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VVI, A <br /> rVE <br /> �Aw <br /> All VAI <br /> "moi 2-�' a r �� r -' '�¢5a". ° .N Iry Ys 7 F . .�''� <br /> DINEt VIA VIA <br /> VAIg *ATTACHNEAl vr� <br /> �T IT ilk <br /> , ` f� x � f <br /> ars s�, x <br /> III <br /> IV. INDk1N RIPER CO TAI E�ARTMENT �^ <br /> 4vs t : tt"wl ', . t° wvw <br /> 3 C, xy^r s <br /> }`s xa ntx <br /> ,Part II Sources ofobuIons oCountIII <br /> yIealth Department `r <br /> IV � �a . , s ._ Y 't '� rt `, � - t Uctober <br /> 4 4 wt TN yt 2 4�+ <br /> ' , '�i-ux 's f x .� eu u ^tev <br /> . y � ��. , r s i , x`� «: .x4.,�+' -s,'x `� CiOLLI11 ' <br /> d <br /> , .. _,.� `s' �'txcad.,4.- � ;fi�` "�t ➢S LL (� AL <br /> , � r; r� treII VIA ' 'ryLLB WAS t rt jib <br /> VIA ,"` a zY lr * - �, F ; r III �s '" ,r`' z § fIf LI4 ,� i kty ? �"„ <br /> C83 Ly TCLL3L,BLLLLAIr <br /> � ` 3 17 1 <br /> t nAtfg ryJ .3 <br /> Afr :1 <br /> Llf: RA- <br /> 6. MEDICAID - STATE/COUNTY <br /> 001083 MEDICAID FAMILY PLANNING 0 179,549 1795549 0 1791V549 <br /> 001087 MEDICAID STD 0 485579 483579 0 489579 <br /> 001089 MEDICAIDAIDS 0 39,099 393099 0 39,099 <br /> 001147 MEDICAID HMO CAPITATION 0 0 0 0 0 <br /> 001191 MEDICAID MATERNITY 0 0 0 0 0 <br /> 001192 MEDICAID COMPREHENSIVE CHILD 0 503 ,914 503 ,914 0 503 ,914 <br /> 001193 MEDICAID COMPREHENSIVE ADULT 0 309, 891 3095891 0 309, 891 <br /> 001194 MEDICAID LABORATORY 0 0 0 0 0 <br /> 001208 MEDIPASS $3 . 00 ADM. FEE 0 7200 725000 0 72,000 <br /> 001059 MEDICAID LOW INCOME POOL 0 0 0 0 0 <br /> 001051 EMERGENCY MEDICAID 0 0 0 0 0 <br /> 001058 MEDICAID - BEHAVIORAL HEALTH 0 0 0 0 0 <br /> 001071 MEDICAID - ORTHOPEDIC 0 0 0 0 0 <br /> 001072 MEDICAID - DERMATOLOGY 0 0 0 0 0 <br /> 001075 MEDICAID - SCHOOL HEALTH CERTIFIED MATCH 0 0 0 0 0 <br /> 001069 MEDICAID - REFUGEE HEALTH 0 0 0 0 0 <br /> 001055 MEDICAID - HOSPITAL 0 0 0 0 0 <br /> 001148 MEDICAID HMO NON-CAPITATION 0 0 0 0 0 <br /> 001074 MEDICAID - NEWBORN SCREENING 0 0 0 0 0 <br /> MEDICAID TOTAL 0 11970,484 159707484 0 15970,484 <br /> 7. ALLOCABLE REVENUE - STATE <br /> 018000 REFUNDS 0 0 0 0 0 <br /> 037000 PRIOR YEAR WARRANT p <br /> 0 0 0 0 <br /> 038000 12 MONTH OLD WARRANT p <br /> 0 0 0 0 <br /> ALLOCABLE REVENUE TOTAL 0 0 0 0 0 <br /> 8. OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND - STATE <br /> PHARMACY SERVICES 0 0 <br /> 0 76,889 765889 <br /> LABORATORY SERVICES 0 p <br /> 0 43 , 579 43 ,579 <br /> TB SERVICES 0 0 <br /> 0 0 0 <br /> IMMUNIZATION SERVICES 0 p <br /> 0 5451l362 54515362 <br /> STD SERVICES 0 0 <br /> 0 0 0 <br /> CONSTRUCTION/RENOVATION 0 p <br /> 0 0 0 <br /> WIC FOOD 0 0 <br /> 0 2,057,867 2,057, 867 <br /> ADAP 0 0 <br /> 0 0 0 <br /> DENTAL SERVICES 0 p <br /> 0 0 0 <br /> OTHER (SPECIFY) 0 0 <br /> 0 0 0 <br /> OTHER (SPECIFY) 0 p <br /> 0 0 0 <br /> OTHER STATE CONTRIBUTIONS TOTAL 0 0 p 2, 723 ,697 2,723 ,697 <br /> 9. DIRECT LOCAL CONTRIBUTIONS - BCC/TAX DISTRICT <br /> 008010 CONTRIBUTION FROM CITYGOVERNMENT 0 p <br /> 0 0 0 <br /> 008020 CONTRIBUTION FROM HEALTH CARE TAX NOT THRU BCC 0 1 ,910, 845 15910, 845 0 1 ,9103845 <br /> 008040 BCC GRANT/CONTRACT 0 801488 805488 0 80,488 <br /> 008030 CONTRIBUTION FROM HEALTH CARE TAX 0 p <br /> 0 0 0 <br /> 008034 BCC CONTRIBUTION FROM GENERALFUND 0 534, 521 534, 521 0 534, 521 <br /> /ersion : 1 Page 4 of 7 <br />