of Rights 18,085 9,043 9,042Immigration Status (77,504,265) (77,504,265) 0Nurse Aide Training Costs 0 0 0Preadmission Screening (5,837,329) (4,377,997) (1,459,332)Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 4,530,060 4,077,054 453,006TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 1,037,266,810 518,633,410 518,633,400Balance 1,224,758,329 633,262,836 591,495,493


California National

FMR CHIP

Service Category Total Computable Federal Share State ShareCollections 0 0 0Total Net Expenditures 1,224,758,329 633,262,836 591,495,493CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 1,283,781 845,498 438,283Premiums - Up To 150%: Cost Sharing Offset (238,781) (157,261) (81,520)Premiums - Over 150%: Gross Premiums Paid 465,240 306,407 158,833Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0


California National

FMR CHIP

Service Category Total Computable Federal Share State ShareAbortions 0 0 0Screening Services 16,381 10,789 5,592Home Health 0 0 0Reserved 0 0 0Home and Community 0 0 0Hospice 0 0 0Medical Transportation 0 0 0Case Management 0 0 0Other Services 0 0 0Outreach 133,705 88,058 45,647Administration 167,804 110,516 57,288Balance 1,828,130 1,204,007 624,123Less: Collections 0 0 0Total 1,828,130 1,204,007 624,123



Colorado National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 2,886,306 2,597,675 288,631MMIS - Drug Claims 0 0 0Skilled Professional 706,422 529,817 176,605Approved MMIS: Inhouse 567,488 425,617 141,871Approved MMIS: Private 9,151,713 6,863,785 2,287,928Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 4,617,500 3,463,125 1,154,375TPL - Recovery 10,498 5,249 5,249TPL - Assignment Of Rights 4,961 2,481 2,480Immigration Status 13,803 13,803 0Nurse Aide Training Costs 264,087 132,044 132,043Preadmission Screening 350,471 262,853 87,618Resident Review 453,780 340,335 113,445Drug Use Review 0 0 0Outstationed Eligibility 73,651 36,826 36,825TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 45,837,910 22,918,956 22,918,954Balance 64,938,590 37,592,566 27,346,024


Colorado National

FMR CHIP

Service Category Total Computable Federal Share State ShareCollections 0 0 0Total Net Expenditures 64,938,590 37,592,566 27,346,024CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 1,051,773 698,166 353,607Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 287,788 191,034 96,754Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0


Colorado National

FMR CHIP

Service Category Total Computable Federal Share State ShareAbortions 0 0 0Screening Services 0 0 0Home Health 0 0 0Reserved 0 0 0Home and Community 0 0 0Hospice 0 0 0Medical Transportation 0 0 0Case Management 0 0 0Other Services 0 0 0Outreach 61,021 40,505 20,516Administration 87,819 58,294 29,525Balance 1,488,401 987,999 500,402Less: Collections 0 0 0Total 1,488,401 987,999 500,402




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 44,569 40,112 4,457MMIS - Private Sector 182,032 163,829 18,203MMIS - Drug Claims 0 0 0Skilled Professional 1,998,666 1,499,000 499,666Approved MMIS: Inhouse 0 0 0Approved MMIS: Private 23,855,881 17,891,910 5,963,971Mechanized Systems - In-House 6,822,361 3,411,181 3,411,180

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 1,987,669 1,490,753 496,916TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 134,267 67,134 67,133Preadmission Screening (198,967) (149,225) (49,742)Resident Review 789,154 591,866 197,288Drug Use Review 316,969 158,485 158,484Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 58,299,515 29,149,761 29,149,754Balance 94,232,116 54,314,806 39,917,310



FMR CHIP



Delaware National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 1,844,405 1,383,305 461,100Approved MMIS: Inhouse 0 0 0Approved MMIS: Private 7,894,292 5,920,719 1,973,573Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 256,665 192,499 64,166TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 1,368,670 1,026,503 342,167Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 90,858 81,772 9,086TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 16,684,879 8,342,441 8,342,438Balance 28,139,769 16,947,239 11,192,530


Delaware National

FMR CHIP




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 1,098,780 824,086 274,694Approved MMIS: Inhouse 159,603 119,703 39,900Approved MMIS: Private 11,018,981 8,264,237 2,754,744Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 1,272,011 954,009 318,002TPL - Recovery (5,095) (2,548) (2,547)TPL - Assignment Of Rights (4,143) (2,073) (2,070)Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 0 0 0Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 27,687,960 13,843,982 13,843,978Balance 41,228,097 24,001,396 17,226,701



FMR CHIP



National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 18,310 16,479 1,831MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 6,716,707 5,037,530 1,679,177Approved MMIS: Inhouse 1,355,033 1,016,274 338,759Approved MMIS: Private 15,165,841 11,374,382 3,791,459Mechanized Systems - In-House 1,352 676 676

Mechanized Systems: Private Sector 5,703,614 2,851,809 2,851,805Peer Review Organizations 4,194,094 3,145,570 1,048,524TPL - Recovery 178,526 89,264 89,262TPL - Assignment Of Rights 85,159 42,580 42,579Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 7,939,303 5,954,478 1,984,825Resident Review 1,765 1,324 441Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 207,843,256 103,921,630 103,921,626Balance 249,202,960 133,451,996 115,750,964


National

FMR CHIP

Service Category Total Computable Federal Share State ShareCollections 0 0 0Total Net Expenditures 249,202,960 133,451,996 115,750,964CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 2,166,973 1,494,345 672,628Premiums - Up To 150%: Cost Sharing Offset (296,580) (204,522) (92,058)Premiums - Over 150%: Gross Premiums Paid 613,713 423,216 190,497Premiums - Over 150%: Cost Sharing Offset (92,327) (63,669) (28,658)Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0


National

FMR CHIP

Service Category Total Computable Federal Share State ShareAbortions 0 0 0Screening Services 0 0 0Home Health 0 0 0Reserved 0 0 0Home and Community 0 0 0Hospice 0 0 0Medical Transportation 0 0 0Case Management 0 0 0Other Services 0 0 0Outreach 0 0 0Administration 371,466 256,163 115,303Balance 2,763,245 1,905,533 857,712Less: Collections 0 0 0Total 2,763,245 1,905,533 857,712



FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 4,524,922 3,541,209 983,713MMIS - Drug Claims 0 0 0Skilled Professional 5,199,769 3,899,827 1,299,942Approved MMIS: Inhouse 8,608,332 6,456,249 2,152,083Approved MMIS: Private 20,551,779 15,413,835 5,137,944Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 6,676,249 3,338,126 3,338,123Peer Review Organizations 2,014,279 1,510,710 503,569TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 2,309,204 1,154,603 1,154,601Preadmission Screening 0 0 0Resident Review 0 0 0Drug Use Review 4,117 2,059 2,058Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 197,357,946 98,678,974 98,678,972Balance 247,246,597 133,995,592 113,251,005


FMR CHIP



National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 102,222 76,666 25,556Approved MMIS: Inhouse 0 0 0Approved MMIS: Private 0 0 0Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 0 0 0TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 0 0 0Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 483,573 241,788 241,785Balance 585,795 318,454 267,341


National

FMR CHIP

Service Category Total Computable Federal Share State ShareCollections 0 0 0Total Net Expenditures 585,795 318,454 267,341CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 0 0 0Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 0 0 0Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0


National

FMR CHIP




National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 188,333 169,500 18,833MMIS - Drug Claims 0 0 0Skilled Professional 914,643 685,984 228,659Approved MMIS: Inhouse 0 0 0Approved MMIS: Private 5,812,687 4,359,515 1,453,172Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 0 0 0TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 20,932 10,466 10,466Preadmission Screening 2,790 2,093 697Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 23,641,976 11,820,989 11,820,987Balance 30,581,361 17,048,547 13,532,814


National

FMR CHIP



National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 767,026 690,324 76,702MMIS - Private Sector 9,889,964 8,900,968 988,996MMIS - Drug Claims 0 0 0Skilled Professional 932,600 699,450 233,150Approved MMIS: Inhouse 824,412 618,309 206,103Approved MMIS: Private 2,584,942 1,938,707 646,235Mechanized Systems - In-House 856,631 428,316 428,315

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 1,412,730 1,059,548 353,182TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 113,076 56,539 56,537Preadmission Screening 40,224 30,169 10,055Resident Review 368,702 276,527 92,175Drug Use Review 193,709 96,855 96,854Outstationed Eligibility 0 0 0TANF Base 940,299 846,269 94,030TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 36,517,933 18,258,967 18,258,966Balance 55,442,248 33,900,948 21,541,300


National

FMR CHIP



National

FMR CHIP

Service Category Total Computable Federal Share State ShareAbortions 0 0 0Screening Services 0 0 0Home Health 0 0 0Reserved 0 0 0Home and Community 0 0 0Hospice 0 0 0Medical Transportation 0 0 0Case Management 0 0 0Other Services 0 0 0Outreach 25,663 20,199 5,464Administration 147,904 116,415 31,489Balance 173,567 136,614 36,953Less: Collections (1) 0 (1)Total 173,566 136,614 36,952



National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 780,510 702,460 78,050MMIS - Inhouse Activities 61,768 55,592 6,176MMIS - Private Sector 2,667,523 2,400,771 266,752MMIS - Drug Claims 0 0 0Skilled Professional 75,055,804 56,291,854 18,763,950Approved MMIS: Inhouse 16,680,934 12,510,701 4,170,233Approved MMIS: Private 9,042,897 6,782,173 2,260,724Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 4,954,915 3,716,188 1,238,727TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 1,678,625 839,314 839,311Preadmission Screening 2,569,167 1,926,875 642,292Resident Review 1,177,336 883,003 294,333Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 15,312 13,781 1,531TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 1,457,958 728,980 728,978Other Financial Participation 431,942,655 215,971,328 215,971,327Balance 548,085,404 302,823,020 245,262,384


National

FMR CHIP



FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 649,853 487,391 162,462Approved MMIS: Inhouse 0 0 0Approved MMIS: Private 15,674,111 11,755,583 3,918,528Mechanized Systems - In-House 3,662,491 1,831,247 1,831,244

Mechanized Systems: Private Sector 226,441 113,221 113,220Peer Review Organizations 0 0 0TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 92,411 46,206 46,205Preadmission Screening 2,351,999 1,764,000 587,999Resident Review 2,221,789 1,666,342 555,447Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 300,031 270,028 30,003TANF Secondary 90% 242,679 218,411 24,268TANF Secondary 75% 0 0 0External Review 158,674 119,005 39,669Enrollment Brokers 3,695,508 1,847,755 1,847,753Other Financial Participation 71,217,815 35,616,400 35,601,415Balance 100,493,802 55,735,589 44,758,213


FMR CHIP



Iowa National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 1,153,221 1,037,899 115,322MMIS - Drug Claims 0 0 0Skilled Professional 1,191,223 893,417 297,806Approved MMIS: Inhouse 938,331 703,749 234,582Approved MMIS: Private 11,742,460 8,806,845 2,935,615Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 3,193,692 1,596,847 1,596,845Peer Review Organizations 4,600,124 3,450,093 1,150,031TPL - Recovery 19,283 9,642 9,641TPL - Assignment Of Rights 9,219 4,610 4,609Immigration Status 22,059 22,059 0Nurse Aide Training Costs 867,198 433,599 433,599Preadmission Screening 0 0 0Resident Review 0 0 0Drug Use Review 238,765 141,844 96,921Outstationed Eligibility 0 0 0TANF Base 3,004,415 2,703,974 300,441TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 41,567,016 20,783,130 20,783,886Balance 68,547,006 40,587,708 27,959,298


Iowa National

FMR CHIP



National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 79,321 71,388 7,933MMIS - Private Sector 9,143,315 8,228,983 914,332MMIS - Drug Claims 0 0 0Skilled Professional 1,580,414 1,185,311 395,103Approved MMIS: Inhouse 0 0 0Approved MMIS: Private 18,867,933 14,150,949 4,716,984Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 2,339,833 1,754,874 584,959TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 1,701,281 1,275,961 425,320Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 21,780 19,602 2,178TANF Secondary 90% 0 0 0TANF Secondary 75% 8,911 6,683 2,228External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 30,486,106 15,243,054 15,243,052Balance 64,228,894 41,936,805 22,292,089


National

FMR CHIP



Kentucky National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 1,698 1,529 169MMIS - Inhouse Activities 17,409 15,668 1,741MMIS - Private Sector 6,506,036 5,855,432 650,604MMIS - Drug Claims 0 0 0Skilled Professional 1,607,350 1,205,513 401,837Approved MMIS: Inhouse 232,893 174,671 58,222Approved MMIS: Private 16,785,629 12,589,223 4,196,406Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 357,832 178,917 178,915Peer Review Organizations 8,892,000 6,669,000 2,223,000TPL - Recovery 71,263 35,633 35,630TPL - Assignment Of Rights 31,957 15,980 15,977Immigration Status 0 0 0Nurse Aide Training Costs 730,510 365,256 365,254Preadmission Screening 258,476 189,065 69,411Resident Review 508,514 371,954 136,560Drug Use Review 420,810 210,406 210,404Outstationed Eligibility 22,130 11,066 11,064TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 45,851,732 22,925,867 22,925,865Balance 82,296,239 50,815,180 31,481,059


Kentucky National

FMR CHIP

Service Category Total Computable Federal Share State ShareCollections (830) (415) (415)Total Net Expenditures 82,295,409 50,814,765 31,480,644CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 0 0 0Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 0 0 0Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0


Kentucky National

FMR CHIP




Louisiana National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 544,197 489,777 54,420MMIS - Drug Claims 0 0 0Skilled Professional 2,042,777 1,532,083 510,694Approved MMIS: Inhouse 185,004 138,754 46,250Approved MMIS: Private 20,866,116 15,649,587 5,216,529Mechanized Systems - In-House 27,428 13,714 13,714

Mechanized Systems: Private Sector (1,499,071) (749,536) (749,535)Peer Review Organizations 0 0 0TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 17,455 13,091 4,364Resident Review 187,699 140,775 46,924Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 575,791 287,896 287,895Other Financial Participation 76,135,812 38,067,907 38,067,905Balance 99,083,208 55,584,048 43,499,160


Louisiana National

FMR CHIP



National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 5,942,163 5,347,947 594,216MMIS - Drug Claims 0 0 0Skilled Professional 1,319,447 989,586 329,861Approved MMIS: Inhouse 6,870,952 5,153,216 1,717,736Approved MMIS: Private 361,600 271,201 90,399Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 0 0 0TPL - Recovery 12,019 6,010 6,009TPL - Assignment Of Rights 5,858 2,930 2,928Immigration Status 0 0 0Nurse Aide Training Costs 190,950 95,476 95,474Preadmission Screening 19,150 14,364 4,786Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 33,829,026 16,914,514 16,914,512Balance 48,551,165 28,795,244 19,755,921


National

FMR CHIP



Maryland National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities (2,176,495) (1,958,846) (217,649)MMIS - Private Sector 7,452,239 6,707,015 745,224MMIS - Drug Claims 0 0 0Skilled Professional 14,656,611 10,992,458 3,664,153Approved MMIS: Inhouse 13,664,188 10,248,140 3,416,048Approved MMIS: Private 3,195,539 2,396,654 798,885Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 2,396,223 1,797,168 599,055TPL - Recovery 14,962 7,481 7,481TPL - Assignment Of Rights 7,996 3,998 3,998Immigration Status 0 0 0Nurse Aide Training Costs 1,744,900 872,451 872,449Preadmission Screening 703,570 527,678 175,892Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 460,004 345,003 115,001Enrollment Brokers 6,329,969 3,164,985 3,164,984Other Financial Participation 158,207,386 79,103,694 79,103,692Balance 206,657,092 114,207,879 92,449,213


Maryland National

FMR CHIP




FMR CHIP


Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 0 0 0TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 0 0 0Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 0 0 0Balance 0 0 0



FMR CHIP

Service Category Total Computable Federal Share State ShareCollections 0 0 0Total Net Expenditures 0 0 0CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 0 0 0Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 0 0 0Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0



FMR CHIP





FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 94,125 84,714 9,411MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 6,051,905 4,538,930 1,512,975Approved MMIS: Inhouse 6,370,660 4,777,995 1,592,665Approved MMIS: Private 21,231,963 15,923,972 5,307,991Mechanized Systems - In-House 54,179 27,090 27,089

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 3,961,999 2,971,500 990,499TPL - Recovery 68,086 34,044 34,042TPL - Assignment Of Rights 33,768 16,885 16,883Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 700,425 525,319 175,106Resident Review 306,592 229,945 76,647Drug Use Review 570,014 285,007 285,007Outstationed Eligibility 0 0 0TANF Base 739,705 665,734 73,971TANF Secondary 90% 1,107,007 996,306 110,701TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 124,674,507 62,337,257 62,337,250Balance 165,964,935 93,414,698 72,550,237



FMR CHIP



Michigan National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 431,164 388,047 43,117MMIS - Inhouse Activities 2,760,360 1,377,183 1,383,177MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 41,773,836 31,330,379 10,443,457Approved MMIS: Inhouse 36,945,371 27,709,030 9,236,341Approved MMIS: Private 7,590,056 5,692,543 1,897,513Mechanized Systems - In-House 81,693 40,847 40,846

Mechanized Systems: Private Sector 164,113 82,058 82,055Peer Review Organizations 1,933,054 1,449,792 483,262TPL - Recovery 79,821 39,911 39,910TPL - Assignment Of Rights 37,163 18,582 18,581Immigration Status 0 0 0Nurse Aide Training Costs 2,572,055 1,286,029 1,286,026Preadmission Screening 0 0 0Resident Review 0 0 0Drug Use Review 52,550 26,275 26,275Outstationed Eligibility 495,599 247,800 247,799TANF Base 197,820 178,038 19,782TANF Secondary 90% 5,094,927 4,585,434 509,493TANF Secondary 75% 0 0 0External Review 164,450 123,338 41,112Enrollment Brokers 6,213,396 3,106,699 3,106,697Other Financial Participation 370,550,708 185,275,356 185,275,352Balance 477,138,136 262,957,341 214,180,795


Michigan National

FMR CHIP



Minnesota National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 341,019 306,916 34,103MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 5,779,370 4,334,528 1,444,842Approved MMIS: Inhouse 21,641,710 16,231,282 5,410,428Approved MMIS: Private 0 0 0Mechanized Systems - In-House 22,264,776 11,132,389 11,132,387

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 0 0 0TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 186,697 140,023 46,674Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 5,000,000 4,500,000 500,000TANF Secondary 90% 1,220,689 1,098,620 122,069TANF Secondary 75% 5,483 4,112 1,371External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 147,288,136 73,644,069 73,644,067Balance 203,727,880 111,391,939 92,335,941


Minnesota National

FMR CHIP




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 2,532,240 2,279,016 253,224MMIS - Drug Claims 0 0 0Skilled Professional 1,162,061 871,547 290,514Approved MMIS: Inhouse 261,521 196,141 65,380Approved MMIS: Private 16,827,966 12,620,974 4,206,992Mechanized Systems - In-House 134,102 67,053 67,049

Mechanized Systems: Private Sector 6,386,787 3,193,394 3,193,393Peer Review Organizations 4,298,463 3,223,848 1,074,615TPL - Recovery 10,033 5,017 5,016TPL - Assignment Of Rights 6,356 3,178 3,178Immigration Status 0 0 0Nurse Aide Training Costs 686,252 343,128 343,124Preadmission Screening 50,941 38,205 12,736Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 35,955,929 17,977,966 17,977,963Balance 68,312,651 40,819,467 27,493,184



FMR CHIP



Missouri National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 1,502,960 1,127,221 375,739Approved MMIS: Inhouse 2,900,277 2,175,209 725,068Approved MMIS: Private 9,019,435 6,764,577 2,254,858Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 0 0 0TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 504,928 252,464 252,464Preadmission Screening 512,434 378,183 134,251Resident Review 21,513 15,686 5,827Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 5,098,919 4,589,027 509,892TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 101,882,157 50,941,079 50,941,078Balance 121,442,623 66,243,446 55,199,177


Missouri National

FMR CHIP



Montana National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 41,524 37,372 4,152MMIS - Private Sector 3,384 3,046 338MMIS - Drug Claims 0 0 0Skilled Professional (16,245) (12,184) (4,061)Approved MMIS: Inhouse 1,294,098 970,573 323,525Approved MMIS: Private 653,815 490,361 163,454Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 682,520 511,890 170,630TPL - Recovery 181 91 90TPL - Assignment Of Rights 361 181 180Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 133,455 100,092 33,363Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 8,379 7,541 838TANF Secondary 90% 7,930 7,137 793TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 22,233,966 11,116,985 11,116,981Balance 25,043,368 13,233,085 11,810,283


Montana National

FMR CHIP




FMR CHIP


Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 0 0 0TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 0 0 0Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 286,916 143,459 143,457Balance 286,916 143,459 143,457



FMR CHIP

Service Category Total Computable Federal Share State ShareCollections 0 0 0Total Net Expenditures 286,916 143,459 143,457CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 0 0 0Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 0 0 0Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0



FMR CHIP




Nebraska National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 243,521 219,168 24,353MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 657,985 493,489 164,496Approved MMIS: Inhouse 7,849,942 5,887,457 1,962,485Approved MMIS: Private 0 0 0Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 801,841 601,381 200,460TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 737 737 0Nurse Aide Training Costs 583,582 291,792 291,790Preadmission Screening 93,069 69,802 23,267Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 41,182,055 20,591,028 20,591,027Balance 51,412,732 28,154,854 23,257,878


Nebraska National

FMR CHIP



FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 2,381,757 1,786,319 595,438Approved MMIS: Inhouse 0 0 0Approved MMIS: Private 0 0 0Mechanized Systems - In-House 218,677 109,688 108,989

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 1,470,518 1,102,888 367,630TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 118,407 59,204 59,203Preadmission Screening 89,644 67,233 22,411Resident Review 104,580 78,436 26,144Drug Use Review 52,884 26,444 26,440Outstationed Eligibility 100,710 50,356 50,354TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 24,711,830 12,355,916 12,355,914Balance 29,249,007 15,636,484 13,612,523


FMR CHIP




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 5,228 2,615 2,613MMIS - Private Sector 11,401 5,701 5,700MMIS - Drug Claims 0 0 0Skilled Professional 1,014,508 760,882 253,626Approved MMIS: Inhouse 0 0 0Approved MMIS: Private 0 0 0Mechanized Systems - In-House 762,128 381,065 381,063

Mechanized Systems: Private Sector 9,677,154 4,838,578 4,838,576Peer Review Organizations 91,233 68,425 22,808TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 183,160 91,580 91,580Preadmission Screening 181,468 136,102 45,366Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 12,843 6,422 6,421TANF Base 0 0 0TANF Secondary 90% 28,530 25,677 2,853TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 18,468,280 9,234,141 9,234,139Balance 30,435,933 15,551,188 14,884,745



FMR CHIP



New Jersey National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 4,458,330 4,012,498 445,832MMIS - Inhouse Activities 7,566 6,809 757MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 9,541,546 7,156,161 2,385,385Approved MMIS: Inhouse 10,886,617 8,164,966 2,721,651Approved MMIS: Private 14,859,540 11,144,655 3,714,885Mechanized Systems - In-House (473,588) (236,793) (236,795)

Mechanized Systems: Private Sector 801,017 400,510 400,507Peer Review Organizations 2,950,546 2,212,910 737,636TPL - Recovery 63,332 31,667 31,665TPL - Assignment Of Rights 33,480 16,741 16,739Immigration Status 3,980 3,980 0Nurse Aide Training Costs 652,526 326,264 326,262Preadmission Screening 754,863 566,148 188,715Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 8,090,812 4,045,406 4,045,406TANF Base 4,999,997 4,499,998 499,999TANF Secondary 90% 798,741 718,867 79,874TANF Secondary 75% 1,051,672 788,755 262,917External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 220,139,077 110,069,538 110,069,539Balance 279,620,054 153,929,080 125,690,974


New Jersey National

FMR CHIP

Service Category Total Computable Federal Share State ShareCollections 0 0 0Total Net Expenditures 279,620,054 153,929,080 125,690,974CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 114,084 74,154 39,930Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 243,697 158,403 85,294Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 114 74 40Outpatient Hospital 9,022 5,864 3,158Outpatient Mental Health 0 0 0Prescribed Drugs 285 185 100Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 3,244 2,109 1,135Therapy Services 0 0 0Laboratory/Radiological 63 41 22Medical Equipment 0 0 0Family Planning 0 0 0


New Jersey National

FMR CHIP

Service Category Total Computable Federal Share State ShareAbortions 0 0 0Screening Services 0 0 0Home Health 0 0 0Reserved 0 0 0Home and Community 0 0 0Hospice 0 0 0Medical Transportation 0 0 0Case Management 0 0 0Other Services 145 94 51Outreach 0 0 0Administration 544,793 354,116 190,677Balance 915,447 595,040 320,407Less: Collections 0 0 0Total 915,447 595,040 320,407



New Mexico National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 4,113,980 3,702,583 411,397MMIS - Drug Claims 0 0 0Skilled Professional 970,516 727,887 242,629Approved MMIS: Inhouse 231,342 173,507 57,835Approved MMIS: Private 8,768,510 6,576,383 2,192,127Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 150,123 112,592 37,531TPL - Recovery 20,505 10,253 10,252TPL - Assignment Of Rights 7,646 3,823 3,823Immigration Status 1,482 1,482 0Nurse Aide Training Costs 220,278 110,140 110,138Preadmission Screening 265,545 199,159 66,386Resident Review 0 0 0Drug Use Review 25,085 12,543 12,542Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 44,409,414 22,204,709 22,204,705Balance 59,184,426 33,835,061 25,349,365


New Mexico National

FMR CHIP



New York National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 12,137,172 10,923,454 1,213,718MMIS - Inhouse Activities 572,206 514,985 57,221MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 41,960,806 31,470,605 10,490,201Approved MMIS: Inhouse 33,334,035 25,000,525 8,333,510Approved MMIS: Private 32,837,626 24,628,219 8,209,407Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 15,137,575 11,353,181 3,784,394TPL - Recovery 198,022 99,011 99,011TPL - Assignment Of Rights 107,398 53,699 53,699Immigration Status 0 0 0Nurse Aide Training Costs 1,436,840 718,420 718,420Preadmission Screening 129,551 97,163 32,388Resident Review 6,231 4,674 1,557Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 86,985 78,286 8,699TANF Secondary 75% 17,143 12,857 4,286External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 590,328,688 295,164,344 295,164,344Balance 728,290,278 400,119,423 328,170,855


New York National

FMR CHIP

Service Category Total Computable Federal Share State ShareCollections 0 0 0Total Net Expenditures 728,290,278 400,119,423 328,170,855CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 63,970,709 41,580,961 22,389,748Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 13,443,952 8,738,569 4,705,383Premiums - Over 150%: Cost Sharing Offset (1,863,173) (1,211,063) (652,110)Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0


New York National

FMR CHIP

Service Category Total Computable Federal Share State ShareAbortions 0 0 0Screening Services 0 0 0Home Health 0 0 0Reserved 0 0 0Home and Community 0 0 0Hospice 0 0 0Medical Transportation 0 0 0Case Management 0 0 0Other Services 0 0 0Outreach 973,605 632,843 340,762Administration 519,470 337,655 181,815Balance 77,044,563 50,078,965 26,965,598Less: Collections 0 0 0Total 77,044,563 50,078,965 26,965,598




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 114,082 102,674 11,408MMIS - Private Sector 1,786,566 1,462,863 323,703MMIS - Drug Claims 0 0 0Skilled Professional 2,135,215 1,601,412 533,803Approved MMIS: Inhouse 1,026,618 769,965 256,653Approved MMIS: Private 17,874,656 13,405,993 4,468,663Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 8,245,166 4,122,584 4,122,582Peer Review Organizations 1,115,111 836,335 278,776TPL - Recovery 94,774 47,388 47,386TPL - Assignment Of Rights 40,231 20,116 20,115Immigration Status 0 0 0Nurse Aide Training Costs 726,881 363,442 363,439Preadmission Screening 493,842 370,382 123,460Resident Review 268,527 201,395 67,132Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 151,411,825 75,705,913 75,705,912Balance 185,333,494 99,010,462 86,323,032



FMR CHIP




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 60 54 6MMIS - Private Sector 0 0 0MMIS - Drug Claims (197,235) (177,511) (19,724)Skilled Professional 352,134 264,101 88,033Approved MMIS: Inhouse 1,494,255 1,120,692 373,563Approved MMIS: Private 0 0 0Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 307,252 230,439 76,813TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 321,013 240,760 80,253Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 13,419 12,077 1,342TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 11,582,756 5,791,377 5,791,379Balance 13,873,654 7,481,989 6,391,665



FMR CHIP

Service Category Total Computable Federal Share State ShareCollections (1,050) (525) (525)Total Net Expenditures 13,872,604 7,481,464 6,391,140CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 0 0 0Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 0 0 0Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0



FMR CHIP




Ohio National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional (3,330,942) (2,498,206) (832,736)Approved MMIS: Inhouse 7,297,821 5,473,366 1,824,455Approved MMIS: Private 0 0 0Mechanized Systems - In-House 11,254,080 5,627,042 5,627,038

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 2,408,518 1,806,389 602,129TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 238,464 119,234 119,230Preadmission Screening 11,458,129 8,555,141 2,902,988Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 334,635 167,318 167,317TANF Base 0 0 0TANF Secondary 90% 3,191,875 2,872,687 319,188TANF Secondary 75% 695,923 521,943 173,980External Review 833,989 625,492 208,497Enrollment Brokers 515,373 257,686 257,687Other Financial Participation 131,196,479 66,066,210 65,130,269Balance 166,094,344 89,594,302 76,500,042


Ohio National

FMR CHIP



Oklahoma National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 107,598 96,838 10,760MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 6,576,354 4,932,266 1,644,088Approved MMIS: Inhouse 4,017,365 3,212,408 804,957Approved MMIS: Private 14,224,828 11,413,373 2,811,455Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 3,616,830 2,712,623 904,207TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 731 731 0Nurse Aide Training Costs 0 0 0Preadmission Screening 1,074,675 806,007 268,668Resident Review 263,718 197,789 65,929Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 79,044 71,139 7,905TANF Secondary 90% 219,929 197,937 21,992TANF Secondary 75% 4,985 3,739 1,246External Review 0 0 0Enrollment Brokers 870,017 435,009 435,008Other Financial Participation 92,716,652 46,358,327 46,358,325Balance 123,772,726 70,438,186 53,334,540


Oklahoma National

FMR CHIP



FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 340,093 306,083 34,010MMIS - Inhouse Activities 2,200,929 1,980,837 220,092MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 3,602,209 2,701,658 900,551Approved MMIS: Inhouse 24,499,152 18,374,365 6,124,787Approved MMIS: Private 0 0 0Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 469,720 352,291 117,429TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 712,153 356,078 356,075Preadmission Screening 2,813,221 2,109,917 703,304Resident Review 0 0 0Drug Use Review 3,651 1,826 1,825Outstationed Eligibility 0 0 0TANF Base 1,568,667 1,411,800 156,867TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 114,677,243 57,338,623 57,338,620Balance 150,887,038 84,933,478 65,953,560


FMR CHIP

Service Category Total Computable Federal Share State ShareCollections 0 0 0Total Net Expenditures 150,887,038 84,933,478 65,953,560CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 280,206 204,606 75,600Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 0 0 0Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 127,513 93,110 34,403Inpatient Mental Health 2,988 2,182 806Nursing Care Services 0 0 0Physician/Surgical 21,668 15,822 5,846Outpatient Hospital 20,382 14,883 5,499Outpatient Mental Health 0 0 0Prescribed Drugs 25,330 18,496 6,834Dental Services 2,747 2,006 741Vision Services 646 472 174Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 430 314 116Family Planning 435 318 117


FMR CHIP





FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 1,911,991 1,720,791 191,200MMIS - Private Sector 402,140 361,927 40,213MMIS - Drug Claims 0 0 0Skilled Professional 9,871,022 7,403,266 2,467,756Approved MMIS: Inhouse 28,180,512 21,135,384 7,045,128Approved MMIS: Private 9,294,088 6,970,566 2,323,522Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 0 0 0TPL - Recovery 97,667 48,835 48,832TPL - Assignment Of Rights 51,989 25,996 25,993Immigration Status 20,034 20,034 0Nurse Aide Training Costs 528,593 264,297 264,296Preadmission Screening 3,277,494 2,458,121 819,373Resident Review 50,420 37,815 12,605Drug Use Review 494,097 247,050 247,047Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 3,909,491 1,954,746 1,954,745Other Financial Participation 285,005,576 142,502,790 142,502,786Balance 343,095,114 185,151,618 157,943,496



FMR CHIP

Service Category Total Computable Federal Share State ShareCollections 0 0 0Total Net Expenditures 343,095,114 185,151,618 157,943,496CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 14,971,661 10,086,408 4,885,253Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 0 0 0Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0



FMR CHIP

Service Category Total Computable Federal Share State ShareAbortions 0 0 0Screening Services 0 0 0Home Health 0 0 0Reserved 0 0 0Home and Community 0 0 0Hospice 0 0 0Medical Transportation 0 0 0Case Management 0 0 0Other Services 0 0 0Outreach 0 0 0Administration 22,263 14,999 7,264Balance 14,993,924 10,101,407 4,892,517Less: Collections 0 0 0Total 14,993,924 10,101,407 4,892,517




FMR CHIP


Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 0 0 0TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 0 0 0Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 42,477,460 21,238,730 21,238,730Balance 42,477,460 21,238,730 21,238,730



FMR CHIP




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 1,000,134 750,101 250,033Approved MMIS: Inhouse 0 0 0Approved MMIS: Private 9,164,966 6,693,792 2,471,174Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 99,171 74,378 24,793TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 0 0 0Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 27,565,518 13,782,760 13,782,758Balance 37,829,789 21,301,031 16,528,758



FMR CHIP




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning (2,405,895) (3,604,850) 1,198,955MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 5,483,372 4,112,529 1,370,843Approved MMIS: Inhouse 10,574,020 7,930,515 2,643,505Approved MMIS: Private 0 0 0Mechanized Systems - In-House 175,171 87,587 87,584

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 741,844 556,383 185,461TPL - Recovery 16,686 8,343 8,343TPL - Assignment Of Rights 9,857 4,929 4,928Immigration Status 0 0 0Nurse Aide Training Costs 809,868 404,934 404,934Preadmission Screening 329,647 247,235 82,412Resident Review 225 169 56Drug Use Review 64,740 32,372 32,368Outstationed Eligibility 5,663,144 2,831,573 2,831,571TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 66,404,607 33,201,836 33,202,771Balance 87,867,286 45,813,555 42,053,731



FMR CHIP




FMR CHIP

Service Category Total Computable Federal Share State ShareAbortions 0 0 0Screening Services 0 0 0Home Health 0 0 0Reserved 0 0 0Home and Community 0 0 0Hospice 0 0 0Medical Transportation 0 0 0Case Management 0 0 0Other Services 0 0 0Outreach 0 0 0Administration 1,346,470 1,065,866 280,604Balance 1,346,470 1,065,866 280,604Less: Collections 0 0 0Total 1,346,470 1,065,866 280,604




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 95,536 85,982 9,554Skilled Professional (126,004) (94,503) (31,501)Approved MMIS: Inhouse 1,121,631 841,225 280,406Approved MMIS: Private 0 0 0Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 308,801 231,601 77,200TPL - Recovery 2,499 1,250 1,249TPL - Assignment Of Rights 905 453 452Immigration Status 0 0 0Nurse Aide Training Costs 29,545 14,773 14,772Preadmission Screening 7,333 5,501 1,832Resident Review 134,580 100,936 33,644Drug Use Review 108,584 54,292 54,292Outstationed Eligibility 0 0 0TANF Base 640,839 576,756 64,083TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 8,940,381 4,470,191 4,470,190Balance 11,264,630 6,288,457 4,976,173



FMR CHIP



Tennessee National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 1,768,184 1,326,138 442,046Approved MMIS: Inhouse 15,992,548 11,994,413 3,998,135Approved MMIS: Private 0 0 0Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 0 0 0TPL - Recovery 44,504 22,252 22,252TPL - Assignment Of Rights 16,866 8,433 8,433Immigration Status 0 0 0Nurse Aide Training Costs 1,433,878 716,942 716,936Preadmission Screening 656,843 492,633 164,210Resident Review 611,322 458,492 152,830Drug Use Review 0 0 0Outstationed Eligibility 835,778 417,889 417,889TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 2,554,054 1,915,541 638,513Enrollment Brokers 0 0 0Other Financial Participation 99,254,164 49,627,084 49,627,080Balance 123,168,141 66,979,817 56,188,324


Tennessee National

FMR CHIP



National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 420,467 378,420 42,047MMIS - Inhouse Activities 20,380,185 18,342,166 2,038,019MMIS - Private Sector 14,264,303 12,837,873 1,426,430MMIS - Drug Claims 0 0 0Skilled Professional 11,596,494 8,697,374 2,899,120Approved MMIS: Inhouse 24,482,440 18,284,091 6,198,349Approved MMIS: Private 93,101,992 54,884,148 38,217,844Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 2,077,637 1,558,228 519,409TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 601,532 601,532 0Nurse Aide Training Costs 1,002,148 501,075 501,073Preadmission Screening 71,718 53,789 17,929Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 2,612,338 1,306,171 1,306,167TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 13,669,803 6,834,902 6,834,901Other Financial Participation 404,381,082 202,190,545 202,190,537Balance 588,662,139 326,470,314 262,191,825


National

FMR CHIP

Service Category Total Computable Federal Share State ShareCollections (11,709,899) (6,707,459) (5,002,440)Total Net Expenditures 576,952,240 319,762,855 257,189,385CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 0 0 0Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 0 0 0Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0


National

FMR CHIP




Utah National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 538,532 484,679 53,853MMIS - Private Sector 0 0 0MMIS - Drug Claims 16,223 14,601 1,622Skilled Professional 2,586,344 1,939,758 646,586Approved MMIS: Inhouse 8,906,959 6,680,220 2,226,739Approved MMIS: Private 1,222,910 917,182 305,728Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 0 0 0TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 124,915 62,458 62,457Preadmission Screening 0 0 0Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 2,302,946 1,151,474 1,151,472TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 36,955,476 18,477,738 18,477,738Balance 52,654,305 29,728,110 22,926,195


Utah National

FMR CHIP



Vermont National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 3,296,854 2,472,641 824,213Approved MMIS: Inhouse 401,729 301,297 100,432Approved MMIS: Private 5,414,203 4,060,653 1,353,550Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 391,560 195,781 195,779Peer Review Organizations 3,631 1,816 1,815TPL - Recovery 2,538 1,269 1,269TPL - Assignment Of Rights 837 419 418Immigration Status 0 0 0Nurse Aide Training Costs 61,230 30,615 30,615Preadmission Screening 0 0 0Resident Review 42,550 31,913 10,637Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 23,287,226 11,643,613 11,643,613Balance 32,902,358 18,740,017 14,162,341


Vermont National

FMR CHIP




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 0 0 0MMIS - Drug Claims 0 0 0Skilled Professional 32,530 24,398 8,132Approved MMIS: Inhouse 0 0 0Approved MMIS: Private 0 0 0Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 0 0 0TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 0 0 0Resident Review 0 0 0Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 1,437,584 718,792 718,792Balance 1,470,114 743,190 726,924



FMR CHIP

Service Category Total Computable Federal Share State ShareCollections 0 0 0Total Net Expenditures 1,470,114 743,190 726,924CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 0 0 0Premiums - Up To 150%: Cost Sharing Offset 0 0 0Premiums - Over 150%: Gross Premiums Paid 0 0 0Premiums - Over 150%: Cost Sharing Offset 0 0 0Inpatient Hospital 0 0 0Inpatient Mental Health 0 0 0Nursing Care Services 0 0 0Physician/Surgical 0 0 0Outpatient Hospital 0 0 0Outpatient Mental Health 0 0 0Prescribed Drugs 0 0 0Dental Services 0 0 0Vision Services 0 0 0Other Practitioners 0 0 0Clinic Services 0 0 0Therapy Services 0 0 0Laboratory/Radiological 0 0 0Medical Equipment 0 0 0Family Planning 0 0 0



FMR CHIP




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 11,141 10,027 1,114MMIS - Private Sector 1,170,648 1,053,583 117,065MMIS - Drug Claims 0 0 0Skilled Professional 2,145,575 1,609,182 536,393Approved MMIS: Inhouse 1,309,435 982,077 327,358Approved MMIS: Private 11,562,820 8,672,114 2,890,706Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 66,290 49,718 16,572TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 1,770,186 885,094 885,092Preadmission Screening 2,097,694 1,573,271 524,423Resident Review (444,778) (333,583) (111,195)Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 2,222,222 2,000,000 222,222TANF Secondary 90% 2,828,051 2,545,246 282,805TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 1,332,477 666,240 666,237Other Financial Participation 92,308,715 46,154,359 46,154,356Balance 118,380,476 65,867,328 52,513,148


FMR CHIP



Washington National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 2,285,007 2,056,508 228,499MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 506,117 455,505 50,612MMIS - Drug Claims 0 0 0Skilled Professional 19,955,321 14,966,492 4,988,829Approved MMIS: Inhouse 13,736,038 10,302,029 3,434,009Approved MMIS: Private 82,900 62,176 20,724Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 199,636 149,727 49,909TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 28,601 21,450 7,151Resident Review 592,428 444,322 148,106Drug Use Review 12,030 6,015 6,015Outstationed Eligibility 1,326,907 663,455 663,452TANF Base 2,000,000 1,800,000 200,000TANF Secondary 90% 52,604 47,343 5,261TANF Secondary 75% 6,172,652 4,629,490 1,543,162External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 228,072,820 114,036,414 114,036,406Balance 275,023,061 149,640,926 125,382,135


Washington National

FMR CHIP




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 0 0 0MMIS - Private Sector 2,877,684 2,589,916 287,768MMIS - Drug Claims 0 0 0Skilled Professional 4,131,185 3,098,391 1,032,794Approved MMIS: Inhouse 1,171,184 878,389 292,795Approved MMIS: Private 3,530,430 2,647,823 882,607Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 1,195,468 896,601 298,867TPL - Recovery 30,159 15,081 15,078TPL - Assignment Of Rights 9,078 4,541 4,537Immigration Status 0 0 0Nurse Aide Training Costs 296,704 148,352 148,352Preadmission Screening 69,564 52,174 17,390Resident Review 54,532 40,899 13,633Drug Use Review 0 0 0Outstationed Eligibility 1,110,389 555,196 555,193TANF Base 0 0 0TANF Secondary 90% 2,472,723 2,225,451 247,272TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 666,564 333,283 333,281Other Financial Participation 33,185,460 16,592,729 16,592,731Balance 50,801,124 30,078,826 20,722,298



FMR CHIP



Wisconsin National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 43,984 39,585 4,399MMIS - Private Sector 54,991 49,492 5,499MMIS - Drug Claims 0 0 0Skilled Professional 1,726,875 1,295,157 431,718Approved MMIS: Inhouse 1,277,537 958,153 319,384Approved MMIS: Private 17,324,447 12,993,336 4,331,111Mechanized Systems - In-House 13,043,354 6,521,677 6,521,677

Mechanized Systems: Private Sector 16,414,252 8,207,127 8,207,125Peer Review Organizations 881,276 660,957 220,319TPL - Recovery 0 0 0TPL - Assignment Of Rights 0 0 0Immigration Status 0 0 0Nurse Aide Training Costs 922,952 461,477 461,475Preadmission Screening 624,944 468,709 156,235Resident Review 9,291 6,970 2,321Drug Use Review 0 0 0Outstationed Eligibility 0 0 0TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 216,293 162,220 54,073External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 68,132,402 34,066,202 34,066,200Balance 120,672,598 65,891,062 54,781,536


Wisconsin National

FMR CHIP



Wyoming National

FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 0 0 0MMIS - Inhouse Activities 8 7 1MMIS - Private Sector 21,502 19,353 2,149MMIS - Drug Claims 0 0 0Skilled Professional 494,904 371,178 123,726Approved MMIS: Inhouse 217,508 163,132 54,376Approved MMIS: Private 3,020,233 2,265,176 755,057Mechanized Systems - In-House 0 0 0

Mechanized Systems: Private Sector 0 0 0Peer Review Organizations 954,484 715,864 238,620TPL - Recovery 1,973 987 986TPL - Assignment Of Rights 1,296 648 648Immigration Status 0 0 0Nurse Aide Training Costs 0 0 0Preadmission Screening 505,135 378,852 126,283Resident Review 0 0 0Drug Use Review 396,013 198,008 198,005Outstationed Eligibility 2,415,379 1,207,690 1,207,689TANF Base 0 0 0TANF Secondary 90% 0 0 0TANF Secondary 75% 0 0 0External Review 0 0 0Enrollment Brokers 0 0 0Other Financial Participation 4,369,635 2,184,818 2,184,817Balance 12,398,070 7,505,713 4,892,357


Wyoming National

FMR CHIP




FMR CHIP

Service Category Total Computable Federal Share State ShareFamily Planning 18,974,155 15,637,199 3,336,956MMIS - Inhouse Activities 39,494,401 34,435,728 5,058,673MMIS - Private Sector 82,640,364 73,588,404 9,051,960MMIS - Drug Claims (85,476) (76,928) (8,548)Skilled Professional 405,223,510 303,917,669 101,305,841Approved MMIS: Inhouse 366,223,514 274,789,305 91,434,209Approved MMIS: Private 624,176,599 453,754,931 170,421,668Mechanized Systems - In-House 78,058,075 39,029,404 39,028,671

Mechanized Systems: Private Sector 80,710,920 40,355,477 40,355,443Peer Review Organizations 90,557,048 67,916,893 22,640,155TPL - Recovery 1,567,108 783,568 783,540TPL - Assignment Of Rights 531,994 266,009 265,985Immigration Status (76,757,769) (76,757,769) 0Nurse Aide Training Costs 27,572,135 13,786,098 13,786,037Preadmission Screening 44,291,873 33,169,530 11,122,343Resident Review 8,119,866 6,080,032 2,039,834Drug Use Review 3,275,511 1,660,230 1,615,281Outstationed Eligibility 31,232,436 16,099,566 15,132,870TANF Base 32,922,254 29,630,029 3,292,225TANF Secondary 90% 17,443,528 15,699,174 1,744,354TANF Secondary 75% 8,173,062 6,129,799 2,043,263External Review 4,171,171 3,128,379 1,042,792Enrollment Brokers 39,236,347 19,618,181 19,618,166Other Financial Participation 6,417,910,285 3,209,429,821 3,208,480,464Balance 8,345,662,911 4,582,070,729 3,763,592,182



FMR CHIP

Service Category Total Computable Federal Share State ShareCollections (11,966,755) (6,838,285) (5,128,470)Total Net Expenditures 8,333,696,156 4,575,232,444 3,758,463,712CHIP 0 0 0Premiums - Up To 150%: Gross Premiums Paid 83,839,187 54,984,138 28,855,049Premiums - Up To 150%: Cost Sharing Offset (535,361) (361,783) (173,578)Premiums - Over 150%: Gross Premiums Paid 15,054,390 9,817,629 5,236,761Premiums - Over 150%: Cost Sharing Offset (1,955,500) (1,274,732) (680,768)Inpatient Hospital 127,513 93,110 34,403Inpatient Mental Health 2,988 2,182 806Nursing Care Services 0 0 0Physician/Surgical 21,782 15,896 5,886Outpatient Hospital 29,404 20,747 8,657Outpatient Mental Health 0 0 0Prescribed Drugs 25,615 18,681 6,934Dental Services 2,747 2,006 741Vision Services 646 472 174Other Practitioners 0 0 0Clinic Services 3,244 2,109 1,135Therapy Services 0 0 0Laboratory/Radiological 63 41 22Medical Equipment 430 314 116Family Planning 435 318 117



FMR CHIP

Service Category Total Computable Federal Share State ShareAbortions 0 0 0Screening Services 16,932 11,191 5,741Home Health 0 0 0Reserved 0 0 0Home and Community 0 0 0Hospice 0 0 0Medical Transportation 73 53 20Case Management 121 88 33Other Services 145 94 51Outreach 1,220,238 801,123 419,115Administration 3,723,192 2,700,330 1,022,862Balance 101,578,284 66,834,007 34,744,277Less: Collections (1) 0 (1)Total 101,578,283 66,834,007 34,744,276


medicaid financial management report - net chip expenditures … · 2013. 4. 3. · medicaid...

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