medicaid capitation summary 12-feb-2002 06:32 2001-12 filemdch - monthly medicaid capitation...

58
MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 1 of 58 2001-12 Funding Group Total Capitation 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Check Values 1 DAB Capitation $27,650,829.89 $2,791,853.45 $2,127,629.23 $7,995,899.54 $7,712,809.30 $5,371,547.26 $1,651,091.11 - 2 TANF Capitation $4,613,650.14 $3,067,437.32 $444,592.46 $812,763.45 $250,037.69 $38,708.87 $110.35 - 3 Combined DAB and TANF Capitation $32,264,480.03 $5,859,290.77 $2,572,221.69 $8,808,662.99 $7,962,846.99 $5,410,256.13 $1,651,201.46 - DD Capitation $68,423,355.74 $742,446.79 $3,449,442.26 $21,233,756.82 $23,260,214.37 $15,101,624.43 $4,635,871.07 - 4 Total MH Capitation $100,687,835.77 $6,601,737.56 $6,021,663.95 $30,042,419.81 $31,223,061.36 $20,511,880.56 $6,287,072.53 - 5 SA Capitation $2,158,325.97 $98,308.58 $131,255.03 $847,688.79 $828,479.98 $239,964.54 $12,629.05 - 6 Total MA Capitation $102,846,161.74 $6,700,046.14 $6,152,918.98 $30,890,108.60 $32,051,541.34 $20,751,845.10 $6,299,701.58 - Funding Group Total Population 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ 1 DAB Population 353,692 64,206 29,602 48,486 51,885 65,349 94,164 - 2 TANF Population 718,899 541,315 70,729 80,434 22,046 4,311 64 - 3 Combined DAB and TANF Population 1,072,591 605,521 100,331 128,920 73,931 69,660 94,228 4 - 5 DD Population 239,275 33,411 20,167 48,017 51,469 64,914 21,297 - 6 Total Current MA Population* 1,072,591 605,521 100,331 128,920 73,931 69,660 94,228 Medicaid Capitation Summary * Population figures do not include Retroactive Eligibles 12-Feb-2002 06:32 Medicaid Revenue $- $5 $10 $15 $20 $25 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Millions DAB Capitation TANF Capitation DD Capitation SA Capitation Medicaid Population - 100 200 300 400 500 600 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Thousands DAB Population TANF Population DD Population Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, Summary

Upload: phamanh

Post on 25-Apr-2019

214 views

Category:

Documents


0 download

TRANSCRIPT

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 1 of 58

2001-12

Funding Group Total Capitation 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Check Values

1 DAB Capitation $27,650,829.89 $2,791,853.45 $2,127,629.23 $7,995,899.54 $7,712,809.30 $5,371,547.26 $1,651,091.11 -

2 TANF Capitation $4,613,650.14 $3,067,437.32 $444,592.46 $812,763.45 $250,037.69 $38,708.87 $110.35 -

3 Combined DAB and TANF Capitation $32,264,480.03 $5,859,290.77 $2,572,221.69 $8,808,662.99 $7,962,846.99 $5,410,256.13 $1,651,201.46 -

DD Capitation $68,423,355.74 $742,446.79 $3,449,442.26 $21,233,756.82 $23,260,214.37 $15,101,624.43 $4,635,871.07 -

4 Total MH Capitation $100,687,835.77 $6,601,737.56 $6,021,663.95 $30,042,419.81 $31,223,061.36 $20,511,880.56 $6,287,072.53 -

5 SA Capitation $2,158,325.97 $98,308.58 $131,255.03 $847,688.79 $828,479.98 $239,964.54 $12,629.05 -

6 Total MA Capitation $102,846,161.74 $6,700,046.14 $6,152,918.98 $30,890,108.60 $32,051,541.34 $20,751,845.10 $6,299,701.58 -

Funding Group Total Population 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+

1 DAB Population 353,692 64,206 29,602 48,486 51,885 65,349 94,164 -

2 TANF Population 718,899 541,315 70,729 80,434 22,046 4,311 64 -

3 Combined DAB and TANF Population 1,072,591 605,521 100,331 128,920 73,931 69,660 94,228 4 -5 DD Population 239,275 33,411 20,167 48,017 51,469 64,914 21,297 -

6 Total Current MA Population* 1,072,591 605,521 100,331 128,920 73,931 69,660 94,228

Medicaid Capitation Summary

* Population figures do not include Retroactive Eligibles

12-Feb-2002 06:32

Medicaid Revenue

$-

$5

$10

$15

$20

$25

0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+

Mill

ions

DAB CapitationTANF CapitationDD CapitationSA Capitation

Medicaid Population

-

100

200

300

400

500

600

0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+

Thou

sand

s

DAB PopulationTANF PopulationDD Population

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, Summary

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 2 of 58

Code Group Code Group 2 Age Group Statewide Base

Cap RateCode Group Code Group 2 Age Group Statewide Base

Cap RateCode Group Code Group 2 Age Group Statewide Base

Cap Rate

MH DAB - E&P only 0 - 17 $42.40 DD DAB - E&P only 0 - 17 $22.52 SA DAB - E&P only 0 - 17 $0.75 MH DAB - E&P only 18 - 25 $70.61 DD DAB - E&P only 18 - 25 $161.75 SA DAB - E&P only 18 - 25 $2.48 MH DAB - E&P only 26 - 39 $162.06 DD DAB - E&P only 26 - 39 $419.34 SA DAB - E&P only 26 - 39 $10.39 MH DAB - E&P only 40 - 49 $145.39 DD DAB - E&P only 40 - 49 $430.99 SA DAB - E&P only 40 - 49 $13.07 MH DAB - E&P only 50 - 64 $79.99 DD DAB - E&P only 50 - 64 $218.66 SA DAB - E&P only 50 - 64 $3.55 MH DAB - E&P only 65+ $16.89 DD DAB - E&P only 65+ $206.81 SA DAB - E&P only 65+ $0.14 MH DAB - Other 0 - 17 $42.40 SA DAB - Other 0 - 17 $0.75 MH DAB - Other 18 - 25 $70.61 SA DAB - Other 18 - 25 $2.48 MH DAB - Other 26 - 39 $162.06 SA DAB - Other 26 - 39 $10.39 MH DAB - Other 40 - 49 $145.39 SA DAB - Other 40 - 49 $13.07 MH DAB - Other 50 - 64 $79.99 SA DAB - Other 50 - 64 $3.55 MH DAB - Other 65+ $16.89 SA DAB - Other 65+ $0.14 MH TANF 0 - 17 $5.59 SA TANF 0 - 17 $0.09 MH TANF 18 - 25 $6.15 SA TANF 18 - 25 $0.84 MH TANF 26 - 39 $10.06 SA TANF 26 - 39 $4.27 MH TANF 40 - 49 $11.22 SA TANF 40 - 49 $6.70 MH TANF 50 - 64 $8.95 SA TANF 50 - 64 $1.95 MH TANF 65+ $1.65 SA TANF 65+ $0.00

MA Capitation Statewide Base Rates2001-12

12-Feb-2002 06:32

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, Cap Base Rates

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 3 of 58

MA Capitation Intensity Factors2001-12

Provider ID Provider Name Code Group Code Group 2

Effective Payment Month

Intensity Factor

1709690 Allegan County CMH MH DAB - Other 200112 1.030900 1709690 Allegan County CMH MH DAB - E&P only 200112 1.030900 1709690 Allegan County CMH MH TANF 200112 1.436600 1712283 Antrim-Kalkaska CMH MH DAB - Other 200112 1.019000 1712283 Antrim-Kalkaska CMH MH DAB - E&P only 200112 1.019000 1712283 Antrim-Kalkaska CMH MH TANF 200112 0.956800 1706830 AuSable Valley CMH MH DAB - Other 200112 0.729200 1706830 AuSable Valley CMH MH DAB - E&P only 200112 0.729200 1706830 AuSable Valley CMH MH TANF 200112 1.653500 1705260 Barry County CMH MH DAB - Other 200112 0.605100 1705260 Barry County CMH MH DAB - E&P only 200112 0.605100 1705260 Barry County CMH MH TANF 200112 0.691000 1705322 Bay-Arenac CMH MH DAB - Other 200112 1.001400 1705322 Bay-Arenac CMH MH DAB - Other 200112 1.001400 1705322 Bay-Arenac CMH MH DAB - E&P only 200112 1.001400 1705322 Bay-Arenac CMH MH DAB - E&P only 200112 1.001400 1705322 Bay-Arenac CMH MH TANF 200112 1.306500 1705322 Bay-Arenac CMH MH TANF 200112 1.306500 1716175 Berrien County CMH MH DAB - Other 200112 0.869600 1716175 Berrien County CMH MH DAB - E&P only 200112 0.869600 1716175 Berrien County CMH MH TANF 200112 0.818900 4344340 Central Michigan CMH MH DAB - Other 200112 0.785500 4344340 Central Michigan CMH MH DAB - E&P only 200112 0.785500 4344340 Central Michigan CMH MH TANF 200112 0.824800 1708001 Clinton-Eaton-Ingham CMH MH DAB - Other 200112 0.893300 1708001 Clinton-Eaton-Ingham CMH MH DAB - E&P only 200112 0.893300 1708001 Clinton-Eaton-Ingham CMH MH TANF 200112 0.791800 1707962 Copper County CMH MH DAB - Other 200112 1.272900 1707962 Copper County CMH MH DAB - E&P only 200112 1.272900 1707962 Copper County CMH MH TANF 200112 0.991500 3119549 Detroit-Wayne CMH MH DAB - Other 200112 1.138500 3119549 Detroit-Wayne CMH MH DAB - Other 200112 1.138500 3119549 Detroit-Wayne CMH MH DAB - E&P only 200112 1.138500

12-Feb-2002 06:32Statewide Base Rate X Intensity Factor = Local Capitation Rate

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, Intensity Factors

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 4 of 58

MA Capitation Intensity Factors2001-12

Provider ID Provider Name Code Group Code Group 2

Effective Payment Month

Intensity Factor

12-Feb-2002 06:32Statewide Base Rate X Intensity Factor = Local Capitation Rate

3119549 Detroit-Wayne CMH MH DAB - E&P only 200112 1.138500 3119549 Detroit-Wayne CMH MH TANF 200112 0.966900 3119549 Detroit-Wayne CMH MH TANF 200112 0.966900 1705233 Genesee County CMH MH DAB - Other 200112 0.662200 1705233 Genesee County CMH MH DAB - E&P only 200112 0.662200 1705233 Genesee County CMH MH TANF 200112 0.386600 1708119 Gogebic County CMH MH DAB - Other 200112 1.407600 1708119 Gogebic County CMH MH DAB - E&P only 200112 1.407600 1708119 Gogebic County CMH MH TANF 200112 2.802200 1715955 Gratiot County CMH MH DAB - Other 200112 0.880000 1715955 Gratiot County CMH MH DAB - E&P only 200112 0.880000 1715955 Gratiot County CMH MH TANF 200112 1.570400 1705251 Great Lakes CMH MH DAB - Other 200112 1.835000 1705251 Great Lakes CMH MH DAB - E&P only 200112 1.835000 1705251 Great Lakes CMH MH TANF 200112 1.382200 1715919 Hiawatha MH DAB - Other 200112 1.636400 1715919 Hiawatha MH DAB - E&P only 200112 1.636400 1715919 Hiawatha MH TANF 200112 1.113800 1708128 Huron Behavioral Health MH DAB - Other 200112 1.167900 1708128 Huron Behavioral Health MH DAB - E&P only 200112 1.167900 1708128 Huron Behavioral Health MH TANF 200112 0.998300 1715928 Ionia County CMH MH DAB - Other 200112 0.917900 1715928 Ionia County CMH MH DAB - E&P only 200112 0.917900 1715928 Ionia County CMH MH TANF 200112 1.035800 3402136 Kalamazoo County CMH MH DAB - Other 200112 1.239700 3402136 Kalamazoo County CMH MH DAB - E&P only 200112 1.239700 3402136 Kalamazoo County CMH MH TANF 200112 1.078900 1705430 Kent County CMH MH DAB - Other 200112 1.031900 1705430 Kent County CMH MH DAB - E&P only 200112 1.031900 1705430 Kent County CMH MH TANF 200112 0.922900 1705242 Lapeer County CMH MH DAB - Other 200112 1.009300 1705242 Lapeer County CMH MH DAB - E&P only 200112 1.009300 1705242 Lapeer County CMH MH TANF 200112 1.062100 1705270 Lenawee County CMH MH DAB - Other 200112 1.017600

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, Intensity Factors

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 5 of 58

MA Capitation Intensity Factors2001-12

Provider ID Provider Name Code Group Code Group 2

Effective Payment Month

Intensity Factor

12-Feb-2002 06:32Statewide Base Rate X Intensity Factor = Local Capitation Rate

1705270 Lenawee County CMH MH DAB - E&P only 200112 1.017600 1705270 Lenawee County CMH MH TANF 200112 1.080400 1712229 Lifeways MH DAB - Other 200112 1.006600 1712229 Lifeways MH DAB - E&P only 200112 1.006600 1712229 Lifeways MH TANF 200112 1.095000 1707167 Livingston County CMH MH DAB - Other 200112 1.476000 1707167 Livingston County CMH MH DAB - E&P only 200112 1.476000 1707167 Livingston County CMH MH TANF 200112 2.698300 3396315 Macomb County CMH MH DAB - Other 200112 0.997600 3396315 Macomb County CMH MH DAB - E&P only 200112 0.997600 3396315 Macomb County CMH MH TANF 200112 1.026200 1705304 Manistee-Benzie CMH MH DAB - Other 200112 1.004800 1705304 Manistee-Benzie CMH MH DAB - E&P only 200112 1.004800 1705304 Manistee-Benzie CMH MH TANF 200112 1.241400 1712318 Midland-Gladwin CMH MH DAB - Other 200112 0.794300 1712318 Midland-Gladwin CMH MH DAB - E&P only 200112 0.794300 1712318 Midland-Gladwin CMH MH TANF 200112 1.015500 1710547 Monroe County CMH MH DAB - Other 200112 1.030000 1710547 Monroe County CMH MH DAB - E&P only 200112 1.030000 1710547 Monroe County CMH MH TANF 200112 1.309400 1712461 Montcalm Center MH DAB - Other 200112 0.459500 1712461 Montcalm Center MH DAB - E&P only 200112 0.459500 1712461 Montcalm Center MH TANF 200112 0.706500 1712452 Muskegon County CMH MH DAB - Other 200112 0.771800 1712452 Muskegon County CMH MH DAB - E&P only 200112 0.771800 1712452 Muskegon County CMH MH TANF 200112 0.994600 1708066 Newaygo County CMH MH DAB - Other 200112 0.747500 1708066 Newaygo County CMH MH DAB - E&P only 200112 0.747500 1708066 Newaygo County CMH MH TANF 200112 1.588000 1707158 North Central CMH MH DAB - Other 200112 0.922400 1707158 North Central CMH MH DAB - E&P only 200112 0.922400 1707158 North Central CMH MH TANF 200112 1.016700 1708100 Northeast CMH MH DAB - Other 200112 0.729400 1708100 Northeast CMH MH DAB - E&P only 200112 0.729400

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, Intensity Factors

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 6 of 58

MA Capitation Intensity Factors2001-12

Provider ID Provider Name Code Group Code Group 2

Effective Payment Month

Intensity Factor

12-Feb-2002 06:32Statewide Base Rate X Intensity Factor = Local Capitation Rate

1708100 Northeast CMH MH TANF 200112 0.999200 1707185 Northern Michigan CMH MH DAB - Other 200112 1.007400 1707185 Northern Michigan CMH MH DAB - E&P only 200112 1.007400 1707185 Northern Michigan CMH MH TANF 200112 0.823100 3140186 Northpointe Behavioral Health MH DAB - Other 200112 1.295200 3140186 Northpointe Behavioral Health MH DAB - Other 200112 1.295200 3140186 Northpointe Behavioral Health MH DAB - E&P only 200112 1.295200 3140186 Northpointe Behavioral Health MH DAB - E&P only 200112 1.295200 3140186 Northpointe Behavioral Health MH TANF 200112 1.412700 3140186 Northpointe Behavioral Health MH TANF 200112 1.412700 1705289 Oakland County CMH MH DAB - Other 200112 1.018800 1705289 Oakland County CMH MH DAB - E&P only 200112 1.018800 1705289 Oakland County CMH MH TANF 200112 0.798200 1712425 Ottawa County CMH MH DAB - Other 200112 1.297400 1712425 Ottawa County CMH MH DAB - E&P only 200112 1.297400 1712425 Ottawa County CMH MH TANF 200112 1.361100 1724945 Pathways MH DAB - Other 200112 1.632100 1724945 Pathways MH DAB - E&P only 200112 1.632100 1724945 Pathways MH TANF 200112 2.432200 1712372 Pines Behavioral Health MH DAB - Other 200112 1.013100 1712372 Pines Behavioral Health MH DAB - E&P only 200112 1.013100 1712372 Pines Behavioral Health MH TANF 200112 1.316000 1712541 Saginaw County CMH MH DAB - Other 200112 0.766400 1712541 Saginaw County CMH MH DAB - E&P only 200112 0.766400 1712541 Saginaw County CMH MH TANF 200112 0.634200 1706849 Sanilac County CMH MH DAB - Other 200112 0.823900 1706849 Sanilac County CMH MH DAB - E&P only 200112 0.823900 1706849 Sanilac County CMH MH TANF 200112 0.709300 1712407 Shiawassee County CMH MH DAB - Other 200112 0.935800 1712407 Shiawassee County CMH MH DAB - E&P only 200112 0.935800 1712407 Shiawassee County CMH MH TANF 200112 1.011000 1708164 St. Clair County CMH MH DAB - Other 200112 1.027700 1708164 St. Clair County CMH MH DAB - E&P only 200112 1.027700 1708164 St. Clair County CMH MH TANF 200112 2.734500

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, Intensity Factors

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 7 of 58

MA Capitation Intensity Factors2001-12

Provider ID Provider Name Code Group Code Group 2

Effective Payment Month

Intensity Factor

12-Feb-2002 06:32Statewide Base Rate X Intensity Factor = Local Capitation Rate

1708146 St. Joseph County CMH MH DAB - Other 200112 1.025100 1708146 St. Joseph County CMH MH DAB - E&P only 200112 1.025100 1708146 St. Joseph County CMH MH TANF 200112 1.064100 2920843 Summit Pointe MH DAB - Other 200112 0.793500 2920843 Summit Pointe MH DAB - E&P only 200112 0.793500 2920843 Summit Pointe MH TANF 200112 1.410000 1707130 Tuscola County CMH MH DAB - Other 200112 0.997400 1707130 Tuscola County CMH MH DAB - E&P only 200112 0.997400 1707130 Tuscola County CMH MH TANF 200112 1.189800 1705298 Van Buren County CMH MH DAB - Other 200112 1.155000 1705298 Van Buren County CMH MH DAB - E&P only 200112 1.155000 1705298 Van Buren County CMH MH TANF 200112 1.196200 1707176 Wastenaw County CMH MH DAB - Other 200112 1.337800 1707176 Wastenaw County CMH MH DAB - E&P only 200112 1.337800 1707176 Wastenaw County CMH MH TANF 200112 1.848200 3220732 Western Michigan CMH MH DAB - Other 200112 0.744400 3220732 Western Michigan CMH MH DAB - E&P only 200112 0.744400 3220732 Western Michigan CMH MH TANF 200112 1.010500 1706114 Woodland Behavioral Health MH DAB - Other 200112 0.670800 1706114 Woodland Behavioral Health MH DAB - E&P only 200112 0.670800 1706114 Woodland Behavioral Health MH TANF 200112 0.622800

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, Intensity Factors

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 8 of 58

MA Capitation Intensity Factors2001-12

Provider ID Provider Name Code Group Code Group 2

Effective Payment Month

Intensity Factor

12-Feb-2002 06:32Statewide Base Rate X Intensity Factor = Local Capitation Rate

1709690 Allegan County CMH DD DD 200112 1.611600 1712283 Antrim-Kalkaska CMH DD DD 200112 1.812000 1706830 AuSable Valley CMH DD DD 200112 0.700700 1705260 Barry County CMH DD DD 200112 0.491700 1705322 Bay-Arenac CMH DD DD 200112 1.347200 1705322 Bay-Arenac CMH DD DD 200112 1.347200 1716175 Berrien County CMH DD DD 200112 0.885600 4344340 Central Michigan CMH DD DD 200112 1.922000 1708001 Clinton-Eaton-Ingham CMH DD DD 200112 0.806800 1707962 Copper County CMH DD DD 200112 1.552000 3119549 Detroit-Wayne CMH DD DD 200112 0.737800 3119549 Detroit-Wayne CMH DD DD 200112 0.737800 1705233 Genesee County CMH DD DD 200112 0.905300 1708119 Gogebic County CMH DD DD 200112 1.834100 1715955 Gratiot County CMH DD DD 200112 1.709400 1705251 Great Lakes CMH DD DD 200112 1.287000 1715919 Hiawatha DD DD 200112 1.315800 1708128 Huron Behavioral Health DD DD 200112 1.353200 1715928 Ionia County CMH DD DD 200112 1.477700 3402136 Kalamazoo County CMH DD DD 200112 1.231800 1705430 Kent County CMH DD DD 200112 0.868400 1705242 Lapeer County CMH DD DD 200112 1.811100 1705270 Lenawee County CMH DD DD 200112 1.312600 1712229 Lifeways DD DD 200112 0.913200 1707167 Livingston County CMH DD DD 200112 2.005600 3396315 Macomb County CMH DD DD 200112 1.577300 1705304 Manistee-Benzie CMH DD DD 200112 2.717000 1712318 Midland-Gladwin CMH DD DD 200112 1.239700 1710547 Monroe County CMH DD DD 200112 1.703300 1712461 Montcalm Center DD DD 200112 0.459800 1712452 Muskegon County CMH DD DD 200112 0.781000 1708066 Newaygo County CMH DD DD 200112 0.685600 1707158 North Central CMH DD DD 200112 0.890200

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, Intensity Factors

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 9 of 58

MA Capitation Intensity Factors2001-12

Provider ID Provider Name Code Group Code Group 2

Effective Payment Month

Intensity Factor

12-Feb-2002 06:32Statewide Base Rate X Intensity Factor = Local Capitation Rate

1708100 Northeast CMH DD DD 200112 1.857900 1707185 Northern Michigan CMH DD DD 200112 1.380300 3140186 Northpointe Behavioral Health DD DD 200112 1.423100 3140186 Northpointe Behavioral Health DD DD 200112 1.423100 1705289 Oakland County CMH DD DD 200112 1.600400 1712425 Ottawa County CMH DD DD 200112 2.266400 1724945 Pathways DD DD 200112 1.843100 1712372 Pines Behavioral Health DD DD 200112 1.591500 1712541 Saginaw County CMH DD DD 200112 0.612900 1706849 Sanilac County CMH DD DD 200112 3.479000 1712407 Shiawassee County CMH DD DD 200112 1.160400 1708164 St. Clair County CMH DD DD 200112 1.869100 1708146 St. Joseph County CMH DD DD 200112 1.161100 2920843 Summit Pointe DD DD 200112 0.502100 1707130 Tuscola County CMH DD DD 200112 1.779900 1705298 Van Buren County CMH DD DD 200112 0.642800 1707176 Wastenaw County CMH DD DD 200112 1.361800 3220732 Western Michigan CMH DD DD 200112 0.747600 1706114 Woodland Behavioral Health DD DD 200112 1.024900

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, Intensity Factors

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 10 of 58

MA Capitation Intensity Factors2001-12

Provider ID Provider Name Code Group Code Group 2

Effective Payment Month

Intensity Factor

12-Feb-2002 06:32Statewide Base Rate X Intensity Factor = Local Capitation Rate

1724945 Eastern U.P. SAS SA DAB - Other 200112 0.618600 1724945 Eastern U.P. SAS SA DAB - E&P only 200112 0.618600 1724945 Eastern U.P. SAS SA TANF 200112 1.018600 1705233 Genesee Co. Health Dept. SA DAB - Other 200112 0.969200 1705233 Genesee Co. Health Dept. SA DAB - E&P only 200112 0.969200 1705233 Genesee Co. Health Dept. SA TANF 200112 0.895600 3402136 Kalamazoo Co. Human Services Department SA DAB - Other 200112 0.795300 3402136 Kalamazoo Co. Human Services Department SA DAB - E&P only 200112 0.795300 3402136 Kalamazoo Co. Human Services Department SA TANF 200112 1.386400 1712452 Lakeshore Coordinating Council SA DAB - Other 200112 0.763600 1712452 Lakeshore Coordinating Council SA DAB - E&P only 200112 0.763600 1712452 Lakeshore Coordinating Council SA TANF 200112 0.908100 3396315 Macomb County SA DAB - Other 200112 1.008900 3396315 Macomb County SA DAB - E&P only 200112 1.008900 3396315 Macomb County SA TANF 200112 1.440600 1708001 Mid-South SA Com. SA DAB - Other 200112 0.671200 1708001 Mid-South SA Com. SA DAB - E&P only 200112 0.671200 1708001 Mid-South SA Com. SA TANF 200112 0.843700 1705430 Mink Substance Abuse Coordinating Agency SA DAB - Other 200112 0.780100 1705430 Mink Substance Abuse Coordinating Agency SA DAB - E&P only 200112 0.780100 1705430 Mink Substance Abuse Coordinating Agency SA TANF 200112 1.182500 1715937 Northern Michigan SA Services Inc. SA DAB - Other 200112 0.607100 1715937 Northern Michigan SA Services Inc. SA DAB - E&P only 200112 0.607100 1715937 Northern Michigan SA Services Inc. SA TANF 200112 0.918600 1705289 Oakland County Health Division SA DAB - Other 200112 0.995500 1705289 Oakland County Health Division SA DAB - E&P only 200112 0.995500 1705289 Oakland County Health Division SA TANF 200112 1.335900 1712541 Saginaw County Health Department SA DAB - Other 200112 1.524600 1712541 Saginaw County Health Department SA DAB - E&P only 200112 1.524600 1712541 Saginaw County Health Department SA TANF 200112 0.944400 3119549 Southeast Michigan Community Alliance SA DAB - Other 200112 1.132300 3119549 Southeast Michigan Community Alliance SA DAB - Other 200112 1.132300 3119549 Southeast Michigan Community Alliance SA DAB - E&P only 200112 1.132300

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, Intensity Factors

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 11 of 58

MA Capitation Intensity Factors2001-12

Provider ID Provider Name Code Group Code Group 2

Effective Payment Month

Intensity Factor

12-Feb-2002 06:32Statewide Base Rate X Intensity Factor = Local Capitation Rate

3119549 Southeast Michigan Community Alliance SA DAB - E&P only 200112 1.132300 3119549 Southeast Michigan Community Alliance SA TANF 200112 0.851000 3119549 Southeast Michigan Community Alliance SA TANF 200112 0.851000 1708164 St. Clair Sounty Health Department SA DAB - Other 200112 0.632900 1708164 St. Clair Sounty Health Department SA DAB - E&P only 200112 0.632900 1708164 St. Clair Sounty Health Department SA TANF 200112 0.852600 1707176 Washtenaw County CMHC SA DAB - Other 200112 0.991300 1707176 Washtenaw County CMHC SA DAB - E&P only 200112 0.991300 1707176 Washtenaw County CMHC SA TANF 200112 0.938500 1707962 Western U.P. SAS Coordinating Agency SA DAB - Other 200112 0.800800 1707962 Western U.P. SAS Coordinating Agency SA DAB - E&P only 200112 0.800800 1707962 Western U.P. SAS Coordinating Agency SA TANF 200112 1.707500

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, Intensity Factors

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 12 of 58

MACap - Rates: 95a - Summary recordcode02 for CMHA Provider ID DD Cap

Provider ID Agent ID Provider Name DAB Eligibles

TANF Eligibles DD Eligibles Total

Eligibles SubTotal DAB

Cap SubTotal TANF

Cap SubTotal MH/DD

Cap SubTotal MHCap SubTotal DDCap

1 1705233 0028 Genesee County Health Dept 4,666 47,576 14,170 66,412 $105,274.93 $118,106.40 $939,244.97 $1,162,626.30 $3,440,623.782 1705242 00GT Lapeer County CMH 593 4,041 1,047 5,681 $16,551.99 $26,969.21 $108,372.46 $151,893.66 $548,555.553 1705251 00GM Great Lakes CMH 962 4,836 1,456 7,254 $50,686.46 $41,565.02 $265,917.45 $358,168.93 $509,787.624 1705260 00GD Barry County CMH 463 2,946 767 4,176 $8,368.20 $12,946.85 $47,331.07 $68,646.12 $105,710.145 1705270 00GU Lenawee County CMH 953 5,593 1,895 8,441 $27,918.05 $38,008.66 $195,235.00 $261,161.71 $682,061.036 1705289 0058 Oakland County CMHA 9,619 38,094 14,564 62,277 $254,228.83 $192,939.43 $1,474,962.45 $1,922,130.71 $6,533,478.497 1705298 00HT Van Buren County CMH 1,309 7,648 2,257 11,214 $43,707.36 $58,904.80 $252,782.82 $355,394.98 $389,459.618 1705304 00GY Manistee-Benzie CMH 573 3,031 994 4,598 $14,702.18 $23,425.09 $99,579.23 $137,706.50 $752,076.799 1705322 00GE Bay-Arenac CMH 1,436 10,093 3,236 14,765 $36,750.77 $83,908.02 $332,988.79 $453,647.58 $1,239,713.9910 1705430 00GS Kent County CMH 5,846 39,650 12,484 57,980 $182,520.78 $230,559.55 $1,257,304.65 $1,670,384.98 $2,828,699.3511 1706114 00HW Woodlands Behavioral Healthcare 680 4,053 1,146 5,879 $13,358.04 $16,296.37 $76,157.27 $105,811.68 $316,480.3612 1706830 00GC AuSable Valley CMH 980 5,578 1,834 8,392 $18,526.11 $58,722.22 $137,417.55 $214,665.88 $368,245.0613 1706849 00HM Sanilac County CMH 538 3,400 993 4,931 $11,537.05 $15,105.98 $80,401.94 $107,044.97 $957,593.8014 1707130 00HS Tuscola County CMH 670 4,137 1,237 6,044 $20,394.16 $30,824.69 $122,979.52 $174,198.37 $592,701.6515 1707158 00HC North Central CMH 1,317 8,188 2,422 11,927 $34,550.38 $53,021.12 $228,981.90 $316,553.40 $611,899.4816 1707167 00GW Livingston County CMH 639 3,108 948 4,695 $28,910.34 $52,476.61 $147,186.86 $228,573.81 $541,979.3417 1707176 00HU Washtenaw County CMH 2,070 10,732 4,103 16,905 $86,465.84 $125,395.20 $559,965.91 $771,826.95 $1,574,632.8418 1707185 00HF Northern Michigan CMH 1,448 7,819 2,055 11,322 $39,110.21 $40,021.05 $206,919.26 $286,050.52 $781,809.8819 1707962 00GI Copper County CMH 1,073 4,069 1,399 6,541 $30,986.94 $25,190.47 $168,545.28 $224,722.69 $595,500.7220 1708001 00BJ CEI CMH 4,641 27,778 8,511 40,930 $135,696.89 $139,846.13 $767,767.00 $1,043,310.02 $1,873,548.9721 1708066 00HB Newaygo County CMH 663 4,106 1,331 6,100 $13,942.72 $41,325.40 $101,802.48 $157,070.60 $258,231.1522 1708100 00HE Northeast Michigan CMH 1,069 5,310 1,959 8,338 $20,519.44 $33,828.01 $145,785.05 $200,132.50 $1,042,776.6123 1708119 00GL Gogebic County CMH 476 1,467 487 2,430 $16,213.10 $25,956.02 $67,827.84 $109,996.96 $253,016.6124 1708128 00GP Huron Behavioral Health 499 2,603 853 3,955 $14,269.15 $16,270.75 $98,881.75 $129,421.65 $325,901.5625 1708146 00HP St. Joseph County CMH 793 5,393 1,326 7,512 $25,305.89 $36,065.12 $137,025.33 $198,396.34 $432,525.7426 1708164 00HO St. Clair County CMH 1,655 10,088 2,980 14,723 $53,927.68 $175,837.44 $311,543.14 $541,308.26 $1,542,029.8827 1709690 00GA Allegan County CMH 991 5,645 1,637 8,273 $28,207.50 $50,108.61 $167,084.55 $245,400.66 $719,978.1528 1710547 00HX Monroe County CMH 1,028 6,674 2,236 9,938 $30,275.44 $54,857.12 $234,950.24 $320,082.80 $1,055,028.8329 1712229 00GV Lifeways CMH 2,345 14,743 4,930 22,018 $70,394.23 $100,889.79 $493,058.90 $664,342.92 $1,207,958.4430 1712283 00GB Antrim-Kalkaska CMH 542 3,016 862 4,420 $15,267.31 $17,805.85 $84,775.34 $117,848.50 $418,718.7431 1712372 00HL Pines Behavioral Health CMH 553 3,218 943 4,714 $16,597.12 $26,796.08 $95,472.10 $138,865.30 $414,349.8232 1712407 00HN Shiawassee County CMH 716 4,828 1,410 6,954 $18,417.86 $30,984.22 $135,235.51 $184,637.59 $453,497.3733 1712425 00HI Ottawa County CMH 1,450 8,588 2,037 12,075 $50,546.04 $72,478.00 $273,160.59 $396,184.63 $1,293,077.98

MA Capitation by Provider ID 12-Feb-2002 06:322001-12

Mental Health Capitation Eligible Population

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, MH by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 13 of 58

MACap - Rates: 95a - Summary recordcode02 for CMHA Provider ID DD Cap

Provider ID Agent ID Provider Name DAB Eligibles

TANF Eligibles DD Eligibles Total

Eligibles SubTotal DAB

Cap SubTotal TANF

Cap SubTotal MH/DD

Cap SubTotal MHCap SubTotal DDCap

MA Capitation by Provider ID 12-Feb-2002 06:322001-12

Mental Health Capitation Eligible Population

34 1712452 00HA Muskegon County CMH 2,540 17,154 6,014 25,708 $59,492.68 $107,537.83 $476,651.93 $643,682.44 $1,311,950.6135 1712461 00GZ Montcalm Center Behavl. Hlt 664 4,550 1,546 6,760 $8,649.16 $20,115.96 $70,812.62 $99,577.74 $191,231.7836 1712541 00HQ Saginaw County CMH 2,532 22,644 7,640 32,816 $58,886.50 $91,372.50 $581,810.13 $732,069.13 $1,249,456.9437 1715919 00GO Hiawatha Behavioral Health Authority 913 4,576 1,271 6,760 $41,481.75 $32,158.63 $208,955.94 $282,596.32 $472,081.5138 1715928 00GQ Ionia County CMH 517 3,773 1,114 5,404 $14,209.14 $24,631.93 $103,410.38 $142,251.45 $454,088.8839 1715955 00GN Gratiot County CMH 604 2,856 1,004 4,464 $12,999.08 $28,192.14 $87,143.24 $128,334.46 $466,395.4840 1716175 00GF Berrien Mental Health 2,503 15,232 5,145 22,880 $63,558.99 $79,002.28 $425,590.44 $568,151.71 $1,178,650.3641 1724945 00HJ Pathways CMH 1,837 8,230 2,727 12,794 $78,609.80 $127,963.29 $448,807.37 $655,380.46 $1,417,239.1342 2920843 00HR Summit Pointe CMH 1,878 11,987 4,424 18,289 $43,829.07 $106,214.17 $351,599.27 $501,642.51 $607,740.5543 3119549 00GJ Detroit-Wayne County CMH 32,810 233,988 82,489 349,287 $1,172,999.62 $1,433,226.73 $9,087,441.05 $11,693,667.40 $16,202,001.6144 3140186 00HG Northpointe CMH 1,280 4,407 1,354 7,041 $38,338.39 $39,406.92 $168,065.50 $245,810.81 $521,170.8945 3220732 00HV West Michigan CMH 1,047 7,013 2,199 10,259 $22,804.94 $45,341.80 $161,168.60 $229,315.34 $447,698.8946 3396315 00GX Macomb County CA 6,517 29,335 10,139 45,991 $167,854.36 $193,384.86 $1,009,937.72 $1,371,176.94 $4,477,164.5047 3402136 00GR Kalamazoo County CMH 2,498 15,747 5,283 23,528 $94,124.15 $107,554.65 $655,822.78 $857,501.58 $1,786,924.4648 4344340 00GG Central Michigan CMH 3,021 19,358 6,417 28,796 $73,858.29 $110,111.17 $511,143.81 $695,113.27 $2,977,910.8249

50

State Subtotals 114,417 718,899 239,275 1,072,591 $3,485,824.91 $4,613,650.14 $24,165,004.98 $32,264,480.03 $68,423,355.74

833,316 $27,650,829.89 State Total $100,687,835.77

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, MH by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 14 of 58

MACap - Rates: 95b - qSummary recordcode02 for CMHA Provider ID by County DD Cap

Provider ID Agent ID Provider Name Co ID County Name MH Eligibles TANF

Eligibles DD Eligibles Total Eligibles

SubTotal DAB Cap

SubTotal TANF Cap

SubTotal MH/DD Cap SubTotal MHCap SubTotal DDCap

1 1708100 00HE Northeast Michigan CMH 01 Alcona 164 907 273 1,344 $3,110.76 $5,867.62 $18,779.27 $27,757.65 $137,126.082 1724945 00HJ Pathways CMH 02 Alger 165 616 216 997 $5,989.12 $9,639.67 $33,780.34 $49,409.13 $109,957.473 1709690 00GA Allegan County CMH 03 Allegan 991 5,645 1,637 8,273 $28,207.50 $50,108.61 $167,084.55 $245,400.66 $719,978.154 1708100 00HE Northeast Michigan CMH 04 Alpena 462 2,652 1,017 4,131 $8,950.08 $17,000.77 $77,942.96 $103,893.81 $551,839.855 1712283 00GB Antrim-Kalkaska CMH 05 Antrim 301 1,459 409 2,169 $8,506.56 $8,448.20 $41,977.47 $58,932.23 $205,007.786 1705322 00GE Bay-Arenac CMH 06 Arenac 251 1,721 523 2,495 $6,193.28 $14,315.68 $52,438.04 $72,947.00 $198,418.887 1707962 00GI Copper County CMH 07 Baraga 164 680 208 1,052 $5,235.37 $4,170.26 $23,971.36 $33,376.99 $87,273.438 1705260 00GD Barry County CMH 08 Barry 463 2,946 767 4,176 $8,368.20 $12,946.85 $47,331.07 $68,646.12 $105,710.149 1705322 00GE Bay-Arenac CMH 09 Bay 1,185 8,372 2,713 12,270 $30,557.49 $69,592.34 $280,550.75 $380,700.58 $1,041,295.1110 1705304 00GY Manistee-Benzie CMH 10 Benzie 196 1,074 338 1,608 $4,934.47 $8,171.76 $32,508.35 $45,614.58 $247,926.4711 1716175 00GF Berrien Mental Health 11 Berrien 2,503 15,232 5,145 22,880 $63,558.99 $79,002.28 $425,590.44 $568,151.71 $1,178,650.3612 1712372 00HL Pines Behavioral Health CMH 12 Branch 553 3,218 943 4,714 $16,597.12 $26,796.08 $95,472.10 $138,865.30 $414,349.8213 2920843 00HR Summit Pointe CMH 13 Calhoun 1,878 11,987 4,424 18,289 $43,829.07 $106,214.17 $351,599.27 $501,642.51 $607,740.5514 1706114 00HW Woodlands Behavioral Healthcare 14 Cass 680 4,053 1,146 5,879 $13,358.04 $16,296.37 $76,157.27 $105,811.68 $316,480.3615 1707185 00HF Northern Michigan CMH 15 Charlevoix 325 1,687 459 2,471 $8,471.93 $8,469.40 $45,391.02 $62,332.35 $171,005.0416 1707185 00HF Northern Michigan CMH 16 Cheboygan 473 2,384 618 3,475 $13,286.11 $12,342.46 $62,416.61 $88,045.18 $235,835.8217 1715919 00GO Hiawatha Behavioral Health Authority 17 Chippewa 516 2,993 788 4,297 $25,156.29 $21,038.77 $129,294.04 $175,489.10 $292,158.0418 4344340 00GG Central Michigan CMH 18 Clare 436 3,455 1,208 5,099 $10,086.98 $19,828.16 $97,312.67 $127,227.81 $570,155.6019 1708001 00BJ CEI CMH 19 Clinton 426 2,254 655 3,335 $11,756.97 $11,118.74 $62,215.13 $85,090.84 $152,413.2520 1707158 00HC North Central CMH 20 Crawford 188 1,341 395 1,924 $4,928.91 $8,612.55 $37,067.57 $50,609.03 $99,124.5321 1724945 00HJ Pathways CMH 21 Delta 663 3,045 917 4,625 $28,171.38 $47,145.78 $151,856.62 $227,173.78 $478,870.1522 3140186 00HG Northpointe CMH 22 Dickinson 454 1,843 521 2,818 $13,352.81 $16,376.06 $67,574.52 $97,303.39 $205,529.6123 1708001 00BJ CEI CMH 23 Eaton 743 4,775 1,274 6,792 $19,027.85 $23,838.22 $114,532.25 $157,398.32 $273,906.5124 1707185 00HF Northern Michigan CMH 24 Emmet 438 1,810 532 2,780 $10,714.84 $9,150.10 $54,205.75 $74,070.69 $207,766.5825 1705233 0028 Genesee County Health Dept 25 Genesee 4,666 47,576 14,170 66,412 $105,274.93 $118,106.40 $939,244.97 $1,162,626.30 $3,440,623.7826 4344340 00GG Central Michigan CMH 26 Gladwin 378 2,340 752 3,470 $8,163.03 $13,026.20 $60,787.91 $81,977.14 $359,291.1527 1708119 00GL Gogebic County CMH 27 Gogebic 476 1,467 487 2,430 $16,213.10 $25,956.02 $67,827.84 $109,996.96 $253,016.6128 1705251 00GM Great Lakes CMH 28 Grand Traverse 801 3,941 1,260 6,002 $42,237.47 $33,773.13 $232,435.48 $308,446.08 $446,728.9529 1715955 00GN Gratiot County CMH 29 Gratiot 604 2,856 1,004 4,464 $12,999.08 $28,192.14 $87,143.24 $128,334.46 $466,395.4830 1712229 00GV Lifeways CMH 30 Hillsdale 530 3,035 1,105 4,670 $15,158.35 $20,962.43 $106,581.11 $142,701.89 $263,878.9531 1707962 00GI Copper County CMH 31 Houghton 659 2,698 906 4,263 $18,887.61 $16,718.82 $110,497.53 $146,103.96 $386,495.2632 1708128 00GP Huron Behavioral Health 32 Huron 499 2,603 853 3,955 $14,269.15 $16,270.75 $98,881.75 $129,421.65 $325,901.5633 1708001 00BJ CEI CMH 33 Ingham 3,472 20,749 6,582 30,803 $104,912.07 $104,889.17 $591,019.62 $800,820.86 $1,447,229.21

MA Capitation by Provider ID by County 12-Feb-2002 06:322001-12

Mental Health Capitation Eligible Population

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, MH by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 15 of 58

MACap - Rates: 95b - qSummary recordcode02 for CMHA Provider ID by County DD Cap

Provider ID Agent ID Provider Name Co ID County Name MH Eligibles TANF

Eligibles DD Eligibles Total Eligibles

SubTotal DAB Cap

SubTotal TANF Cap

SubTotal MH/DD Cap SubTotal MHCap SubTotal DDCap

MA Capitation by Provider ID by County 12-Feb-2002 06:322001-12

Mental Health Capitation Eligible Population

34 1715928 00GQ Ionia County CMH 34 Ionia 517 3,773 1,114 5,404 $14,209.14 $24,631.93 $103,410.38 $142,251.45 $454,088.8835 1706830 00GC AuSable Valley CMH 35 Iosco 406 2,504 748 3,658 $7,566.06 $26,273.22 $56,014.12 $89,853.40 $148,215.0336 3140186 00HG Northpointe CMH 36 Iron 427 936 354 1,717 $11,695.81 $8,467.31 $42,734.11 $62,897.23 $133,189.6837 4344340 00GG Central Michigan CMH 37 Isabella 501 3,483 1,247 5,231 $12,426.25 $19,925.68 $97,647.25 $129,999.18 $560,176.6938 1712229 00GV Lifeways CMH 38 Jackson 1,815 11,708 3,825 17,348 $55,235.88 $79,927.36 $386,477.79 $521,641.03 $944,079.4939 3402136 00GR Kalamazoo County CMH 39 Kalamazoo 2,498 15,747 5,283 23,528 $94,124.15 $107,554.65 $655,822.78 $857,501.58 $1,786,924.4640 1712283 00GB Antrim-Kalkaska CMH 40 Kalkaska 241 1,557 453 2,251 $6,760.75 $9,357.65 $42,797.87 $58,916.27 $213,710.9641 1705430 00GS Kent County CMH 41 Kent 5,846 39,650 12,484 57,980 $182,520.78 $230,559.55 $1,257,304.65 $1,670,384.98 $2,828,699.3542 1707962 00GI Copper County CMH 42 Keweenaw 61 153 56 270 $1,542.23 $949.26 $6,300.41 $8,791.90 $22,406.5443 3220732 00HV West Michigan CMH 43 Lake 268 1,303 655 2,226 $5,784.58 $8,531.83 $48,601.12 $62,917.53 $137,798.2844 1705242 00GT Lapeer County CMH 44 Lapeer 593 4,041 1,047 5,681 $16,551.99 $26,969.21 $108,372.46 $151,893.66 $548,555.5545 1705251 00GM Great Lakes CMH 45 Leelanau 161 895 196 1,252 $8,448.99 $7,791.89 $33,481.97 $49,722.85 $63,058.6746 1705270 00GU Lenawee County CMH 46 Lenawee 953 5,593 1,895 8,441 $27,918.05 $38,008.66 $195,235.00 $261,161.71 $682,061.0347 1707167 00GW Livingston County CMH 47 Livingston 639 3,108 948 4,695 $28,910.34 $52,476.61 $147,186.86 $228,573.81 $541,979.3448 1724945 00HJ Pathways CMH 48 Luce 167 782 315 1,264 $7,328.30 $12,314.10 $45,969.94 $65,612.34 $150,771.1949 1715919 00GO Hiawatha Behavioral Health Authority 49 Mackinac 171 716 192 1,079 $7,008.96 $4,993.67 $32,223.09 $44,225.72 $72,202.5550 3396315 00GX Macomb County CA 50 Macomb 6,517 29,335 10,139 45,991 $167,854.36 $193,384.86 $1,009,937.72 $1,371,176.94 $4,477,164.5051 1705304 00GY Manistee-Benzie CMH 51 Manistee 377 1,957 656 2,990 $9,767.71 $15,253.33 $67,070.88 $92,091.92 $504,150.3252 1724945 00HJ Pathways CMH 52 Marquette 842 3,787 1,279 5,908 $37,121.00 $58,863.74 $217,200.47 $313,185.21 $677,640.3253 3220732 00HV West Michigan CMH 53 Mason 451 2,410 700 3,561 $10,068.37 $15,478.54 $51,526.25 $77,073.16 $140,418.7654 4344340 00GG Central Michigan CMH 54 Mecosta 525 3,492 1,032 5,049 $13,502.78 $19,978.66 $80,623.05 $114,104.49 $467,801.0155 3140186 00HG Northpointe CMH 55 Menominee 399 1,628 479 2,506 $13,289.77 $14,563.55 $57,756.87 $85,610.19 $182,451.6056 4344340 00GG Central Michigan CMH 56 Midland 876 4,355 1,454 6,685 $22,235.33 $24,698.40 $119,681.78 $166,615.51 $692,499.5857 1707158 00HC North Central CMH 57 Missaukee 35 35 $1,368.85 $1,368.8558 1710547 00HX Monroe County CMH 58 Monroe 1,028 6,674 2,236 9,938 $30,275.44 $54,857.12 $234,950.24 $320,082.80 $1,055,028.8359 1712461 00GZ Montcalm Center Behavl. Hlt 59 Montcalm 664 4,550 1,546 6,760 $8,649.16 $20,115.96 $70,812.62 $99,577.74 $191,231.7860 1708100 00HE Northeast Michigan CMH 60 Montmorency 194 921 324 1,439 $3,647.73 $5,824.34 $22,542.09 $32,014.16 $165,093.3961 1712452 00HA Muskegon County CMH 61 Muskegon 2,540 17,154 6,014 25,708 $59,492.68 $107,537.83 $476,651.93 $643,682.44 $1,311,950.6162 1708066 00HB Newaygo County CMH 62 Newaygo 663 4,106 1,331 6,100 $13,942.72 $41,325.40 $101,802.48 $157,070.60 $258,231.1563 1705289 0058 Oakland County CMHA 63 Oakland 9,619 38,094 14,564 62,277 $254,228.83 $192,939.43 $1,474,962.45 $1,922,130.71 $6,533,478.4964 3220732 00HV West Michigan CMH 64 Oceana 328 3,300 844 4,472 $6,951.99 $21,331.43 $61,041.23 $89,324.65 $169,481.8565 1706830 00GC AuSable Valley CMH 65 Ogemaw 413 2,207 769 3,389 $8,036.85 $23,224.33 $57,027.11 $88,288.29 $155,084.4666 1707962 00GI Copper County CMH 66 Ontonagon 189 538 229 956 $5,321.73 $3,352.13 $27,775.98 $36,449.84 $99,325.49

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, MH by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 16 of 58

MACap - Rates: 95b - qSummary recordcode02 for CMHA Provider ID by County DD Cap

Provider ID Agent ID Provider Name Co ID County Name MH Eligibles TANF

Eligibles DD Eligibles Total Eligibles

SubTotal DAB Cap

SubTotal TANF Cap

SubTotal MH/DD Cap SubTotal MHCap SubTotal DDCap

MA Capitation by Provider ID by County 12-Feb-2002 06:322001-12

Mental Health Capitation Eligible Population

67 4344340 00GG Central Michigan CMH 67 Osceola 305 2,233 724 3,262 $7,443.92 $12,654.07 $55,091.15 $75,189.14 $327,986.7968 1706830 00GC AuSable Valley CMH 68 Oscoda 161 867 317 1,345 $2,923.20 $9,224.67 $24,376.32 $36,524.19 $64,945.5769 1707185 00HF Northern Michigan CMH 69 Otsego 212 1,938 446 2,596 $6,637.33 $10,059.09 $44,905.88 $61,602.30 $167,202.4470 1712425 00HI Ottawa County CMH 70 Ottawa 1,450 8,588 2,037 12,075 $50,546.04 $72,478.00 $273,160.59 $396,184.63 $1,293,077.9871 1708100 00HE Northeast Michigan CMH 71 Presque Isle 249 830 345 1,424 $4,810.87 $5,135.28 $26,520.73 $36,466.88 $188,717.2972 1707158 00HC North Central CMH 72 Roscommon 413 2,555 804 3,772 $10,512.27 $16,967.59 $77,023.67 $104,503.53 $205,266.5673 1712541 00HQ Saginaw County CMH 73 Saginaw 2,532 22,644 7,640 32,816 $58,886.50 $91,372.50 $581,810.13 $732,069.13 $1,249,456.9474 1708164 00HO St. Clair County CMH 74 St. Clair 1,655 10,088 2,980 14,723 $53,927.68 $175,837.44 $311,543.14 $541,308.26 $1,542,029.8875 1708146 00HP St. Joseph County CMH 75 St. Joseph 793 5,393 1,326 7,512 $25,305.89 $36,065.12 $137,025.33 $198,396.34 $432,525.7476 1706849 00HM Sanilac County CMH 76 Sanilac 538 3,400 993 4,931 $11,537.05 $15,105.98 $80,401.94 $107,044.97 $957,593.8077 1715919 00GO Hiawatha Behavioral Health Authority 77 Schoolcraft 226 867 291 1,384 $9,316.50 $6,126.19 $47,438.81 $62,881.50 $107,720.9278 1712407 00HN Shiawassee County CMH 78 Shiawassee 716 4,828 1,410 6,954 $18,417.86 $30,984.22 $135,235.51 $184,637.59 $453,497.3779 1707130 00HS Tuscola County CMH 79 Tuscola 670 4,137 1,237 6,044 $20,394.16 $30,824.69 $122,979.52 $174,198.37 $592,701.6580 1705298 00HT Van Buren County CMH 80 Van Buren 1,309 7,648 2,257 11,214 $43,707.36 $58,904.80 $252,782.82 $355,394.98 $389,459.6181 1707176 00HU Washtenaw County CMH 81 Washtenaw 2,070 10,732 4,103 16,905 $86,465.84 $125,395.20 $559,965.91 $771,826.95 $1,574,632.8482 3119549 00GJ Detroit-Wayne County CMH 82 Wayne 32,810 233,988 82,489 349,287 $1,172,999.62 $1,433,226.73 $9,087,441.05 $11,693,667.40 $16,202,001.6183 1707158 00HC North Central CMH 83 Wexford 681 4,292 1,223 6,196 $17,740.35 $27,440.98 $114,890.66 $160,071.99 $307,508.3984

85

114,417 718,899 239,275 1,072,591 $32,264,480.03 $68,423,355.74Check Values - - - - $0.00 $0.00

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, MH by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 17 of 58

MACap - Rates: 95c - qSummary recordcode02 for CA Provider ID

Provider ID Agent ID Provider Name DAB Eligibles

TANF Eligibles DD Eligibles Total

Eligibles SubTotal SA Cap

1 1705233 00HZ Genesee County Health Dept 4,666 47,576 14,170 66,412 $129,172.462 1705289 00IF Oakland County Health Div 9,619 38,094 14,564 62,277 $138,379.473 1705430 00ID Mink Substance Abuse Coordinating Agency 7,690 52,079 16,475 76,244 $131,730.674 1707176 00HU Washtenaw County CMH 2,709 13,840 5,051 21,600 $45,165.735 1707962 00IL Western U.P. SAS 2,430 8,315 2,761 13,506 $25,348.036 1708001 00IC Mid-South CA 11,137 67,785 22,174 101,096 $144,992.057 1708164 00II St. Clair County Health Dept. CA 3,955 24,269 7,110 35,334 $47,074.088 1710547 00IH Southeast MI Community Alliance 11,555 75,588 27,069 114,212 $252,404.679 1712452 00IB Lakeshore CA 9,473 58,320 18,236 86,029 $133,952.8310 1712541 00IG Saginaw County Health Dept 3,717 31,016 10,353 45,086 $128,021.1811 1724945 00HY Eastern U.P. Substance Abuse 3,149 14,434 4,477 22,060 $31,280.9112 3119549 00XO Detroit Health Department 22,283 165,074 57,656 245,013 $633,684.8113 3396315 00GX Macomb County CA 6,517 29,335 10,139 45,991 $106,973.5414 3402136 00GR Kalamazoo County CMH 4,307 27,304 8,319 39,930 $75,471.6715 4344340 00IE Northern Michigan CA 11,210 65,870 20,721 97,801 $134,673.8716

114,417 718,899 239,275 1,072,591 $2,158,325.97Check Value 833,316 - $0.00

SA Capitation by Provider ID 12-Feb-2002 06:322001-12

Eligible Population

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, SA by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 18 of 58

MACap - Rates: 95d - qSummary recordcode02 for CA Provider ID by County

Provider ID Agent ID Provider Name Co ID County Name DAB

EligiblesTANF

Eligibles DD Eligibles Total Eligibles SubTotal SA Cap

1 4344340 00IE Northern Michigan CA 01 Alcona 164 907 273 1,344 $1,835.482 1724945 00HY Eastern U.P. Substance Abuse 02 Alger 165 616 216 997 $1,428.563 1712452 00IB Lakeshore CA 03 Allegan 991 5,645 1,637 8,273 $11,554.354 4344340 00IE Northern Michigan CA 04 Alpena 462 2,652 1,017 4,131 $6,641.625 4344340 00IE Northern Michigan CA 05 Antrim 301 1,459 409 2,169 $2,430.976 4344340 00IE Northern Michigan CA 06 Arenac 251 1,721 523 2,495 $3,458.587 1707962 00IL Western U.P. SAS 07 Baraga 164 680 208 1,052 $1,763.588 3402136 00GR Kalamazoo County CMH 08 Barry 463 2,946 767 4,176 $7,773.879 1712541 00IG Saginaw County Health Dept 09 Bay 1,185 8,372 2,713 12,270 $35,030.8410 4344340 00IE Northern Michigan CA 10 Benzie 196 1,074 338 1,608 $1,881.3011 1712452 00IB Lakeshore CA 11 Berrien 2,503 15,232 5,145 22,880 $35,558.5212 3402136 00GR Kalamazoo County CMH 12 Branch 553 3,218 943 4,714 $8,617.6513 1708001 00IC Mid-South CA 13 Calhoun 1,878 11,987 4,424 18,289 $27,446.9914 1712452 00IB Lakeshore CA 14 Cass 680 4,053 1,146 5,879 $9,205.5215 4344340 00IE Northern Michigan CA 15 Charlevoix 325 1,687 459 2,471 $2,685.4516 4344340 00IE Northern Michigan CA 16 Cheboygan 473 2,384 618 3,475 $4,236.4517 1724945 00HY Eastern U.P. Substance Abuse 17 Chippewa 516 2,993 788 4,297 $5,804.3718 4344340 00IE Northern Michigan CA 18 Clare 436 3,455 1,208 5,099 $7,983.9219 1708001 00IC Mid-South CA 19 Clinton 426 2,254 655 3,335 $4,604.5320 4344340 00IE Northern Michigan CA 20 Crawford 188 1,341 395 1,924 $2,681.9621 1724945 00HY Eastern U.P. Substance Abuse 21 Delta 663 3,045 917 4,625 $6,598.1022 1707962 00IL Western U.P. SAS 22 Dickinson 454 1,843 521 2,818 $5,317.9723 1708001 00IC Mid-South CA 23 Eaton 743 4,775 1,274 6,792 $8,840.3224 4344340 00IE Northern Michigan CA 24 Emmet 438 1,810 532 2,780 $3,269.7725 1705233 00HZ Genesee County Health Dept 25 Genesee 4,666 47,576 14,170 66,412 $129,172.4626 4344340 00IE Northern Michigan CA 26 Gladwin 378 2,340 752 3,470 $4,709.1227 1707962 00IL Western U.P. SAS 27 Gogebic 476 1,467 487 2,430 $4,705.3328 4344340 00IE Northern Michigan CA 28 Grand Traverse 801 3,941 1,260 6,002 $7,689.5429 1708001 00IC Mid-South CA 29 Gratiot 604 2,856 1,004 4,464 $6,233.6030 1708001 00IC Mid-South CA 30 Hillsdale 530 3,035 1,105 4,670 $6,586.6331 1707962 00IL Western U.P. SAS 31 Houghton 659 2,698 906 4,263 $8,029.8032 1708164 00II St. Clair County Health Dept. CA 32 Huron 499 2,603 853 3,955 $5,252.6533 1708001 00IC Mid-South CA 33 Ingham 3,472 20,749 6,582 30,803 $45,122.92

SA Capitation by Provider ID by County 12-Feb-2002 06:322001-12

Eligible Population

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, SA by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 19 of 58

MACap - Rates: 95d - qSummary recordcode02 for CA Provider ID by County

Provider ID Agent ID Provider Name Co ID County Name DAB

EligiblesTANF

Eligibles DD Eligibles Total Eligibles SubTotal SA Cap

SA Capitation by Provider ID by County 12-Feb-2002 06:322001-12

Eligible Population

34 1705430 00ID Mink Substance Abuse Coordinating Agency 34 Ionia 517 3,773 1,114 5,404 $9,330.5335 4344340 00IE Northern Michigan CA 35 Iosco 406 2,504 748 3,658 $5,088.4336 1707962 00IL Western U.P. SAS 36 Iron 427 936 354 1,717 $3,184.0037 4344340 00IE Northern Michigan CA 37 Isabella 501 3,483 1,247 5,231 $7,801.8338 1708001 00IC Mid-South CA 38 Jackson 1,815 11,708 3,825 17,348 $24,149.2539 3402136 00GR Kalamazoo County CMH 39 Kalamazoo 2,498 15,747 5,283 23,528 $46,128.9640 4344340 00IE Northern Michigan CA 40 Kalkaska 241 1,557 453 2,251 $2,760.9441 1705430 00ID Mink Substance Abuse Coordinating Agency 41 Kent 5,846 39,650 12,484 57,980 $99,207.9742 1707962 00IL Western U.P. SAS 42 Keweenaw 61 153 56 270 $447.8743 4344340 00IE Northern Michigan CA 43 Lake 268 1,303 655 2,226 $3,819.0444 1708164 00II St. Clair County Health Dept. CA 44 Lapeer 593 4,041 1,047 5,681 $7,251.4845 4344340 00IE Northern Michigan CA 45 Leelanau 161 895 196 1,252 $1,377.8346 1708001 00IC Mid-South CA 46 Lenawee 953 5,593 1,895 8,441 $12,131.7547 1707176 00HU Washtenaw County CMH 47 Livingston 639 3,108 948 4,695 $8,893.2548 1724945 00HY Eastern U.P. Substance Abuse 48 Luce 167 782 315 1,264 $1,891.2849 1724945 00HY Eastern U.P. Substance Abuse 49 Mackinac 171 716 192 1,079 $1,416.1850 3396315 00GX Macomb County CA 50 Macomb 6,517 29,335 10,139 45,991 $106,973.5451 4344340 00IE Northern Michigan CA 51 Manistee 377 1,957 656 2,990 $4,068.0152 1724945 00HY Eastern U.P. Substance Abuse 52 Marquette 842 3,787 1,279 5,908 $9,002.2453 4344340 00IE Northern Michigan CA 53 Mason 451 2,410 700 3,561 $4,652.4954 4344340 00IE Northern Michigan CA 54 Mecosta 525 3,492 1,032 5,049 $7,083.7355 1724945 00HY Eastern U.P. Substance Abuse 55 Menominee 399 1,628 479 2,506 $3,211.2056 4344340 00IE Northern Michigan CA 56 Midland 876 4,355 1,454 6,685 $9,658.3257 4344340 00IE Northern Michigan CA 57 Missaukee 35 35 $16.1058 1710547 00IH Southeast MI Community Alliance 58 Monroe 1,028 6,674 2,236 9,938 $21,446.0559 1705430 00ID Mink Substance Abuse Coordinating Agency 59 Montcalm 664 4,550 1,546 6,760 $11,938.3760 4344340 00IE Northern Michigan CA 60 Montmorency 194 921 324 1,439 $1,951.2061 1712452 00IB Lakeshore CA 61 Muskegon 2,540 17,154 6,014 25,708 $43,931.3062 1705430 00ID Mink Substance Abuse Coordinating Agency 62 Newaygo 663 4,106 1,331 6,100 $11,253.8063 1705289 00IF Oakland County Health Div 63 Oakland 9,619 38,094 14,564 62,277 $138,379.4764 4344340 00IE Northern Michigan CA 64 Oceana 328 3,300 844 4,472 $5,924.1465 4344340 00IE Northern Michigan CA 65 Ogemaw 413 2,207 769 3,389 $5,018.0766 1707962 00IL Western U.P. SAS 66 Ontonagon 189 538 229 956 $1,899.48

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, SA by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 20 of 58

MACap - Rates: 95d - qSummary recordcode02 for CA Provider ID by County

Provider ID Agent ID Provider Name Co ID County Name DAB

EligiblesTANF

Eligibles DD Eligibles Total Eligibles SubTotal SA Cap

SA Capitation by Provider ID by County 12-Feb-2002 06:322001-12

Eligible Population

67 4344340 00IE Northern Michigan CA 67 Osceola 305 2,233 724 3,262 $4,485.6768 4344340 00IE Northern Michigan CA 68 Oscoda 161 867 317 1,345 $2,159.2469 4344340 00IE Northern Michigan CA 69 Otsego 212 1,938 446 2,596 $3,248.9170 1712452 00IB Lakeshore CA 70 Ottawa 1,450 8,588 2,037 12,075 $16,202.6271 4344340 00IE Northern Michigan CA 71 Presque Isle 249 830 345 1,424 $2,025.6672 4344340 00IE Northern Michigan CA 72 Roscommon 413 2,555 804 3,772 $5,840.8773 1712541 00IG Saginaw County Health Dept 73 Saginaw 2,532 22,644 7,640 32,816 $92,990.3474 1708164 00II St. Clair County Health Dept. CA 74 St. Clair 1,655 10,088 2,980 14,723 $20,404.9975 3402136 00GR Kalamazoo County CMH 75 St. Joseph 793 5,393 1,326 7,512 $12,951.1976 1708164 00II St. Clair County Health Dept. CA 76 Sanilac 538 3,400 993 4,931 $6,335.4177 1724945 00HY Eastern U.P. Substance Abuse 77 Schoolcraft 226 867 291 1,384 $1,928.9878 1708001 00IC Mid-South CA 78 Shiawassee 716 4,828 1,410 6,954 $9,876.0679 1708164 00II St. Clair County Health Dept. CA 79 Tuscola 670 4,137 1,237 6,044 $7,829.5580 1712452 00IB Lakeshore CA 80 Van Buren 1,309 7,648 2,257 11,214 $17,500.5281 1707176 00HU Washtenaw County CMH 81 Washtenaw 2,070 10,732 4,103 16,905 $36,272.4882 1710547 00IH Southeast MI Community Alliance 82 Wayne 10,527 68,914 24,833 104,274 $230,958.6283 3119549 00XO Detroit Health Department 82 Wayne 22,283 165,074 57,656 245,013 $633,684.8184 4344340 00IE Northern Michigan CA 83 Wexford 681 4,292 1,223 6,196 $8,189.2385

114,417 718,899 239,275 1,072,591 $2,158,325.97Check Value - $0.00

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, SA by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 21 of 58

MACap - Rates: 96a - qSummary recordcode02 by CMHA - Pop - DAB

Provider ID Agent ID Provider Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1705233 0028 Genesee County Health Dept 4,116 1,784 3,149 3,065 3,286 3,436 18,836 2 1705242 00GT Lapeer County CMH 209 134 249 223 297 528 1,640 3 1705251 00GM Great Lakes CMH 432 210 293 319 410 754 2,418 4 1705260 00GD Barry County CMH 168 137 147 186 228 364 1,230 5 1705270 00GU Lenawee County CMH 492 246 439 374 533 764 2,848 6 1705289 0058 Oakland County CMHA 3,263 1,792 3,107 3,102 4,115 8,804 24,183 7 1705298 00HT Van Buren County CMH 577 312 418 468 700 1,091 3,566 8 1705304 00GY Manistee-Benzie CMH 176 109 188 208 363 523 1,567 9 1705322 00GE Bay-Arenac CMH 529 369 715 740 921 1,398 4,672 10 1705430 00GS Kent County CMH 3,904 1,913 2,650 2,493 2,826 4,544 18,330 11 1706114 00HW Woodlands Behavioral Healthcare 350 154 239 235 325 523 1,826 12 1706830 00GC AuSable Valley CMH 314 202 322 497 584 895 2,814 13 1706849 00HM Sanilac County CMH 166 119 173 225 334 514 1,531 14 1707130 00HS Tuscola County CMH 364 194 256 256 345 492 1,907 15 1707158 00HC North Central CMH 545 294 481 597 734 1,088 3,739 16 1707167 00GW Livingston County CMH 290 175 230 208 247 437 1,587 17 1707176 00HU Washtenaw County CMH 1,084 580 895 971 1,037 1,606 6,173 18 1707185 00HF Northern Michigan CMH 514 290 417 434 635 1,213 3,503 19 1707962 00GI Copper County CMH 191 156 233 286 494 1,112 2,472 20 1708001 00BJ CEI CMH 2,873 1,292 1,863 1,879 2,133 3,112 13,152 21 1708066 00HB Newaygo County CMH 306 163 251 336 396 542 1,994 22 1708100 00HE Northeast Michigan CMH 298 253 388 475 607 1,007 3,028 23 1708119 00GL Gogebic County CMH 87 69 98 112 141 456 963 24 1708128 00GP Huron Behavioral Health 106 113 158 190 284 501 1,352 25 1708146 00HP St. Joseph County CMH 390 181 284 283 401 580 2,119 26 1708164 00HO St. Clair County CMH 928 428 622 673 854 1,130 4,635 27 1709690 00GA Allegan County CMH 423 232 323 334 507 809 2,628 28 1710547 00HX Monroe County CMH 529 275 506 495 587 872 3,264 29 1712229 00GV Lifeways CMH 1,494 607 1,044 1,015 1,334 1,781 7,275 30 1712283 00GB Antrim-Kalkaska CMH 235 97 149 184 285 454 1,404 31 1712372 00HL Pines Behavioral Health CMH 270 116 209 190 277 434 1,496 32 1712407 00HN Shiawassee County CMH 319 231 305 320 354 597 2,126 33 1712425 00HI Ottawa County CMH 597 325 463 453 515 1,134 3,487

MA DAB Population by Provider ID by Age Group2001-12

12-Feb-2002 06:32

Eligible Population by Age Group

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DAB Pop by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 22 of 58

34 1712452 00HA Muskegon County CMH 1,501 735 1,297 1,417 1,617 1,987 8,554 35 1712461 00GZ Montcalm Center Behavl. Hlt 372 200 309 339 427 563 2,210 36 1712541 00HQ Saginaw County CMH 1,948 1,058 1,661 1,625 1,707 2,173 10,172 37 1715919 00GO Hiawatha Behavioral Health Authority 318 168 237 300 413 748 2,184 38 1715928 00GQ Ionia County CMH 258 168 242 224 334 405 1,631 39 1715955 00GN Gratiot County CMH 191 130 205 208 290 584 1,608 40 1716175 00GF Berrien Mental Health 1,561 622 949 1,050 1,385 2,081 7,648 41 1724945 00HJ Pathways CMH 509 410 542 626 823 1,654 4,564 42 2920843 00HR Summit Pointe CMH 1,125 529 923 967 1,213 1,545 6,302 43 3119549 00GJ Detroit-Wayne County CMH 23,989 8,704 15,685 17,723 22,675 26,523 115,299 44 3140186 00HG Northpointe CMH 261 185 229 290 440 1,229 2,634 45 3220732 00HV West Michigan CMH 474 304 414 468 692 894 3,246 46 3396315 00GX Macomb County CA 2,197 1,229 2,071 2,245 2,981 5,933 16,656 47 3402136 00GR Kalamazoo County CMH 1,422 673 1,093 1,203 1,392 1,998 7,781 48 4344340 00GG Central Michigan CMH 1,541 935 1,365 1,374 1,871 2,352 9,438 49

50

State Subtotals 64,206 29,602 48,486 51,885 65,349 94,164 353,692

Check Values -

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DAB Pop by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 23 of 58

MACap - Rates: 96b - qSummary recordcode02 by CMHA by County - Pop - DAB

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1708100 00HE Northeast Michigan CMH 01 Alcona 43 27 44 56 103 164 437 2 1724945 00HJ Pathways CMH 02 Alger 26 17 42 43 75 178 381 3 1709690 00GA Allegan County CMH 03 Allegan 423 232 323 334 507 809 2,628 4 1708100 00HE Northeast Michigan CMH 04 Alpena 142 138 218 264 278 439 1,479 5 1712283 00GB Antrim-Kalkaska CMH 05 Antrim 119 58 77 95 127 234 710 6 1705322 00GE Bay-Arenac CMH 06 Arenac 73 57 105 113 171 255 774 7 1707962 00GI Copper County CMH 07 Baraga 40 19 31 38 83 161 372 8 1705260 00GD Barry County CMH 08 Barry 168 137 147 186 228 364 1,230 9 1705322 00GE Bay-Arenac CMH 09 Bay 456 312 610 627 750 1,143 3,898 10 1705304 00GY Manistee-Benzie CMH 10 Benzie 72 34 64 64 112 188 534 11 1716175 00GF Berrien Mental Health 11 Berrien 1,561 622 949 1,050 1,385 2,081 7,648 12 1712372 00HL Pines Behavioral Health CMH 12 Branch 270 116 209 190 277 434 1,496 13 2920843 00HR Summit Pointe CMH 13 Calhoun 1,125 529 923 967 1,213 1,545 6,302 14 1706114 00HW Woodlands Behavioral Healthcare 14 Cass 350 154 239 235 325 523 1,826 15 1707185 00HF Northern Michigan CMH 15 Charlevoix 117 61 94 83 153 276 784 16 1707185 00HF Northern Michigan CMH 16 Cheboygan 184 88 126 130 195 368 1,091 17 1715919 00GO Hiawatha Behavioral Health Authority 17 Chippewa 223 116 139 193 245 388 1,304 18 4344340 00GG Central Michigan CMH 18 Clare 211 145 238 293 365 392 1,644 19 1708001 00BJ CEI CMH 19 Clinton 233 89 163 163 146 287 1,081 20 1707158 00HC North Central CMH 20 Crawford 103 39 72 110 101 158 583 21 1724945 00HJ Pathways CMH 21 Delta 171 150 181 217 270 591 1,580 22 3140186 00HG Northpointe CMH 22 Dickinson 101 70 97 127 147 433 975 23 1708001 00BJ CEI CMH 23 Eaton 382 181 299 248 328 579 2,017 24 1707185 00HF Northern Michigan CMH 24 Emmet 94 79 107 117 172 401 970 25 1705233 0028 Genesee County Health Dept 25 Genesee 4,116 1,784 3,149 3,065 3,286 3,436 18,836 26 4344340 00GG Central Michigan CMH 26 Gladwin 136 88 156 170 248 332 1,130 27 1708119 00GL Gogebic County CMH 27 Gogebic 87 69 98 112 141 456 963 28 1705251 00GM Great Lakes CMH 28 Grand Traverse 359 173 259 282 358 630 2,061 29 1715955 00GN Gratiot County CMH 29 Gratiot 191 130 205 208 290 584 1,608 30 1712229 00GV Lifeways CMH 30 Hillsdale 294 141 215 205 328 452 1,635 31 1707962 00GI Copper County CMH 31 Houghton 109 111 155 186 318 686 1,565

2001-12MA DAB Population by Provider ID by County by Age Group 12-Feb-2002 06:32

Eligible Population by Age Group

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DAB Pop by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 24 of 58

MACap - Rates: 96b - qSummary recordcode02 by CMHA by County - Pop - DAB

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

2001-12MA DAB Population by Provider ID by County by Age Group 12-Feb-2002 06:32

Eligible Population by Age Group

32 1708128 00GP Huron Behavioral Health 32 Huron 106 113 158 190 284 501 1,352 33 1708001 00BJ CEI CMH 33 Ingham 2,258 1,022 1,401 1,468 1,659 2,246 10,054 34 1715928 00GQ Ionia County CMH 34 Ionia 258 168 242 224 334 405 1,631 35 1706830 00GC AuSable Valley CMH 35 Iosco 142 74 149 183 237 369 1,154 36 3140186 00HG Northpointe CMH 36 Iron 63 45 52 69 133 419 781 37 4344340 00GG Central Michigan CMH 37 Isabella 313 185 291 229 324 406 1,748 38 1712229 00GV Lifeways CMH 38 Jackson 1,200 466 829 810 1,006 1,329 5,640 39 3402136 00GR Kalamazoo County CMH 39 Kalamazoo 1,422 673 1,093 1,203 1,392 1,998 7,781 40 1712283 00GB Antrim-Kalkaska CMH 40 Kalkaska 116 39 72 89 158 220 694 41 1705430 00GS Kent County CMH 41 Kent 3,904 1,913 2,650 2,493 2,826 4,544 18,330 42 1707962 00GI Copper County CMH 42 Keweenaw 12 2 8 10 21 64 117 43 3220732 00HV West Michigan CMH 43 Lake 122 71 110 164 214 242 923 44 1705242 00GT Lapeer County CMH 44 Lapeer 209 134 249 223 297 528 1,640 45 1705251 00GM Great Lakes CMH 45 Leelanau 73 37 34 37 52 124 357 46 1705270 00GU Lenawee County CMH 46 Lenawee 492 246 439 374 533 764 2,848 47 1707167 00GW Livingston County CMH 47 Livingston 290 175 230 208 247 437 1,587 48 1724945 00HJ Pathways CMH 48 Luce 71 34 45 64 97 171 482 49 1715919 00GO Hiawatha Behavioral Health Authority 49 Mackinac 48 14 35 53 63 150 363 50 3396315 00GX Macomb County CA 50 Macomb 2,197 1,229 2,071 2,245 2,981 5,933 16,656 51 1705304 00GY Manistee-Benzie CMH 51 Manistee 104 75 124 144 251 335 1,033 52 1724945 00HJ Pathways CMH 52 Marquette 241 209 274 302 381 714 2,121 53 3220732 00HV West Michigan CMH 53 Mason 183 134 151 132 199 352 1,151 54 4344340 00GG Central Michigan CMH 54 Mecosta 259 187 212 217 281 401 1,557 55 3140186 00HG Northpointe CMH 55 Menominee 97 70 80 94 160 377 878 56 4344340 00GG Central Michigan CMH 56 Midland 458 234 328 328 421 561 2,330 57 1707158 00HC North Central CMH 57 Missaukee 35 35 58 1710547 00HX Monroe County CMH 58 Monroe 529 275 506 495 587 872 3,264 59 1712461 00GZ Montcalm Center Behavl. Hlt 59 Montcalm 372 200 309 339 427 563 2,210 60 1708100 00HE Northeast Michigan CMH 60 Montmorency 50 41 45 75 119 188 518 61 1712452 00HA Muskegon County CMH 61 Muskegon 1,501 735 1,297 1,417 1,617 1,987 8,554 62 1708066 00HB Newaygo County CMH 62 Newaygo 306 163 251 336 396 542 1,994

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DAB Pop by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 25 of 58

MACap - Rates: 96b - qSummary recordcode02 by CMHA by County - Pop - DAB

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

2001-12MA DAB Population by Provider ID by County by Age Group 12-Feb-2002 06:32

Eligible Population by Age Group

63 1705289 0058 Oakland County CMHA 63 Oakland 3,263 1,792 3,107 3,102 4,115 8,804 24,183 64 3220732 00HV West Michigan CMH 64 Oceana 169 99 153 172 279 300 1,172 65 1706830 00GC AuSable Valley CMH 65 Ogemaw 120 101 117 218 250 376 1,182 66 1707962 00GI Copper County CMH 66 Ontonagon 30 24 39 52 72 201 418 67 4344340 00GG Central Michigan CMH 67 Osceola 164 96 140 137 232 260 1,029 68 1706830 00GC AuSable Valley CMH 68 Oscoda 52 27 56 96 97 150 478 69 1707185 00HF Northern Michigan CMH 69 Otsego 119 62 90 104 115 168 658 70 1712425 00HI Ottawa County CMH 70 Ottawa 597 325 463 453 515 1,134 3,487 71 1708100 00HE Northeast Michigan CMH 71 Presque Isle 63 47 81 80 107 216 594 72 1707158 00HC North Central CMH 72 Roscommon 154 95 166 197 252 353 1,217 73 1712541 00HQ Saginaw County CMH 73 Saginaw 1,948 1,058 1,661 1,625 1,707 2,173 10,172 74 1708164 00HO St. Clair County CMH 74 St. Clair 928 428 622 673 854 1,130 4,635 75 1708146 00HP St. Joseph County CMH 75 St. Joseph 390 181 284 283 401 580 2,119 76 1706849 00HM Sanilac County CMH 76 Sanilac 166 119 173 225 334 514 1,531 77 1715919 00GO Hiawatha Behavioral Health Authority 77 Schoolcraft 47 38 63 54 105 210 517 78 1712407 00HN Shiawassee County CMH 78 Shiawassee 319 231 305 320 354 597 2,126 79 1707130 00HS Tuscola County CMH 79 Tuscola 364 194 256 256 345 492 1,907 80 1705298 00HT Van Buren County CMH 80 Van Buren 577 312 418 468 700 1,091 3,566 81 1707176 00HU Washtenaw County CMH 81 Washtenaw 1,084 580 895 971 1,037 1,606 6,173 82 3119549 00GJ Detroit-Wayne County CMH 82 Wayne 23,989 8,704 15,685 17,723 22,675 26,523 115,299 83 1707158 00HC North Central CMH 83 Wexford 253 160 243 290 381 577 1,904 84

85

64,206 29,602 48,486 51,885 65,349 94,164 353,692 Check Values -

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DAB Pop by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 26 of 58

MACap - Rates: 96c - qSummary recordcode02 by CMHA - Pop - TANF

Provider ID Agent ID Provider Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1705233 0028 Genesee County Health Dept 34,693 4,994 6,084 1,562 242 1 47,576 2 1705242 00GT Lapeer County CMH 3,099 392 422 115 13 4,041 3 1705251 00GM Great Lakes CMH 3,812 431 423 144 26 4,836 4 1705260 00GD Barry County CMH 2,183 316 331 102 14 2,946 5 1705270 00GU Lenawee County CMH 4,204 626 589 153 21 5,593 6 1705289 0058 Oakland County CMHA 29,056 3,224 4,121 1,305 382 6 38,094 7 1705298 00HT Van Buren County CMH 5,532 834 924 298 60 7,648 8 1705304 00GY Manistee-Benzie CMH 2,366 288 277 84 16 3,031 9 1705322 00GE Bay-Arenac CMH 7,450 1,098 1,181 314 50 10,093 10 1705430 00GS Kent County CMH 29,807 4,305 4,341 1,023 173 1 39,650 11 1706114 00HW Woodlands Behavioral Healthcare 2,916 435 544 135 23 4,053 12 1706830 00GC AuSable Valley CMH 4,133 592 622 200 31 5,578 13 1706849 00HM Sanilac County CMH 2,601 348 332 101 18 3,400 14 1707130 00HS Tuscola County CMH 3,196 392 435 104 10 4,137 15 1707158 00HC North Central CMH 6,057 862 959 259 51 8,188 16 1707167 00GW Livingston County CMH 2,400 301 297 97 12 1 3,108 17 1707176 00HU Washtenaw County CMH 8,031 1,150 1,176 318 54 3 10,732 18 1707185 00HF Northern Michigan CMH 6,098 759 746 193 23 7,819 19 1707962 00GI Copper County CMH 3,164 382 372 126 25 4,069 20 1708001 00BJ CEI CMH 20,606 2,936 3,277 765 190 4 27,778 21 1708066 00HB Newaygo County CMH 3,086 419 438 142 21 4,106 22 1708100 00HE Northeast Michigan CMH 3,959 536 585 205 25 5,310 23 1708119 00GL Gogebic County CMH 1,120 138 148 53 8 1,467 24 1708128 00GP Huron Behavioral Health 2,024 236 249 83 11 2,603 25 1708146 00HP St. Joseph County CMH 4,084 570 593 125 21 5,393 26 1708164 00HO St. Clair County CMH 7,368 1,162 1,170 318 69 1 10,088 27 1709690 00GA Allegan County CMH 4,442 550 503 123 25 2 5,645 28 1710547 00HX Monroe County CMH 5,053 715 730 147 29 6,674 29 1712229 00GV Lifeways CMH 11,218 1,623 1,485 346 71 14,743 30 1712283 00GB Antrim-Kalkaska CMH 2,381 299 248 77 11 3,016 31 1712372 00HL Pines Behavioral Health CMH 2,418 331 380 81 8 3,218 32 1712407 00HN Shiawassee County CMH 3,567 539 575 131 16 4,828 33 1712425 00HI Ottawa County CMH 6,657 916 790 196 28 1 8,588

MA TANF Population by Provider ID by Age Group2001-12

12-Feb-2002 06:32

Eligible Population by Age Group

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, TANF Pop by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 27 of 58

34 1712452 00HA Muskegon County CMH 12,761 2,016 1,865 456 55 1 17,154 35 1712461 00GZ Montcalm Center Behavl. Hlt 3,489 464 469 110 18 4,550 36 1712541 00HQ Saginaw County CMH 16,849 2,349 2,704 650 91 1 22,644 37 1715919 00GO Hiawatha Behavioral Health Authority 3,456 477 482 141 20 4,576 38 1715928 00GQ Ionia County CMH 2,779 469 408 96 20 1 3,773 39 1715955 00GN Gratiot County CMH 2,152 317 305 74 8 2,856 40 1716175 00GF Berrien Mental Health 11,291 1,700 1,787 366 86 2 15,232 41 1724945 00HJ Pathways CMH 5,999 930 990 266 45 8,230 42 2920843 00HR Summit Pointe CMH 9,021 1,333 1,282 301 50 11,987 43 3119549 00GJ Detroit-Wayne County CMH 178,677 20,154 26,016 7,495 1,612 34 233,988 44 3140186 00HG Northpointe CMH 3,277 497 469 144 20 4,407 45 3220732 00HV West Michigan CMH 5,188 698 817 257 52 1 7,013 46 3396315 00GX Macomb County CA 21,791 2,654 3,357 1,232 297 4 29,335 47 3402136 00GR Kalamazoo County CMH 11,636 1,822 1,795 426 68 15,747 48 4344340 00GG Central Michigan CMH 14,168 2,150 2,341 607 92 19,358 49

50

State Subtotals 541,315 70,729 80,434 22,046 4,311 64 718,899

Check Values -

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, TANF Pop by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 28 of 58

MACap - Rates: 96d - qSummary recordcode02 by CMHA by County - Pop - TANF

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1708100 00HE Northeast Michigan CMH 01 Alcona 679 67 119 39 3 907 2 1724945 00HJ Pathways CMH 02 Alger 448 65 76 23 4 616 3 1709690 00GA Allegan County CMH 03 Allegan 4,442 550 503 123 25 2 5,645 4 1708100 00HE Northeast Michigan CMH 04 Alpena 1,938 287 302 110 15 2,652 5 1712283 00GB Antrim-Kalkaska CMH 05 Antrim 1,195 138 91 31 4 1,459 6 1705322 00GE Bay-Arenac CMH 06 Arenac 1,285 171 187 65 13 1,721 7 1707962 00GI Copper County CMH 07 Baraga 524 76 61 12 7 680 8 1705260 00GD Barry County CMH 08 Barry 2,183 316 331 102 14 2,946 9 1705322 00GE Bay-Arenac CMH 09 Bay 6,165 927 994 249 37 8,372 10 1705304 00GY Manistee-Benzie CMH 10 Benzie 864 98 86 23 3 1,074 11 1716175 00GF Berrien Mental Health 11 Berrien 11,291 1,700 1,787 366 86 2 15,232 12 1712372 00HL Pines Behavioral Health CMH 12 Branch 2,418 331 380 81 8 3,218 13 2920843 00HR Summit Pointe CMH 13 Calhoun 9,021 1,333 1,282 301 50 11,987 14 1706114 00HW Woodlands Behavioral Healthcare 14 Cass 2,916 435 544 135 23 4,053 15 1707185 00HF Northern Michigan CMH 15 Charlevoix 1,372 147 132 30 6 1,687 16 1707185 00HF Northern Michigan CMH 16 Cheboygan 1,825 228 264 61 6 2,384 17 1715919 00GO Hiawatha Behavioral Health Authority 17 Chippewa 2,259 311 319 89 15 2,993 18 4344340 00GG Central Michigan CMH 18 Clare 2,511 360 444 127 13 3,455 19 1708001 00BJ CEI CMH 19 Clinton 1,749 224 225 50 6 2,254 20 1707158 00HC North Central CMH 20 Crawford 1,013 135 141 43 9 1,341 21 1724945 00HJ Pathways CMH 21 Delta 2,268 313 335 111 18 3,045 22 3140186 00HG Northpointe CMH 22 Dickinson 1,396 196 186 56 9 1,843 23 1708001 00BJ CEI CMH 23 Eaton 3,602 501 511 127 34 4,775 24 1707185 00HF Northern Michigan CMH 24 Emmet 1,440 181 134 51 4 1,810 25 1705233 0028 Genesee County Health Dept 25 Genesee 34,693 4,994 6,084 1,562 242 1 47,576 26 4344340 00GG Central Michigan CMH 26 Gladwin 1,832 202 226 66 14 2,340 27 1708119 00GL Gogebic County CMH 27 Gogebic 1,120 138 148 53 8 1,467 28 1705251 00GM Great Lakes CMH 28 Grand Traverse 3,112 363 333 114 19 3,941 29 1715955 00GN Gratiot County CMH 29 Gratiot 2,152 317 305 74 8 2,856 30 1712229 00GV Lifeways CMH 30 Hillsdale 2,247 359 333 74 22 3,035 31 1707962 00GI Copper County CMH 31 Houghton 2,101 248 246 89 14 2,698

Eligible Population by Age Group

2001-12MA TANF Population by Provider ID by County by Age Group 12-Feb-2002 06:32

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, TANF Pop by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 29 of 58

MACap - Rates: 96d - qSummary recordcode02 by CMHA by County - Pop - TANF

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

Eligible Population by Age Group

2001-12MA TANF Population by Provider ID by County by Age Group 12-Feb-2002 06:32

32 1708128 00GP Huron Behavioral Health 32 Huron 2,024 236 249 83 11 2,603 33 1708001 00BJ CEI CMH 33 Ingham 15,255 2,211 2,541 588 150 4 20,749 34 1715928 00GQ Ionia County CMH 34 Ionia 2,779 469 408 96 20 1 3,773 35 1706830 00GC AuSable Valley CMH 35 Iosco 1,876 256 267 91 14 2,504 36 3140186 00HG Northpointe CMH 36 Iron 689 99 107 39 2 936 37 4344340 00GG Central Michigan CMH 37 Isabella 2,434 488 433 114 14 3,483 38 1712229 00GV Lifeways CMH 38 Jackson 8,971 1,264 1,152 272 49 11,708 39 3402136 00GR Kalamazoo County CMH 39 Kalamazoo 11,636 1,822 1,795 426 68 15,747 40 1712283 00GB Antrim-Kalkaska CMH 40 Kalkaska 1,186 161 157 46 7 1,557 41 1705430 00GS Kent County CMH 41 Kent 29,807 4,305 4,341 1,023 173 1 39,650 42 1707962 00GI Copper County CMH 42 Keweenaw 114 19 14 4 2 153 43 3220732 00HV West Michigan CMH 43 Lake 949 119 172 52 10 1 1,303 44 1705242 00GT Lapeer County CMH 44 Lapeer 3,099 392 422 115 13 4,041 45 1705251 00GM Great Lakes CMH 45 Leelanau 700 68 90 30 7 895 46 1705270 00GU Lenawee County CMH 46 Lenawee 4,204 626 589 153 21 5,593 47 1707167 00GW Livingston County CMH 47 Livingston 2,400 301 297 97 12 1 3,108 48 1724945 00HJ Pathways CMH 48 Luce 562 80 117 20 3 782 49 1715919 00GO Hiawatha Behavioral Health Authority 49 Mackinac 542 82 67 22 3 716 50 3396315 00GX Macomb County CA 50 Macomb 21,791 2,654 3,357 1,232 297 4 29,335 51 1705304 00GY Manistee-Benzie CMH 51 Manistee 1,502 190 191 61 13 1,957 52 1724945 00HJ Pathways CMH 52 Marquette 2,721 472 462 112 20 3,787 53 3220732 00HV West Michigan CMH 53 Mason 1,816 228 274 80 12 2,410 54 4344340 00GG Central Michigan CMH 54 Mecosta 2,484 437 447 109 15 3,492 55 3140186 00HG Northpointe CMH 55 Menominee 1,192 202 176 49 9 1,628 56 4344340 00GG Central Michigan CMH 56 Midland 3,262 416 527 127 23 4,355 57 1710547 00HX Monroe County CMH 58 Monroe 5,053 715 730 147 29 6,674 58 1712461 00GZ Montcalm Center Behavl. Hlt 59 Montcalm 3,489 464 469 110 18 4,550 59 1708100 00HE Northeast Michigan CMH 60 Montmorency 693 97 89 37 5 921 60 1712452 00HA Muskegon County CMH 61 Muskegon 12,761 2,016 1,865 456 55 1 17,154 61 1708066 00HB Newaygo County CMH 62 Newaygo 3,086 419 438 142 21 4,106 62 1705289 0058 Oakland County CMHA 63 Oakland 29,056 3,224 4,121 1,305 382 6 38,094

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, TANF Pop by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 30 of 58

MACap - Rates: 96d - qSummary recordcode02 by CMHA by County - Pop - TANF

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

Eligible Population by Age Group

2001-12MA TANF Population by Provider ID by County by Age Group 12-Feb-2002 06:32

63 3220732 00HV West Michigan CMH 64 Oceana 2,423 351 371 125 30 3,300 64 1706830 00GC AuSable Valley CMH 65 Ogemaw 1,630 240 256 71 10 2,207 65 1707962 00GI Copper County CMH 66 Ontonagon 425 39 51 21 2 538 66 4344340 00GG Central Michigan CMH 67 Osceola 1,645 247 264 64 13 2,233 67 1706830 00GC AuSable Valley CMH 68 Oscoda 627 96 99 38 7 867 68 1707185 00HF Northern Michigan CMH 69 Otsego 1,461 203 216 51 7 1,938 69 1712425 00HI Ottawa County CMH 70 Ottawa 6,657 916 790 196 28 1 8,588 70 1708100 00HE Northeast Michigan CMH 71 Presque Isle 649 85 75 19 2 830 71 1707158 00HC North Central CMH 72 Roscommon 1,821 250 361 108 15 2,555 72 1712541 00HQ Saginaw County CMH 73 Saginaw 16,849 2,349 2,704 650 91 1 22,644 73 1708164 00HO St. Clair County CMH 74 St. Clair 7,368 1,162 1,170 318 69 1 10,088 74 1708146 00HP St. Joseph County CMH 75 St. Joseph 4,084 570 593 125 21 5,393 75 1706849 00HM Sanilac County CMH 76 Sanilac 2,601 348 332 101 18 3,400 76 1715919 00GO Hiawatha Behavioral Health Authority 77 Schoolcraft 655 84 96 30 2 867 77 1712407 00HN Shiawassee County CMH 78 Shiawassee 3,567 539 575 131 16 4,828 78 1707130 00HS Tuscola County CMH 79 Tuscola 3,196 392 435 104 10 4,137 79 1705298 00HT Van Buren County CMH 80 Van Buren 5,532 834 924 298 60 7,648 80 1707176 00HU Washtenaw County CMH 81 Washtenaw 8,031 1,150 1,176 318 54 3 10,732 81 3119549 00GJ Detroit-Wayne County CMH 82 Wayne 178,677 20,154 26,016 7,495 1,612 34 233,988 82 1707158 00HC North Central CMH 83 Wexford 3,223 477 457 108 27 4,292 83

84

85

541,315 70,729 80,434 22,046 4,311 64 718,899 Check Values -

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, TANF Pop by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 31 of 58

MACap - Rates: 96e - qSummary recordcode02 by CMHA - Pop - DD

Provider ID Agent ID Provider Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1705233 0028 Genesee County Health Dept 2,470 1,258 3,118 3,036 3,259 1,029 14,170 2 1705242 00GT Lapeer County CMH 83 87 245 223 296 113 1,047 3 1705251 00GM Great Lakes CMH 197 129 289 316 409 116 1,456 4 1705260 00GD Barry County CMH 82 77 146 184 225 53 767 5 1705270 00GU Lenawee County CMH 252 171 437 369 529 137 1,895 6 1705289 0058 Oakland County CMHA 1,442 1,221 3,069 3,080 4,090 1,662 14,564 7 1705298 00HT Van Buren County CMH 286 184 409 468 698 212 2,257 8 1705304 00GY Manistee-Benzie CMH 88 66 187 207 361 85 994 9 1705322 00GE Bay-Arenac CMH 348 254 708 737 917 272 3,236 10 1705430 00GS Kent County CMH 2,218 1,383 2,627 2,476 2,808 972 12,484 11 1706114 00HW Woodlands Behavioral Healthcare 162 101 238 231 323 91 1,146 12 1706830 00GC AuSable Valley CMH 176 130 319 490 582 137 1,834 13 1706849 00HM Sanilac County CMH 93 73 169 225 334 99 993 14 1707130 00HS Tuscola County CMH 175 124 254 254 345 85 1,237 15 1707158 00HC North Central CMH 264 170 475 594 732 187 2,422 16 1707167 00GW Livingston County CMH 93 124 226 205 246 54 948 17 1707176 00HU Washtenaw County CMH 485 389 878 963 1,027 361 4,103 18 1707185 00HF Northern Michigan CMH 231 176 413 431 634 170 2,055 19 1707962 00GI Copper County CMH 109 92 230 285 492 191 1,399 20 1708001 00BJ CEI CMH 1,257 845 1,843 1,852 2,103 611 8,511 21 1708066 00HB Newaygo County CMH 149 100 251 336 395 100 1,331 22 1708100 00HE Northeast Michigan CMH 177 139 386 472 604 181 1,959 23 1708119 00GL Gogebic County CMH 47 28 98 110 141 63 487 24 1708128 00GP Huron Behavioral Health 63 68 157 189 284 92 853 25 1708146 00HP St. Joseph County CMH 128 114 281 279 400 124 1,326 26 1708164 00HO St. Clair County CMH 367 289 615 663 847 199 2,980 27 1709690 00GA Allegan County CMH 181 161 323 331 503 138 1,637 28 1710547 00HX Monroe County CMH 307 196 498 489 584 162 2,236 29 1712229 00GV Lifeways CMH 755 441 1,040 1,006 1,321 367 4,930 30 1712283 00GB Antrim-Kalkaska CMH 103 70 146 181 282 80 862 31 1712372 00HL Pines Behavioral Health CMH 113 72 207 188 275 88 943 32 1712407 00HN Shiawassee County CMH 183 163 304 319 351 90 1,410 33 1712425 00HI Ottawa County CMH 243 241 461 450 511 131 2,037

Eligible Population by Age Group

MA DD Population by Provider ID by Age Group2001-12

12-Feb-2002 06:32

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DD Pop by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 32 of 58

34 1712452 00HA Muskegon County CMH 813 490 1,285 1,409 1,606 411 6,014 35 1712461 00GZ Montcalm Center Behavl. Hlt 238 133 308 337 424 106 1,546 36 1712541 00HQ Saginaw County CMH 1,308 775 1,654 1,619 1,695 589 7,640 37 1715919 00GO Hiawatha Behavioral Health Authority 120 85 235 299 413 119 1,271 38 1715928 00GQ Ionia County CMH 122 118 241 221 333 79 1,114 39 1715955 00GN Gratiot County CMH 126 91 202 206 288 91 1,004 40 1716175 00GF Berrien Mental Health 886 429 936 1,045 1,374 475 5,145 41 1724945 00HJ Pathways CMH 257 242 537 622 816 253 2,727 42 2920843 00HR Summit Pointe CMH 610 375 919 960 1,203 357 4,424 43 3119549 00GJ Detroit-Wayne County CMH 12,654 6,149 15,539 17,575 22,524 8,048 82,489 44 3140186 00HG Northpointe CMH 149 101 227 289 437 151 1,354 45 3220732 00HV West Michigan CMH 257 185 410 466 689 192 2,199 46 3396315 00GX Macomb County CA 1,036 825 2,051 2,225 2,959 1,043 10,139 47 3402136 00GR Kalamazoo County CMH 722 461 1,074 1,192 1,387 447 5,283 48 4344340 00GG Central Michigan CMH 786 572 1,352 1,365 1,858 484 6,417 49

50

State Subtotals 33,411 20,167 48,017 51,469 64,914 21,297 239,275

Check Values -

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DD Pop by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 33 of 58

MACap - Rates: 96f - qSummary recordcode02 by CMHA by County - Pop - DD

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1708100 00HE Northeast Michigan CMH 01 Alcona 28 9 43 56 103 34 273 2 1724945 00HJ Pathways CMH 02 Alger 21 8 41 43 73 30 216 3 1709690 00GA Allegan County CMH 03 Allegan 181 161 323 331 503 138 1,637 4 1708100 00HE Northeast Michigan CMH 04 Alpena 95 87 217 262 276 80 1,017 5 1712283 00GB Antrim-Kalkaska CMH 05 Antrim 45 41 76 94 124 29 409 6 1705322 00GE Bay-Arenac CMH 06 Arenac 47 37 104 113 170 52 523 7 1707962 00GI Copper County CMH 07 Baraga 12 10 30 38 83 35 208 8 1705260 00GD Barry County CMH 08 Barry 82 77 146 184 225 53 767 9 1705322 00GE Bay-Arenac CMH 09 Bay 301 217 604 624 747 220 2,713 10 1705304 00GY Manistee-Benzie CMH 10 Benzie 36 24 63 64 112 39 338 11 1716175 00GF Berrien Mental Health 11 Berrien 886 429 936 1,045 1,374 475 5,145 12 1712372 00HL Pines Behavioral Health CMH 12 Branch 113 72 207 188 275 88 943 13 2920843 00HR Summit Pointe CMH 13 Calhoun 610 375 919 960 1,203 357 4,424 14 1706114 00HW Woodlands Behavioral Healthcare 14 Cass 162 101 238 231 323 91 1,146 15 1707185 00HF Northern Michigan CMH 15 Charlevoix 53 37 94 83 153 39 459 16 1707185 00HF Northern Michigan CMH 16 Cheboygan 67 53 125 129 194 50 618 17 1715919 00GO Hiawatha Behavioral Health Authority 17 Chippewa 73 66 138 193 245 73 788 18 4344340 00GG Central Michigan CMH 18 Clare 145 84 237 291 364 87 1,208 19 1708001 00BJ CEI CMH 19 Clinton 86 60 162 160 144 43 655 20 1707158 00HC North Central CMH 20 Crawford 55 25 72 109 100 34 395 21 1724945 00HJ Pathways CMH 21 Delta 84 88 181 214 268 82 917 22 3140186 00HG Northpointe CMH 22 Dickinson 65 43 96 127 145 45 521 23 1708001 00BJ CEI CMH 23 Eaton 215 124 294 245 323 73 1,274 24 1707185 00HF Northern Michigan CMH 24 Emmet 47 41 107 117 172 48 532 25 1705233 0028 Genesee County Health Dept 25 Genesee 2,470 1,258 3,118 3,036 3,259 1,029 14,170 26 4344340 00GG Central Michigan CMH 26 Gladwin 70 53 155 168 248 58 752 27 1708119 00GL Gogebic County CMH 27 Gogebic 47 28 98 110 141 63 487 28 1705251 00GM Great Lakes CMH 28 Grand Traverse 160 110 255 279 357 99 1,260 29 1715955 00GN Gratiot County CMH 29 Gratiot 126 91 202 206 288 91 1,004 30 1712229 00GV Lifeways CMH 30 Hillsdale 162 101 214 203 325 100 1,105 31 1707962 00GI Copper County CMH 31 Houghton 72 67 154 185 316 112 906

Eligible Population by Age Group

2001-12MA DD Population by Provider ID by County by Age Group 12-Feb-2002 06:32

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DD Pop by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 34 of 58

MACap - Rates: 96f - qSummary recordcode02 by CMHA by County - Pop - DD

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

Eligible Population by Age Group

2001-12MA DD Population by Provider ID by County by Age Group 12-Feb-2002 06:32

32 1708128 00GP Huron Behavioral Health 32 Huron 63 68 157 189 284 92 853 33 1708001 00BJ CEI CMH 33 Ingham 956 661 1,387 1,447 1,636 495 6,582 34 1715928 00GQ Ionia County CMH 34 Ionia 122 118 241 221 333 79 1,114 35 1706830 00GC AuSable Valley CMH 35 Iosco 83 50 148 179 236 52 748 36 3140186 00HG Northpointe CMH 36 Iron 36 24 52 69 133 40 354 37 4344340 00GG Central Michigan CMH 37 Isabella 186 129 286 227 323 96 1,247 38 1712229 00GV Lifeways CMH 38 Jackson 593 340 826 803 996 267 3,825 39 3402136 00GR Kalamazoo County CMH 39 Kalamazoo 722 461 1,074 1,192 1,387 447 5,283 40 1712283 00GB Antrim-Kalkaska CMH 40 Kalkaska 58 29 70 87 158 51 453 41 1705430 00GS Kent County CMH 41 Kent 2,218 1,383 2,627 2,476 2,808 972 12,484 42 1707962 00GI Copper County CMH 42 Keweenaw 7 1 8 10 21 9 56 43 3220732 00HV West Michigan CMH 43 Lake 61 47 109 163 212 63 655 44 1705242 00GT Lapeer County CMH 44 Lapeer 83 87 245 223 296 113 1,047 45 1705251 00GM Great Lakes CMH 45 Leelanau 37 19 34 37 52 17 196 46 1705270 00GU Lenawee County CMH 46 Lenawee 252 171 437 369 529 137 1,895 47 1707167 00GW Livingston County CMH 47 Livingston 93 124 226 205 246 54 948 48 1724945 00HJ Pathways CMH 48 Luce 39 22 44 64 96 50 315 49 1715919 00GO Hiawatha Behavioral Health Authority 49 Mackinac 23 5 34 52 63 15 192 50 3396315 00GX Macomb County CA 50 Macomb 1,036 825 2,051 2,225 2,959 1,043 10,139 51 1705304 00GY Manistee-Benzie CMH 51 Manistee 52 42 124 143 249 46 656 52 1724945 00HJ Pathways CMH 52 Marquette 113 124 271 301 379 91 1,279 53 3220732 00HV West Michigan CMH 53 Mason 92 75 149 131 199 54 700 54 4344340 00GG Central Michigan CMH 54 Mecosta 147 97 209 217 279 83 1,032 55 3140186 00HG Northpointe CMH 55 Menominee 48 34 79 93 159 66 479 56 4344340 00GG Central Michigan CMH 56 Midland 158 147 325 326 415 83 1,454 57 1710547 00HX Monroe County CMH 58 Monroe 307 196 498 489 584 162 2,236 58 1712461 00GZ Montcalm Center Behavl. Hlt 59 Montcalm 238 133 308 337 424 106 1,546 59 1708100 00HE Northeast Michigan CMH 60 Montmorency 27 21 45 75 118 38 324 60 1712452 00HA Muskegon County CMH 61 Muskegon 813 490 1,285 1,409 1,606 411 6,014 61 1708066 00HB Newaygo County CMH 62 Newaygo 149 100 251 336 395 100 1,331 62 1705289 0058 Oakland County CMHA 63 Oakland 1,442 1,221 3,069 3,080 4,090 1,662 14,564

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DD Pop by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 35 of 58

MACap - Rates: 96f - qSummary recordcode02 by CMHA by County - Pop - DD

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

Eligible Population by Age Group

2001-12MA DD Population by Provider ID by County by Age Group 12-Feb-2002 06:32

63 3220732 00HV West Michigan CMH 64 Oceana 104 63 152 172 278 75 844 64 1706830 00GC AuSable Valley CMH 65 Ogemaw 57 67 115 216 249 65 769 65 1707962 00GI Copper County CMH 66 Ontonagon 18 14 38 52 72 35 229 66 4344340 00GG Central Michigan CMH 67 Osceola 80 62 140 136 229 77 724 67 1706830 00GC AuSable Valley CMH 68 Oscoda 36 13 56 95 97 20 317 68 1707185 00HF Northern Michigan CMH 69 Otsego 64 45 87 102 115 33 446 69 1712425 00HI Ottawa County CMH 70 Ottawa 243 241 461 450 511 131 2,037 70 1708100 00HE Northeast Michigan CMH 71 Presque Isle 27 22 81 79 107 29 345 71 1707158 00HC North Central CMH 72 Roscommon 83 53 164 197 251 56 804 72 1712541 00HQ Saginaw County CMH 73 Saginaw 1,308 775 1,654 1,619 1,695 589 7,640 73 1708164 00HO St. Clair County CMH 74 St. Clair 367 289 615 663 847 199 2,980 74 1708146 00HP St. Joseph County CMH 75 St. Joseph 128 114 281 279 400 124 1,326 75 1706849 00HM Sanilac County CMH 76 Sanilac 93 73 169 225 334 99 993 76 1715919 00GO Hiawatha Behavioral Health Authority 77 Schoolcraft 24 14 63 54 105 31 291 77 1712407 00HN Shiawassee County CMH 78 Shiawassee 183 163 304 319 351 90 1,410 78 1707130 00HS Tuscola County CMH 79 Tuscola 175 124 254 254 345 85 1,237 79 1705298 00HT Van Buren County CMH 80 Van Buren 286 184 409 468 698 212 2,257 80 1707176 00HU Washtenaw County CMH 81 Washtenaw 485 389 878 963 1,027 361 4,103 81 3119549 00GJ Detroit-Wayne County CMH 82 Wayne 12,654 6,149 15,539 17,575 22,524 8,048 82,489 82 1707158 00HC North Central CMH 83 Wexford 126 92 239 288 381 97 1,223 83

84

85

33,411 20,167 48,017 51,469 64,914 21,297 239,275 Check Values -

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DD Pop by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 36 of 58

MACap - Rates: 96g - qSummary recordcode02 by CA - Pop

Provider ID Agent ID CA_ProviderName 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1705233 00HZ Genesee County Health Dept 38,809 6,778 9,233 4,627 3,528 3,437 66,412 2 1705289 00IF Oakland County Health Div 32,319 5,016 7,228 4,407 4,497 8,810 62,277 3 1705430 00ID Mink Substance Abuse Coordinating Agency 44,001 8,101 9,108 4,763 4,215 6,056 76,244 4 1707176 00HU Washtenaw County CMH 11,805 2,206 2,598 1,594 1,350 2,047 21,600 5 1707962 00IL Western U.P. SAS 6,811 1,155 1,293 868 959 2,420 13,506 6 1708001 00IC Mid-South CA 57,262 10,409 12,292 6,533 6,213 8,387 101,096 7 1708164 00II St. Clair County Health Dept. CA 20,061 3,518 4,066 2,288 2,235 3,166 35,334 8 1710547 00IH Southeast MI Community Alliance 64,855 9,785 13,689 8,374 7,863 9,646 114,212 9 1712452 00IB Lakeshore CA 48,608 8,831 10,102 5,531 5,326 7,631 86,029 10 1712541 00IG Saginaw County Health Dept 25,418 4,646 5,969 3,151 2,585 3,317 45,086 11 1724945 00HY Eastern U.P. Substance Abuse 11,571 2,257 2,507 1,476 1,470 2,779 22,060 12 3119549 00XO Detroit Health Department 143,393 20,063 29,248 17,486 17,040 17,783 245,013 13 3396315 00GX Macomb County CA 23,988 3,883 5,428 3,477 3,278 5,937 45,991 14 3402136 00GR Kalamazoo County CMH 22,571 4,146 4,832 2,596 2,409 3,376 39,930 15 4344340 00IE Northern Michigan CA 54,049 9,537 11,327 6,760 6,692 9,436 97,801 16

State Subtotals 605,521 100,331 128,920 73,931 69,660 94,228 1,072,591

Check Values -

MA SA Population by Provider ID by Age Group 12-Feb-2002 06:322001-12

Eligible Population by Age Group

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, SA Pop by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 37 of 58

MACap - Rates: 96h - qSummary recordcode02 by CA by County - Pop - SA

Provider ID Agent ID CA_ProviderName Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 4344340 00IE Northern Michigan CA 01 Alcona 722 94 163 95 106 164 1,344 2 1724945 00HY Eastern U.P. Substance Abuse 02 Alger 474 82 118 66 79 178 997 3 1712452 00IB Lakeshore CA 03 Allegan 4,865 782 826 457 532 811 8,273 4 4344340 00IE Northern Michigan CA 04 Alpena 2,080 425 520 374 293 439 4,131 5 4344340 00IE Northern Michigan CA 05 Antrim 1,314 196 168 126 131 234 2,169 6 4344340 00IE Northern Michigan CA 06 Arenac 1,358 228 292 178 184 255 2,495 7 1707962 00IL Western U.P. SAS 07 Baraga 564 95 92 50 90 161 1,052 8 3402136 00GR Kalamazoo County CMH 08 Barry 2,351 453 478 288 242 364 4,176 9 1712541 00IG Saginaw County Health Dept 09 Bay 6,621 1,239 1,604 876 787 1,143 12,270 10 4344340 00IE Northern Michigan CA 10 Benzie 936 132 150 87 115 188 1,608 11 1712452 00IB Lakeshore CA 11 Berrien 12,852 2,322 2,736 1,416 1,471 2,083 22,880 12 3402136 00GR Kalamazoo County CMH 12 Branch 2,688 447 589 271 285 434 4,714 13 1708001 00IC Mid-South CA 13 Calhoun 10,146 1,862 2,205 1,268 1,263 1,545 18,289 14 1712452 00IB Lakeshore CA 14 Cass 3,266 589 783 370 348 523 5,879 15 4344340 00IE Northern Michigan CA 15 Charlevoix 1,489 208 226 113 159 276 2,471 16 4344340 00IE Northern Michigan CA 16 Cheboygan 2,009 316 390 191 201 368 3,475 17 1724945 00HY Eastern U.P. Substance Abuse 17 Chippewa 2,482 427 458 282 260 388 4,297 18 4344340 00IE Northern Michigan CA 18 Clare 2,722 505 682 420 378 392 5,099 19 1708001 00IC Mid-South CA 19 Clinton 1,982 313 388 213 152 287 3,335 20 4344340 00IE Northern Michigan CA 20 Crawford 1,116 174 213 153 110 158 1,924 21 1724945 00HY Eastern U.P. Substance Abuse 21 Delta 2,439 463 516 328 288 591 4,625 22 1707962 00IL Western U.P. SAS 22 Dickinson 1,497 266 283 183 156 433 2,818 23 1708001 00IC Mid-South CA 23 Eaton 3,984 682 810 375 362 579 6,792 24 4344340 00IE Northern Michigan CA 24 Emmet 1,534 260 241 168 176 401 2,780 25 1705233 00HZ Genesee County Health Dept 25 Genesee 38,809 6,778 9,233 4,627 3,528 3,437 66,412 26 4344340 00IE Northern Michigan CA 26 Gladwin 1,968 290 382 236 262 332 3,470 27 1707962 00IL Western U.P. SAS 27 Gogebic 1,207 207 246 165 149 456 2,430 28 4344340 00IE Northern Michigan CA 28 Grand Traverse 3,471 536 592 396 377 630 6,002 29 1708001 00IC Mid-South CA 29 Gratiot 2,343 447 510 282 298 584 4,464 30 1708001 00IC Mid-South CA 30 Hillsdale 2,541 500 548 279 350 452 4,670 31 1707962 00IL Western U.P. SAS 31 Houghton 2,210 359 401 275 332 686 4,263

MA SA Population by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Eligible Population by Age Group

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, SA Pop by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 38 of 58

MACap - Rates: 96h - qSummary recordcode02 by CA by County - Pop - SA

Provider ID Agent ID CA_ProviderName Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

MA SA Population by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Eligible Population by Age Group

32 1708164 00II St. Clair County Health Dept. CA 32 Huron 2,130 349 407 273 295 501 3,955 33 1708001 00IC Mid-South CA 33 Ingham 17,513 3,233 3,942 2,056 1,809 2,250 30,803 34 1705430 00ID Mink Substance Abuse Coordinating Agency 34 Ionia 3,037 637 650 320 354 406 5,404 35 4344340 00IE Northern Michigan CA 35 Iosco 2,018 330 416 274 251 369 3,658 36 1707962 00IL Western U.P. SAS 36 Iron 752 144 159 108 135 419 1,717 37 4344340 00IE Northern Michigan CA 37 Isabella 2,747 673 724 343 338 406 5,231 38 1708001 00IC Mid-South CA 38 Jackson 10,171 1,730 1,981 1,082 1,055 1,329 17,348 39 3402136 00GR Kalamazoo County CMH 39 Kalamazoo 13,058 2,495 2,888 1,629 1,460 1,998 23,528 40 4344340 00IE Northern Michigan CA 40 Kalkaska 1,302 200 229 135 165 220 2,251 41 1705430 00ID Mink Substance Abuse Coordinating Agency 41 Kent 33,711 6,218 6,991 3,516 2,999 4,545 57,980 42 1707962 00IL Western U.P. SAS 42 Keweenaw 126 21 22 14 23 64 270 43 4344340 00IE Northern Michigan CA 43 Lake 1,071 190 282 216 224 243 2,226 44 1708164 00II St. Clair County Health Dept. CA 44 Lapeer 3,308 526 671 338 310 528 5,681 45 4344340 00IE Northern Michigan CA 45 Leelanau 773 105 124 67 59 124 1,252 46 1708001 00IC Mid-South CA 46 Lenawee 4,696 872 1,028 527 554 764 8,441 47 1707176 00HU Washtenaw County CMH 47 Livingston 2,690 476 527 305 259 438 4,695 48 1724945 00HY Eastern U.P. Substance Abuse 48 Luce 633 114 162 84 100 171 1,264 49 1724945 00HY Eastern U.P. Substance Abuse 49 Mackinac 590 96 102 75 66 150 1,079 50 3396315 00GX Macomb County CA 50 Macomb 23,988 3,883 5,428 3,477 3,278 5,937 45,991 51 4344340 00IE Northern Michigan CA 51 Manistee 1,606 265 315 205 264 335 2,990 52 1724945 00HY Eastern U.P. Substance Abuse 52 Marquette 2,962 681 736 414 401 714 5,908 53 4344340 00IE Northern Michigan CA 53 Mason 1,999 362 425 212 211 352 3,561 54 4344340 00IE Northern Michigan CA 54 Mecosta 2,743 624 659 326 296 401 5,049 55 1724945 00HY Eastern U.P. Substance Abuse 55 Menominee 1,289 272 256 143 169 377 2,506 56 4344340 00IE Northern Michigan CA 56 Midland 3,720 650 855 455 444 561 6,685 57 4344340 00IE Northern Michigan CA 57 Missaukee 35 35 58 1710547 00IH Southeast MI Community Alliance 58 Monroe 5,582 990 1,236 642 616 872 9,938 59 1705430 00ID Mink Substance Abuse Coordinating Agency 59 Montcalm 3,861 664 778 449 445 563 6,760 60 4344340 00IE Northern Michigan CA 60 Montmorency 743 138 134 112 124 188 1,439 61 1712452 00IB Lakeshore CA 61 Muskegon 14,262 2,751 3,162 1,873 1,672 1,988 25,708 62 1705430 00ID Mink Substance Abuse Coordinating Agency 62 Newaygo 3,392 582 689 478 417 542 6,100

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, SA Pop by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 39 of 58

MACap - Rates: 96h - qSummary recordcode02 by CA by County - Pop - SA

Provider ID Agent ID CA_ProviderName Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

MA SA Population by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Eligible Population by Age Group

63 1705289 00IF Oakland County Health Div 63 Oakland 32,319 5,016 7,228 4,407 4,497 8,810 62,277 64 4344340 00IE Northern Michigan CA 64 Oceana 2,592 450 524 297 309 300 4,472 65 4344340 00IE Northern Michigan CA 65 Ogemaw 1,750 341 373 289 260 376 3,389 66 1707962 00IL Western U.P. SAS 66 Ontonagon 455 63 90 73 74 201 956 67 4344340 00IE Northern Michigan CA 67 Osceola 1,809 343 404 201 245 260 3,262 68 4344340 00IE Northern Michigan CA 68 Oscoda 679 123 155 134 104 150 1,345 69 4344340 00IE Northern Michigan CA 69 Otsego 1,580 265 306 155 122 168 2,596 70 1712452 00IB Lakeshore CA 70 Ottawa 7,254 1,241 1,253 649 543 1,135 12,075 71 4344340 00IE Northern Michigan CA 71 Presque Isle 712 132 156 99 109 216 1,424 72 4344340 00IE Northern Michigan CA 72 Roscommon 1,975 345 527 305 267 353 3,772 73 1712541 00IG Saginaw County Health Dept 73 Saginaw 18,797 3,407 4,365 2,275 1,798 2,174 32,816 74 1708164 00II St. Clair County Health Dept. CA 74 St. Clair 8,296 1,590 1,792 991 923 1,131 14,723 75 3402136 00GR Kalamazoo County CMH 75 St. Joseph 4,474 751 877 408 422 580 7,512 76 1708164 00II St. Clair County Health Dept. CA 76 Sanilac 2,767 467 505 326 352 514 4,931 77 1724945 00HY Eastern U.P. Substance Abuse 77 Schoolcraft 702 122 159 84 107 210 1,384 78 1708001 00IC Mid-South CA 78 Shiawassee 3,886 770 880 451 370 597 6,954 79 1708164 00II St. Clair County Health Dept. CA 79 Tuscola 3,560 586 691 360 355 492 6,044 80 1712452 00IB Lakeshore CA 80 Van Buren 6,109 1,146 1,342 766 760 1,091 11,214 81 1707176 00HU Washtenaw County CMH 81 Washtenaw 9,115 1,730 2,071 1,289 1,091 1,609 16,905 82 1710547 00IH Southeast MI Community Alliance 82 Wayne 59,273 8,795 12,453 7,732 7,247 8,774 104,274 83 3119549 00XO Detroit Health Department 82 Wayne 143,393 20,063 29,248 17,486 17,040 17,783 245,013 84 4344340 00IE Northern Michigan CA 83 Wexford 3,476 637 700 398 408 577 6,196 85

605,521 100,331 128,920 73,931 69,660 94,228 1,072,591 Check Values -

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, SA Pop by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 40 of 58

MACap - Rates: 97a - qSummary recordcode02 by CMHA - Rev - DAB

Provider ID Agent ID Provider Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1705233 0028 Genesee County Health Dept $115,577.28 $83,419.84 $337,950.68 $295,098.20 $174,059.42 $38,414.48 $1,044,519.902 1705242 00GT Lapeer County CMH $8,943.11 $9,550.18 $40,728.93 $32,723.02 $23,976.81 $9,002.40 $124,924.453 1705251 00GM Great Lakes CMH $33,609.60 $27,209.70 $87,132.34 $85,106.01 $60,179.80 $23,366.46 $316,603.914 1705260 00GD Barry County CMH $4,310.88 $5,854.01 $14,414.82 $16,364.28 $11,035.20 $3,720.08 $55,699.275 1705270 00GU Lenawee County CMH $21,229.80 $17,675.10 $72,395.49 $55,333.30 $43,386.20 $13,133.16 $223,153.056 1705289 0058 Oakland County CMHA $140,961.60 $128,916.48 $512,996.77 $459,468.24 $335,331.35 $151,516.84 $1,729,191.287 1705298 00HT Van Buren County CMH $28,255.69 $25,443.60 $78,241.24 $78,591.24 $64,673.00 $21,285.41 $296,490.188 1705304 00GY Manistee-Benzie CMH $7,497.60 $7,733.55 $30,613.92 $30,386.72 $29,174.31 $8,875.31 $114,281.419 1705322 00GE Bay-Arenac CMH $22,461.34 $26,091.99 $116,037.35 $107,736.60 $73,772.10 $23,640.18 $369,739.5610 1705430 00GS Kent County CMH $170,800.00 $139,381.18 $443,159.50 $374,024.79 $233,258.04 $79,201.92 $1,439,825.4311 1706114 00HW Woodlands Behavioral Healthcare $9,954.00 $7,294.98 $25,981.69 $22,919.55 $17,439.50 $5,925.59 $89,515.3112 1706830 00GC AuSable Valley CMH $9,708.88 $10,400.98 $38,050.74 $52,691.94 $34,064.72 $11,026.40 $155,943.6613 1706849 00HM Sanilac County CMH $5,798.38 $6,923.42 $23,098.96 $26,952.75 $22,010.60 $7,154.88 $91,938.9914 1707130 00HS Tuscola County CMH $15,393.56 $13,663.42 $41,379.84 $37,122.56 $27,524.10 $8,290.20 $143,373.6815 1707158 00HC North Central CMH $21,314.95 $19,148.22 $71,899.88 $80,063.67 $54,154.52 $16,951.04 $263,532.2816 1707167 00GW Livingston County CMH $18,148.20 $18,238.50 $55,016.00 $44,636.80 $29,163.29 $10,894.41 $176,097.2017 1707176 00HU Washtenaw County CMH $61,484.48 $54,786.80 $194,036.00 $188,859.50 $110,969.37 $36,295.60 $646,431.7518 1707185 00HF Northern Michigan CMH $21,952.94 $20,627.70 $68,079.42 $63,567.98 $51,168.30 $20,633.13 $246,029.4719 1707962 00GI Copper County CMH $10,308.27 $14,021.28 $48,065.57 $52,930.02 $50,299.08 $23,908.00 $199,532.2220 1708001 00BJ CEI CMH $108,829.24 $81,499.36 $269,706.51 $244,044.52 $152,424.18 $46,960.08 $903,463.8921 1708066 00HB Newaygo County CMH $9,697.14 $8,603.14 $30,406.14 $36,516.48 $23,676.84 $6,845.46 $115,745.2022 1708100 00HE Northeast Michigan CMH $9,217.14 $13,029.50 $45,865.48 $50,373.75 $35,412.38 $12,406.24 $166,304.4923 1708119 00GL Gogebic County CMH $5,192.16 $6,857.91 $22,355.76 $22,920.80 $15,875.19 $10,839.12 $84,040.9424 1708128 00GP Huron Behavioral Health $5,249.12 $9,319.11 $29,904.66 $32,262.00 $26,531.28 $9,884.73 $113,150.9025 1708146 00HP St. Joseph County CMH $16,949.40 $13,100.78 $47,180.92 $42,178.32 $32,882.00 $10,039.80 $162,331.2226 1708164 00HO St. Clair County CMH $40,432.96 $31,059.96 $103,594.10 $100,559.66 $70,207.34 $19,616.80 $365,470.8227 1709690 00GA Allegan County CMH $18,489.33 $16,887.28 $53,963.61 $50,059.92 $41,807.22 $14,084.69 $195,292.0528 1710547 00HX Monroe County CMH $23,101.43 $20,000.75 $84,461.52 $74,126.25 $48,362.93 $15,172.80 $265,225.6829 1712229 00GV Lifeways CMH $63,763.92 $43,145.56 $170,307.72 $148,545.25 $107,413.68 $30,277.00 $563,453.1330 1712283 00GB Antrim-Kalkaska CMH $10,154.35 $6,979.15 $24,605.86 $27,259.60 $23,230.35 $7,813.34 $100,042.6531 1712372 00HL Pines Behavioral Health CMH $11,599.20 $8,297.48 $34,313.62 $27,985.10 $22,448.08 $7,425.74 $112,069.2232 1712407 00HN Shiawassee County CMH $12,657.92 $15,264.48 $46,256.30 $43,539.20 $26,496.90 $9,438.57 $153,653.3733 1712425 00HI Ottawa County CMH $32,840.97 $29,773.25 $97,350.38 $85,449.39 $53,446.70 $24,845.94 $323,706.63

Capitation Revenue by Age Group

MA DAB Revenue by Provider ID by Age Group2001-12

12-Feb-2002 06:32

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DAB Rev by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 41 of 58

34 1712452 00HA Muskegon County CMH $49,112.72 $40,057.50 $162,228.76 $159,001.57 $99,833.58 $25,910.48 $536,144.6135 1712461 00GZ Montcalm Center Behavl. Hlt $7,246.56 $6,490.00 $23,011.23 $22,648.59 $15,696.52 $4,368.88 $79,461.7836 1712541 00HQ Saginaw County CMH $63,310.00 $57,258.96 $206,296.20 $181,073.75 $104,639.10 $28,118.62 $640,696.6337 1715919 00GO Hiawatha Behavioral Health Authority $22,062.84 $19,412.40 $62,850.03 $71,376.00 $54,061.70 $20,674.72 $250,437.6938 1715928 00GQ Ionia County CMH $10,041.36 $10,888.08 $35,997.50 $29,892.80 $24,522.28 $6,277.50 $117,619.5239 1715955 00GN Gratiot County CMH $7,126.21 $8,078.20 $29,235.05 $26,611.52 $20,413.10 $8,678.24 $100,142.3240 1716175 00GF Berrien Mental Health $57,554.07 $38,190.80 $133,742.57 $132,751.50 $96,340.60 $30,569.89 $489,149.4341 1724945 00HJ Pathways CMH $35,222.80 $47,248.40 $143,359.00 $148,543.54 $107,442.65 $45,600.78 $527,417.1742 2920843 00HR Summit Pointe CMH $37,845.00 $29,639.87 $118,688.57 $111,562.79 $76,989.11 $20,703.00 $395,428.3443 3119549 00GJ Detroit-Wayne County CMH $1,157,949.03 $699,714.56 $2,894,039.35 $2,933,688.19 $2,065,012.25 $510,037.29 $10,260,440.6744 3140186 00HG Northpointe CMH $14,334.12 $16,918.25 $48,067.10 $54,609.90 $45,584.00 $26,890.52 $206,403.8945 3220732 00HV West Michigan CMH $14,959.44 $15,978.24 $49,944.96 $50,651.64 $41,201.68 $11,237.58 $183,973.5446 3396315 00GX Macomb County CA $92,933.10 $86,570.76 $334,818.57 $325,614.80 $237,883.80 $99,971.05 $1,177,792.0847 3402136 00GR Kalamazoo County CMH $74,740.32 $58,914.42 $219,594.63 $216,828.72 $138,030.72 $41,838.12 $749,946.9348 4344340 00GG Central Michigan CMH $51,531.04 $52,070.15 $174,474.30 $157,556.58 $118,041.39 $31,328.64 $585,002.1049

50

State Subtotals $2,791,853.45 $2,127,629.23 $7,995,899.54 $7,712,809.30 $5,371,547.26 $1,651,091.11 $27,650,829.89

Check Values $0.00

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DAB Rev by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 42 of 58

MACap - Rates: 97b - qSummary recordcode02 by CMHA by County - Rev - DAB

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1708100 00HE Northeast Michigan CMH 01 Alcona $1,329.99 $1,390.50 $5,201.24 $5,938.80 $6,009.02 $2,020.48 $21,890.032 1724945 00HJ Pathways CMH 02 Alger $1,799.20 $1,959.08 $11,109.00 $10,203.47 $9,791.25 $4,907.46 $39,769.463 1709690 00GA Allegan County CMH 03 Allegan $18,489.33 $16,887.28 $53,963.61 $50,059.92 $41,807.22 $14,084.69 $195,292.054 1708100 00HE Northeast Michigan CMH 04 Alpena $4,392.06 $7,107.00 $25,769.78 $27,997.20 $16,218.52 $5,408.48 $86,893.045 1712283 00GB Antrim-Kalkaska CMH 05 Antrim $5,141.99 $4,173.10 $12,715.78 $14,074.25 $10,351.77 $4,027.14 $50,484.036 1705322 00GE Bay-Arenac CMH 06 Arenac $3,099.58 $4,030.47 $17,040.45 $16,451.67 $13,697.10 $4,312.05 $58,631.327 1707962 00GI Copper County CMH 07 Baraga $2,158.80 $1,707.72 $6,394.99 $7,032.66 $8,451.06 $3,461.50 $29,206.738 1705260 00GD Barry County CMH 08 Barry $4,310.88 $5,854.01 $14,414.82 $16,364.28 $11,035.20 $3,720.08 $55,699.279 1705322 00GE Bay-Arenac CMH 09 Bay $19,361.76 $22,061.52 $98,996.90 $91,284.93 $60,075.00 $19,328.13 $311,108.2410 1705304 00GY Manistee-Benzie CMH 10 Benzie $3,067.20 $2,412.30 $10,421.76 $9,349.76 $9,001.44 $3,190.36 $37,442.8211 1716175 00GF Berrien Mental Health 11 Berrien $57,554.07 $38,190.80 $133,742.57 $132,751.50 $96,340.60 $30,569.89 $489,149.4312 1712372 00HL Pines Behavioral Health CMH 12 Branch $11,599.20 $8,297.48 $34,313.62 $27,985.10 $22,448.08 $7,425.74 $112,069.2213 2920843 00HR Summit Pointe CMH 13 Calhoun $37,845.00 $29,639.87 $118,688.57 $111,562.79 $76,989.11 $20,703.00 $395,428.3414 1706114 00HW Woodlands Behavioral Healthcare 14 Cass $9,954.00 $7,294.98 $25,981.69 $22,919.55 $17,439.50 $5,925.59 $89,515.3115 1707185 00HF Northern Michigan CMH 15 Charlevoix $4,997.07 $4,338.93 $15,346.44 $12,157.01 $12,328.74 $4,694.76 $53,862.9516 1707185 00HF Northern Michigan CMH 16 Cheboygan $7,858.64 $6,259.44 $20,570.76 $19,041.10 $15,713.10 $6,259.68 $75,702.7217 1715919 00GO Hiawatha Behavioral Health Authority 17 Chippewa $15,471.74 $13,403.80 $36,861.41 $45,918.56 $32,070.50 $10,724.32 $154,450.3318 4344340 00GG Central Michigan CMH 18 Clare $7,055.84 $8,075.05 $30,421.16 $33,598.31 $23,027.85 $5,221.44 $107,399.6519 1708001 00BJ CEI CMH 19 Clinton $8,826.04 $5,614.12 $23,597.51 $21,170.44 $10,433.16 $4,330.83 $73,972.1020 1707158 00HC North Central CMH 20 Crawford $4,028.33 $2,540.07 $10,762.56 $14,752.10 $7,451.78 $2,461.64 $41,996.4821 1724945 00HJ Pathways CMH 21 Delta $11,833.20 $17,286.00 $47,874.50 $51,491.93 $35,248.50 $16,293.87 $180,028.0022 3140186 00HG Northpointe CMH 22 Dickinson $5,546.92 $6,401.50 $20,360.30 $23,915.37 $15,229.20 $9,474.04 $80,927.3323 1708001 00BJ CEI CMH 23 Eaton $14,470.16 $11,417.48 $43,286.23 $32,210.24 $23,438.88 $8,737.11 $133,560.1024 1707185 00HF Northern Michigan CMH 24 Emmet $4,014.74 $5,619.27 $17,468.82 $17,136.99 $13,859.76 $6,821.01 $64,920.5925 1705233 0028 Genesee County Health Dept 25 Genesee $115,577.28 $83,419.84 $337,950.68 $295,098.20 $174,059.42 $38,414.48 $1,044,519.9026 4344340 00GG Central Michigan CMH 26 Gladwin $4,547.84 $4,900.72 $19,939.92 $19,493.90 $15,646.32 $4,422.24 $68,950.9427 1708119 00GL Gogebic County CMH 27 Gogebic $5,192.16 $6,857.91 $22,355.76 $22,920.80 $15,875.19 $10,839.12 $84,040.9428 1705251 00GM Great Lakes CMH 28 Grand Traverse $27,930.20 $22,415.61 $77,021.42 $75,234.78 $52,547.24 $19,523.70 $274,672.9529 1715955 00GN Gratiot County CMH 29 Gratiot $7,126.21 $8,078.20 $29,235.05 $26,611.52 $20,413.10 $8,678.24 $100,142.3230 1712229 00GV Lifeways CMH 30 Hillsdale $12,547.92 $10,022.28 $35,072.95 $30,001.75 $26,410.56 $7,684.00 $121,739.4631 1707962 00GI Copper County CMH 31 Houghton $5,882.73 $9,976.68 $31,974.95 $34,423.02 $32,378.76 $14,749.00 $129,385.14

MA DAB Revenue by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DAB Rev by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 43 of 58

MACap - Rates: 97b - qSummary recordcode02 by CMHA by County - Rev - DAB

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

MA DAB Revenue by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

32 1708128 00GP Huron Behavioral Health 32 Huron $5,249.12 $9,319.11 $29,904.66 $32,262.00 $26,531.28 $9,884.73 $113,150.9033 1708001 00BJ CEI CMH 33 Ingham $85,533.04 $64,467.76 $202,822.77 $190,663.84 $118,552.14 $33,892.14 $695,931.6934 1715928 00GQ Ionia County CMH 34 Ionia $10,041.36 $10,888.08 $35,997.50 $29,892.80 $24,522.28 $6,277.50 $117,619.5235 1706830 00GC AuSable Valley CMH 35 Iosco $4,390.64 $3,810.26 $17,607.33 $19,401.66 $13,824.21 $4,546.08 $63,580.1836 3140186 00HG Northpointe CMH 36 Iron $3,459.96 $4,115.25 $10,914.80 $12,993.39 $13,778.80 $9,167.72 $54,429.9237 4344340 00GG Central Michigan CMH 37 Isabella $10,466.72 $10,302.65 $37,195.62 $26,259.43 $20,441.16 $5,407.92 $110,073.5038 1712229 00GV Lifeways CMH 38 Jackson $51,216.00 $33,123.28 $135,234.77 $118,543.50 $81,003.12 $22,593.00 $441,713.6739 3402136 00GR Kalamazoo County CMH 39 Kalamazoo $74,740.32 $58,914.42 $219,594.63 $216,828.72 $138,030.72 $41,838.12 $749,946.9340 1712283 00GB Antrim-Kalkaska CMH 40 Kalkaska $5,012.36 $2,806.05 $11,890.08 $13,185.35 $12,878.58 $3,786.20 $49,558.6241 1705430 00GS Kent County CMH 41 Kent $170,800.00 $139,381.18 $443,159.50 $374,024.79 $233,258.04 $79,201.92 $1,439,825.4342 1707962 00GI Copper County CMH 42 Keweenaw $647.64 $179.76 $1,650.32 $1,850.70 $2,138.22 $1,376.00 $7,842.6443 3220732 00HV West Michigan CMH 43 Lake $3,850.32 $3,731.76 $13,270.40 $17,749.72 $12,741.56 $3,041.94 $54,385.7044 1705242 00GT Lapeer County CMH 44 Lapeer $8,943.11 $9,550.18 $40,728.93 $32,723.02 $23,976.81 $9,002.40 $124,924.4545 1705251 00GM Great Lakes CMH 45 Leelanau $5,679.40 $4,794.09 $10,110.92 $9,871.23 $7,632.56 $3,842.76 $41,930.9646 1705270 00GU Lenawee County CMH 46 Lenawee $21,229.80 $17,675.10 $72,395.49 $55,333.30 $43,386.20 $13,133.16 $223,153.0547 1707167 00GW Livingston County CMH 47 Livingston $18,148.20 $18,238.50 $55,016.00 $44,636.80 $29,163.29 $10,894.41 $176,097.2048 1724945 00HJ Pathways CMH 48 Luce $4,913.20 $3,918.16 $11,902.50 $15,186.56 $12,663.35 $4,714.47 $53,298.2449 1715919 00GO Hiawatha Behavioral Health Authority 49 Mackinac $3,330.24 $1,617.70 $9,281.65 $12,609.76 $8,246.70 $4,146.00 $39,232.0550 3396315 00GX Macomb County CA 50 Macomb $92,933.10 $86,570.76 $334,818.57 $325,614.80 $237,883.80 $99,971.05 $1,177,792.0851 1705304 00GY Manistee-Benzie CMH 51 Manistee $4,430.40 $5,321.25 $20,192.16 $21,036.96 $20,172.87 $5,684.95 $76,838.5952 1724945 00HJ Pathways CMH 52 Marquette $16,677.20 $24,085.16 $72,473.00 $71,661.58 $49,739.55 $19,684.98 $254,321.4753 3220732 00HV West Michigan CMH 53 Mason $5,775.48 $7,043.04 $18,216.64 $14,286.36 $11,848.46 $4,424.64 $61,594.6254 4344340 00GG Central Michigan CMH 54 Mecosta $8,660.96 $10,414.03 $27,097.84 $24,883.39 $17,728.29 $5,341.32 $94,125.8355 3140186 00HG Northpointe CMH 55 Menominee $5,327.24 $6,401.50 $16,792.00 $17,701.14 $16,576.00 $8,248.76 $71,046.6456 4344340 00GG Central Michigan CMH 56 Midland $15,315.52 $13,031.46 $41,924.96 $37,611.76 $26,560.89 $7,472.52 $141,917.1157 1707158 00HC North Central CMH 57 Missaukee $1,368.85 $1,368.8558 1710547 00HX Monroe County CMH 58 Monroe $23,101.43 $20,000.75 $84,461.52 $74,126.25 $48,362.93 $15,172.80 $265,225.6859 1712461 00GZ Montcalm Center Behavl. Hlt 59 Montcalm $7,246.56 $6,490.00 $23,011.23 $22,648.59 $15,696.52 $4,368.88 $79,461.7860 1708100 00HE Northeast Michigan CMH 60 Montmorency $1,546.50 $2,111.50 $5,319.45 $7,953.75 $6,942.46 $2,316.16 $26,189.8261 1712452 00HA Muskegon County CMH 61 Muskegon $49,112.72 $40,057.50 $162,228.76 $159,001.57 $99,833.58 $25,910.48 $536,144.6162 1708066 00HB Newaygo County CMH 62 Newaygo $9,697.14 $8,603.14 $30,406.14 $36,516.48 $23,676.84 $6,845.46 $115,745.20

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DAB Rev by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 44 of 58

MACap - Rates: 97b - qSummary recordcode02 by CMHA by County - Rev - DAB

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

MA DAB Revenue by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

63 1705289 0058 Oakland County CMHA 63 Oakland $140,961.60 $128,916.48 $512,996.77 $459,468.24 $335,331.35 $151,516.84 $1,729,191.2864 3220732 00HV West Michigan CMH 64 Oceana $5,333.64 $5,203.44 $18,457.92 $18,615.56 $16,611.66 $3,771.00 $67,993.2265 1706830 00GC AuSable Valley CMH 65 Ogemaw $3,710.40 $5,200.49 $13,825.89 $23,112.36 $14,582.50 $4,632.32 $65,063.9666 1707962 00GI Copper County CMH 66 Ontonagon $1,619.10 $2,157.12 $8,045.31 $9,623.64 $7,331.04 $4,321.50 $33,097.7167 4344340 00GG Central Michigan CMH 67 Osceola $5,484.16 $5,346.24 $17,894.80 $15,709.79 $14,636.88 $3,463.20 $62,535.0768 1706830 00GC AuSable Valley CMH 68 Oscoda $1,607.84 $1,390.23 $6,617.52 $10,177.92 $5,658.01 $1,848.00 $27,299.5269 1707185 00HF Northern Michigan CMH 69 Otsego $5,082.49 $4,410.06 $14,693.40 $15,232.88 $9,266.70 $2,857.68 $51,543.2170 1712425 00HI Ottawa County CMH 70 Ottawa $32,840.97 $29,773.25 $97,350.38 $85,449.39 $53,446.70 $24,845.94 $323,706.6371 1708100 00HE Northeast Michigan CMH 71 Presque Isle $1,948.59 $2,420.50 $9,575.01 $8,484.00 $6,242.38 $2,661.12 $31,331.6072 1707158 00HC North Central CMH 72 Roscommon $6,022.94 $6,187.35 $24,813.68 $26,419.67 $18,592.56 $5,499.74 $87,535.9473 1712541 00HQ Saginaw County CMH 73 Saginaw $63,310.00 $57,258.96 $206,296.20 $181,073.75 $104,639.10 $28,118.62 $640,696.6374 1708164 00HO St. Clair County CMH 74 St. Clair $40,432.96 $31,059.96 $103,594.10 $100,559.66 $70,207.34 $19,616.80 $365,470.8275 1708146 00HP St. Joseph County CMH 75 St. Joseph $16,949.40 $13,100.78 $47,180.92 $42,178.32 $32,882.00 $10,039.80 $162,331.2276 1706849 00HM Sanilac County CMH 76 Sanilac $5,798.38 $6,923.42 $23,098.96 $26,952.75 $22,010.60 $7,154.88 $91,938.9977 1715919 00GO Hiawatha Behavioral Health Authority 77 Schoolcraft $3,260.86 $4,390.90 $16,706.97 $12,847.68 $13,744.50 $5,804.40 $56,755.3178 1712407 00HN Shiawassee County CMH 78 Shiawassee $12,657.92 $15,264.48 $46,256.30 $43,539.20 $26,496.90 $9,438.57 $153,653.3779 1707130 00HS Tuscola County CMH 79 Tuscola $15,393.56 $13,663.42 $41,379.84 $37,122.56 $27,524.10 $8,290.20 $143,373.6880 1705298 00HT Van Buren County CMH 80 Van Buren $28,255.69 $25,443.60 $78,241.24 $78,591.24 $64,673.00 $21,285.41 $296,490.1881 1707176 00HU Washtenaw County CMH 81 Washtenaw $61,484.48 $54,786.80 $194,036.00 $188,859.50 $110,969.37 $36,295.60 $646,431.7582 3119549 00GJ Detroit-Wayne County CMH 82 Wayne $1,157,949.03 $699,714.56 $2,894,039.35 $2,933,688.19 $2,065,012.25 $510,037.29 $10,260,440.6783 1707158 00HC North Central CMH 83 Wexford $9,894.83 $10,420.80 $36,323.64 $38,891.90 $28,110.18 $8,989.66 $132,631.0184

85

$2,791,853.45 $2,127,629.23 $7,995,899.54 $7,712,809.30 $5,371,547.26 $1,651,091.11 $27,650,829.89Check Values $0.00

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DAB Rev by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 45 of 58

MACap - Rates: 97d - qSummary recordcode02 by CMHA - Rev - TANF

Provider ID Agent ID Provider Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1705233 0028 Genesee County Health Dept $74,936.88 $11,885.72 $23,666.76 $6,779.08 $837.32 $0.64 $118,106.402 1705242 00GT Lapeer County CMH $18,408.06 $2,559.76 $4,506.96 $1,370.80 $123.63 $26,969.213 1705251 00GM Great Lakes CMH $29,466.76 $3,663.50 $5,879.70 $2,233.44 $321.62 $41,565.024 1705260 00GD Barry County CMH $8,426.38 $1,343.00 $2,300.45 $790.50 $86.52 $12,946.855 1705270 00GU Lenawee County CMH $25,392.16 $4,156.64 $6,402.43 $1,854.36 $203.07 $38,008.666 1705289 0058 Oakland County CMHA $129,589.76 $15,829.84 $33,091.63 $11,692.80 $2,727.48 $7.92 $192,939.437 1705298 00HT Van Buren County CMH $37,009.08 $6,138.24 $11,115.72 $3,999.16 $642.60 $58,904.808 1705304 00GY Manistee-Benzie CMH $16,420.04 $2,197.44 $3,459.73 $1,170.12 $177.76 $23,425.099 1705322 00GE Bay-Arenac CMH $54,385.00 $8,816.94 $15,518.34 $4,603.24 $584.50 $83,908.0210 1705430 00GS Kent County CMH $153,804.12 $24,452.40 $40,284.48 $10,588.05 $1,428.98 $1.52 $230,559.5511 1706114 00HW Woodlands Behavioral Healthcare $10,147.68 $1,666.05 $3,410.88 $943.65 $128.11 $16,296.3712 1706830 00GC AuSable Valley CMH $38,188.92 $6,020.64 $10,343.86 $3,710.00 $458.80 $58,722.2213 1706849 00HM Sanilac County CMH $10,299.96 $1,517.28 $2,370.48 $803.96 $114.30 $15,105.9814 1707130 00HS Tuscola County CMH $21,253.40 $2,869.44 $5,206.95 $1,388.40 $106.50 $30,824.6915 1707158 00HC North Central CMH $34,403.76 $5,387.50 $9,810.57 $2,955.19 $464.10 $53,021.1216 1707167 00GW Livingston County CMH $36,192.00 $4,993.59 $8,060.58 $2,936.19 $289.80 $4.45 $52,476.6117 1707176 00HU Washtenaw County CMH $82,960.23 $13,075.50 $21,861.84 $6,595.32 $893.16 $9.15 $125,395.2018 1707185 00HF Northern Michigan CMH $28,050.80 $3,840.54 $6,176.88 $1,783.32 $169.51 $40,021.0519 1707962 00GI Copper County CMH $17,528.56 $2,330.20 $3,708.84 $1,401.12 $221.75 $25,190.4720 1708001 00BJ CEI CMH $91,284.58 $14,298.32 $26,117.69 $6,793.20 $1,347.10 $5.24 $139,846.1321 1708066 00HB Newaygo County CMH $27,403.68 $4,093.63 $6,999.24 $2,530.44 $298.41 $41,325.4022 1708100 00HE Northeast Michigan CMH $22,130.81 $3,296.40 $5,879.25 $2,298.05 $223.50 $33,828.0123 1708119 00GL Gogebic County CMH $17,539.20 $2,377.74 $4,172.12 $1,666.32 $200.64 $25,956.0224 1708128 00GP Huron Behavioral Health $11,293.92 $1,449.04 $2,499.96 $929.60 $98.23 $16,270.7525 1708146 00HP St. Joseph County CMH $24,299.80 $3,727.80 $6,345.10 $1,492.50 $199.92 $36,065.1226 1708164 00HO St. Clair County CMH $112,656.72 $19,544.84 $32,186.70 $9,756.24 $1,688.43 $4.51 $175,837.4427 1709690 00GA Allegan County CMH $35,669.26 $4,862.00 $7,268.35 $1,982.76 $321.50 $4.74 $50,108.6128 1710547 00HX Monroe County CMH $36,987.96 $5,755.75 $9,614.10 $2,159.43 $339.88 $54,857.1229 1712229 00GV Lifeways CMH $68,654.16 $10,922.79 $16,364.70 $4,252.34 $695.80 $100,889.7930 1712283 00GB Antrim-Kalkaska CMH $12,738.35 $1,758.12 $2,388.24 $826.98 $94.16 $17,805.8531 1712372 00HL Pines Behavioral Health CMH $17,796.48 $2,677.79 $5,031.20 $1,196.37 $94.24 $26,796.0832 1712407 00HN Shiawassee County CMH $20,153.55 $3,352.58 $5,847.75 $1,485.54 $144.80 $30,984.2233 1712425 00HI Ottawa County CMH $50,659.77 $7,666.92 $10,815.10 $2,992.92 $341.04 $2.25 $72,478.00

MA TANF Revenue by Provider ID by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, TANF Rev by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 46 of 58

34 1712452 00HA Muskegon County CMH $70,951.16 $12,337.92 $18,668.65 $5,088.96 $489.50 $1.64 $107,537.8335 1712461 00GZ Montcalm Center Behavl. Hlt $13,781.55 $2,013.76 $3,334.59 $872.30 $113.76 $20,115.9636 1712541 00HQ Saginaw County CMH $59,813.95 $9,161.10 $17,251.52 $4,628.00 $516.88 $1.05 $91,372.5037 1715919 00GO Hiawatha Behavioral Health Authority $21,530.88 $3,267.45 $5,398.40 $1,762.50 $199.40 $32,158.6338 1715928 00GQ Ionia County CMH $16,090.41 $2,987.53 $4,251.36 $1,115.52 $185.40 $1.71 $24,631.9339 1715955 00GN Gratiot County CMH $18,894.56 $3,062.22 $4,819.00 $1,303.88 $112.48 $28,192.1440 1716175 00GF Berrien Mental Health $51,712.78 $8,568.00 $14,724.88 $3,363.54 $630.38 $2.70 $79,002.2841 1724945 00HJ Pathways CMH $81,586.40 $13,912.80 $24,225.30 $7,259.14 $979.65 $127,963.2942 2920843 00HR Summit Pointe CMH $71,085.48 $11,557.11 $18,178.76 $4,761.82 $631.00 $106,214.1743 3119549 00GJ Detroit-Wayne County CMH $964,855.80 $119,916.30 $253,135.68 $81,320.75 $13,943.80 $54.40 $1,433,226.7344 3140186 00HG Northpointe CMH $25,888.30 $4,318.93 $6,664.49 $2,282.40 $252.80 $39,406.9245 3220732 00HV West Michigan CMH $29,312.20 $4,334.58 $8,308.89 $2,914.38 $470.08 $1.67 $45,341.8046 3396315 00GX Macomb County CA $125,080.34 $16,746.74 $34,644.24 $14,180.32 $2,726.46 $6.76 $193,384.8647 3402136 00GR Kalamazoo County CMH $70,165.08 $12,098.08 $19,475.75 $5,158.86 $656.88 $107,554.6548 4344340 00GG Central Michigan CMH $70,556.64 $11,782.00 $20,975.36 $6,063.93 $733.24 $110,111.1749

50

State Subtotals $3,067,437.32 $444,592.46 $812,763.45 $250,037.69 $38,708.87 $110.35 $4,613,650.14

Check Values $0.00

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, TANF Rev by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 47 of 58

MACap - Rates: 97d - qSummary recordcode02 by CMHA by County - Pop - TANF

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1708100 00HE Northeast Michigan CMH 01 Alcona $3,795.61 $412.05 $1,195.95 $437.19 $26.82 $5,867.622 1724945 00HJ Pathways CMH 02 Alger $6,092.80 $972.40 $1,859.72 $627.67 $87.08 $9,639.673 1709690 00GA Allegan County CMH 03 Allegan $35,669.26 $4,862.00 $7,268.35 $1,982.76 $321.50 $4.74 $50,108.614 1708100 00HE Northeast Michigan CMH 04 Alpena $10,833.42 $1,765.05 $3,035.10 $1,233.10 $134.10 $17,000.775 1712283 00GB Antrim-Kalkaska CMH 05 Antrim $6,393.25 $811.44 $876.33 $332.94 $34.24 $8,448.206 1705322 00GE Bay-Arenac CMH 06 Arenac $9,380.50 $1,373.13 $2,457.18 $952.90 $151.97 $14,315.687 1707962 00GI Copper County CMH 07 Baraga $2,902.96 $463.60 $608.17 $133.44 $62.09 $4,170.268 1705260 00GD Barry County CMH 08 Barry $8,426.38 $1,343.00 $2,300.45 $790.50 $86.52 $12,946.859 1705322 00GE Bay-Arenac CMH 09 Bay $45,004.50 $7,443.81 $13,061.16 $3,650.34 $432.53 $69,592.3410 1705304 00GY Manistee-Benzie CMH 10 Benzie $5,996.16 $747.74 $1,074.14 $320.39 $33.33 $8,171.7611 1716175 00GF Berrien Mental Health 11 Berrien $51,712.78 $8,568.00 $14,724.88 $3,363.54 $630.38 $2.70 $79,002.2812 1712372 00HL Pines Behavioral Health CMH 12 Branch $17,796.48 $2,677.79 $5,031.20 $1,196.37 $94.24 $26,796.0813 2920843 00HR Summit Pointe CMH 13 Calhoun $71,085.48 $11,557.11 $18,178.76 $4,761.82 $631.00 $106,214.1714 1706114 00HW Woodlands Behavioral Healthcare 14 Cass $10,147.68 $1,666.05 $3,410.88 $943.65 $128.11 $16,296.3715 1707185 00HF Northern Michigan CMH 15 Charlevoix $6,311.20 $743.82 $1,092.96 $277.20 $44.22 $8,469.4016 1707185 00HF Northern Michigan CMH 16 Cheboygan $8,395.00 $1,153.68 $2,185.92 $563.64 $44.22 $12,342.4617 1715919 00GO Hiawatha Behavioral Health Authority 17 Chippewa $14,073.57 $2,130.35 $3,572.80 $1,112.50 $149.55 $21,038.7718 4344340 00GG Central Michigan CMH 18 Clare $12,504.78 $1,972.80 $3,978.24 $1,268.73 $103.61 $19,828.1619 1708001 00BJ CEI CMH 19 Clinton $7,748.07 $1,090.88 $1,793.25 $444.00 $42.54 $11,118.7420 1707158 00HC North Central CMH 20 Crawford $5,753.84 $843.75 $1,442.43 $490.63 $81.90 $8,612.5521 1724945 00HJ Pathways CMH 21 Delta $30,844.80 $4,682.48 $8,197.45 $3,029.19 $391.86 $47,145.7822 3140186 00HG Northpointe CMH 22 Dickinson $11,028.40 $1,703.24 $2,643.06 $887.60 $113.76 $16,376.0623 1708001 00BJ CEI CMH 23 Eaton $15,956.86 $2,439.87 $4,072.67 $1,127.76 $241.06 $23,838.2224 1707185 00HF Northern Michigan CMH 24 Emmet $6,624.00 $915.86 $1,109.52 $471.24 $29.48 $9,150.1025 1705233 0028 Genesee County Health Dept 25 Genesee $74,936.88 $11,885.72 $23,666.76 $6,779.08 $837.32 $0.64 $118,106.4026 4344340 00GG Central Michigan CMH 26 Gladwin $9,123.36 $1,106.96 $2,024.96 $659.34 $111.58 $13,026.2027 1708119 00GL Gogebic County CMH 27 Gogebic $17,539.20 $2,377.74 $4,172.12 $1,666.32 $200.64 $25,956.0228 1705251 00GM Great Lakes CMH 28 Grand Traverse $24,055.76 $3,085.50 $4,628.70 $1,768.14 $235.03 $33,773.1329 1715955 00GN Gratiot County CMH 29 Gratiot $18,894.56 $3,062.22 $4,819.00 $1,303.88 $112.48 $28,192.1430 1712229 00GV Lifeways CMH 30 Hillsdale $13,751.64 $2,416.07 $3,669.66 $909.46 $215.60 $20,962.4331 1707962 00GI Copper County CMH 31 Houghton $11,639.54 $1,512.80 $2,452.62 $989.68 $124.18 $16,718.82

MA TANF Revenue by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, TANF Rev by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 48 of 58

MACap - Rates: 97d - qSummary recordcode02 by CMHA by County - Pop - TANF

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

MA TANF Revenue by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

32 1708128 00GP Huron Behavioral Health 32 Huron $11,293.92 $1,449.04 $2,499.96 $929.60 $98.23 $16,270.7533 1708001 00BJ CEI CMH 33 Ingham $67,579.65 $10,767.57 $20,251.77 $5,221.44 $1,063.50 $5.24 $104,889.1734 1715928 00GQ Ionia County CMH 34 Ionia $16,090.41 $2,987.53 $4,251.36 $1,115.52 $185.40 $1.71 $24,631.9335 1706830 00GC AuSable Valley CMH 35 Iosco $17,334.24 $2,603.52 $4,440.21 $1,688.05 $207.20 $26,273.2236 3140186 00HG Northpointe CMH 36 Iron $5,443.10 $860.31 $1,520.47 $618.15 $25.28 $8,467.3137 4344340 00GG Central Michigan CMH 37 Isabella $12,121.32 $2,674.24 $3,879.68 $1,138.86 $111.58 $19,925.6838 1712229 00GV Lifeways CMH 38 Jackson $54,902.52 $8,506.72 $12,695.04 $3,342.88 $480.20 $79,927.3639 3402136 00GR Kalamazoo County CMH 39 Kalamazoo $70,165.08 $12,098.08 $19,475.75 $5,158.86 $656.88 $107,554.6540 1712283 00GB Antrim-Kalkaska CMH 40 Kalkaska $6,345.10 $946.68 $1,511.91 $494.04 $59.92 $9,357.6541 1705430 00GS Kent County CMH 41 Kent $153,804.12 $24,452.40 $40,284.48 $10,588.05 $1,428.98 $1.52 $230,559.5542 1707962 00GI Copper County CMH 42 Keweenaw $631.56 $115.90 $139.58 $44.48 $17.74 $949.2643 3220732 00HV West Michigan CMH 43 Lake $5,361.85 $738.99 $1,749.24 $589.68 $90.40 $1.67 $8,531.8344 1705242 00GT Lapeer County CMH 44 Lapeer $18,408.06 $2,559.76 $4,506.96 $1,370.80 $123.63 $26,969.2145 1705251 00GM Great Lakes CMH 45 Leelanau $5,411.00 $578.00 $1,251.00 $465.30 $86.59 $7,791.8946 1705270 00GU Lenawee County CMH 46 Lenawee $25,392.16 $4,156.64 $6,402.43 $1,854.36 $203.07 $38,008.6647 1707167 00GW Livingston County CMH 47 Livingston $36,192.00 $4,993.59 $8,060.58 $2,936.19 $289.80 $4.45 $52,476.6148 1724945 00HJ Pathways CMH 48 Luce $7,643.20 $1,196.80 $2,862.99 $545.80 $65.31 $12,314.1049 1715919 00GO Hiawatha Behavioral Health Authority 49 Mackinac $3,376.66 $561.70 $750.40 $275.00 $29.91 $4,993.6750 3396315 00GX Macomb County CA 50 Macomb $125,080.34 $16,746.74 $34,644.24 $14,180.32 $2,726.46 $6.76 $193,384.8651 1705304 00GY Manistee-Benzie CMH 51 Manistee $10,423.88 $1,449.70 $2,385.59 $849.73 $144.43 $15,253.3352 1724945 00HJ Pathways CMH 52 Marquette $37,005.60 $7,061.12 $11,305.14 $3,056.48 $435.40 $58,863.7453 3220732 00HV West Michigan CMH 53 Mason $10,260.40 $1,415.88 $2,786.58 $907.20 $108.48 $15,478.5454 4344340 00GG Central Michigan CMH 54 Mecosta $12,370.32 $2,394.76 $4,005.12 $1,088.91 $119.55 $19,978.6655 3140186 00HG Northpointe CMH 55 Menominee $9,416.80 $1,755.38 $2,500.96 $776.65 $113.76 $14,563.5556 4344340 00GG Central Michigan CMH 56 Midland $16,244.76 $2,279.68 $4,721.92 $1,268.73 $183.31 $24,698.4057 1710547 00HX Monroe County CMH 58 Monroe $36,987.96 $5,755.75 $9,614.10 $2,159.43 $339.88 $54,857.1258 1712461 00GZ Montcalm Center Behavl. Hlt 59 Montcalm $13,781.55 $2,013.76 $3,334.59 $872.30 $113.76 $20,115.9659 1708100 00HE Northeast Michigan CMH 60 Montmorency $3,873.87 $596.55 $894.45 $414.77 $44.70 $5,824.3460 1712452 00HA Muskegon County CMH 61 Muskegon $70,951.16 $12,337.92 $18,668.65 $5,088.96 $489.50 $1.64 $107,537.8361 1708066 00HB Newaygo County CMH 62 Newaygo $27,403.68 $4,093.63 $6,999.24 $2,530.44 $298.41 $41,325.4062 1705289 0058 Oakland County CMHA 63 Oakland $129,589.76 $15,829.84 $33,091.63 $11,692.80 $2,727.48 $7.92 $192,939.43

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, TANF Rev by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 49 of 58

MACap - Rates: 97d - qSummary recordcode02 by CMHA by County - Pop - TANF

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

MA TANF Revenue by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

63 3220732 00HV West Michigan CMH 64 Oceana $13,689.95 $2,179.71 $3,773.07 $1,417.50 $271.20 $21,331.4364 1706830 00GC AuSable Valley CMH 65 Ogemaw $15,061.20 $2,440.80 $4,257.28 $1,317.05 $148.00 $23,224.3365 1707962 00GI Copper County CMH 66 Ontonagon $2,354.50 $237.90 $508.47 $233.52 $17.74 $3,352.1366 4344340 00GG Central Michigan CMH 67 Osceola $8,192.10 $1,353.56 $2,365.44 $639.36 $103.61 $12,654.0767 1706830 00GC AuSable Valley CMH 68 Oscoda $5,793.48 $976.32 $1,646.37 $704.90 $103.60 $9,224.6768 1707185 00HF Northern Michigan CMH 69 Otsego $6,720.60 $1,027.18 $1,788.48 $471.24 $51.59 $10,059.0969 1712425 00HI Ottawa County CMH 70 Ottawa $50,659.77 $7,666.92 $10,815.10 $2,992.92 $341.04 $2.25 $72,478.0070 1708100 00HE Northeast Michigan CMH 71 Presque Isle $3,627.91 $522.75 $753.75 $212.99 $17.88 $5,135.2871 1707158 00HC North Central CMH 72 Roscommon $10,343.28 $1,562.50 $3,693.03 $1,232.28 $136.50 $16,967.5972 1712541 00HQ Saginaw County CMH 73 Saginaw $59,813.95 $9,161.10 $17,251.52 $4,628.00 $516.88 $1.05 $91,372.5073 1708164 00HO St. Clair County CMH 74 St. Clair $112,656.72 $19,544.84 $32,186.70 $9,756.24 $1,688.43 $4.51 $175,837.4474 1708146 00HP St. Joseph County CMH 75 St. Joseph $24,299.80 $3,727.80 $6,345.10 $1,492.50 $199.92 $36,065.1275 1706849 00HM Sanilac County CMH 76 Sanilac $10,299.96 $1,517.28 $2,370.48 $803.96 $114.30 $15,105.9876 1715919 00GO Hiawatha Behavioral Health Authority 77 Schoolcraft $4,080.65 $575.40 $1,075.20 $375.00 $19.94 $6,126.1977 1712407 00HN Shiawassee County CMH 78 Shiawassee $20,153.55 $3,352.58 $5,847.75 $1,485.54 $144.80 $30,984.2278 1707130 00HS Tuscola County CMH 79 Tuscola $21,253.40 $2,869.44 $5,206.95 $1,388.40 $106.50 $30,824.6979 1705298 00HT Van Buren County CMH 80 Van Buren $37,009.08 $6,138.24 $11,115.72 $3,999.16 $642.60 $58,904.8080 1707176 00HU Washtenaw County CMH 81 Washtenaw $82,960.23 $13,075.50 $21,861.84 $6,595.32 $893.16 $9.15 $125,395.2081 3119549 00GJ Detroit-Wayne County CMH 82 Wayne $964,855.80 $119,916.30 $253,135.68 $81,320.75 $13,943.80 $54.40 $1,433,226.7382 1707158 00HC North Central CMH 83 Wexford $18,306.64 $2,981.25 $4,675.11 $1,232.28 $245.70 $27,440.9883 $0.0084 $0.0085

$3,067,437.32 $444,592.46 $812,763.45 $250,037.69 $38,708.87 $110.35 $4,613,650.14Check Values $0.00

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, TANF Rev by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 50 of 58

MACap - Rates: 97e - qSummary recordcode02 by CMHA - Rev - DD

Provider ID Agent ID Provider Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1705233 0028 Genesee County Health Dept $50,363.30 $184,208.94 $1,183,686.34 $1,184,586.48 $645,119.05 $192,659.67 $3,440,623.782 1705242 00GT Lapeer County CMH $3,385.57 $25,486.65 $186,070.15 $174,067.11 $117,221.92 $42,324.15 $548,555.553 1705251 00GM Great Lakes CMH $5,709.06 $26,853.93 $155,970.41 $175,278.88 $115,100.78 $30,874.56 $509,787.624 1705260 00GD Barry County CMH $907.74 $6,123.81 $30,103.74 $38,993.28 $24,192.00 $5,389.57 $105,710.145 1705270 00GU Lenawee County CMH $7,449.12 $36,305.01 $240,537.91 $208,750.68 $151,828.29 $37,190.02 $682,061.036 1705289 0058 Oakland County CMHA $51,969.68 $316,068.06 $2,059,636.59 $2,124,460.80 $1,431,254.60 $550,088.76 $6,533,478.497 1705298 00HT Van Buren County CMH $4,141.28 $19,130.48 $110,245.95 $129,654.72 $98,103.90 $28,183.28 $389,459.618 1705304 00GY Manistee-Benzie CMH $5,384.72 $29,005.02 $213,058.45 $242,397.00 $214,470.10 $47,761.50 $752,076.799 1705322 00GE Bay-Arenac CMH $10,558.32 $55,349.14 $399,970.44 $427,924.31 $270,129.86 $75,781.92 $1,239,713.9910 1705430 00GS Kent County CMH $43,384.08 $194,256.18 $956,622.05 $926,692.52 $533,183.04 $174,561.48 $2,828,699.3511 1706114 00HW Woodlands Behavioral Healthcare $3,738.96 $16,743.78 $102,287.64 $102,037.32 $72,384.30 $19,288.36 $316,480.3612 1706830 00GC AuSable Valley CMH $2,777.28 $14,734.20 $93,731.77 $147,975.10 $89,174.04 $19,852.67 $368,245.0613 1706849 00HM Sanilac County CMH $7,286.55 $41,079.29 $246,550.72 $337,367.25 $254,080.48 $71,229.51 $957,593.8014 1707130 00HS Tuscola County CMH $7,014.00 $35,699.60 $189,580.52 $194,848.48 $134,270.55 $31,288.50 $592,701.6515 1707158 00HC North Central CMH $5,293.20 $24,478.30 $177,317.50 $227,899.98 $142,483.80 $34,426.70 $611,899.4816 1707167 00GW Livingston County CMH $4,200.81 $40,226.84 $190,072.78 $177,199.95 $107,880.84 $22,398.12 $541,979.3417 1707176 00HU Washtenaw County CMH $14,874.95 $85,685.03 $501,390.68 $565,203.96 $305,809.79 $101,668.43 $1,574,632.8418 1707185 00HF Northern Michigan CMH $7,179.48 $39,293.76 $239,052.66 $256,401.90 $191,353.88 $48,528.20 $781,809.8819 1707962 00GI Copper County CMH $3,809.55 $23,095.68 $149,688.60 $190,636.50 $166,965.12 $61,305.27 $595,500.7220 1708001 00BJ CEI CMH $22,839.69 $110,272.50 $623,523.76 $643,977.44 $370,990.23 $101,945.35 $1,873,548.9721 1708066 00HB Newaygo County CMH $2,300.56 $11,090.00 $72,162.50 $99,284.64 $59,214.45 $14,179.00 $258,231.1522 1708100 00HE Northeast Michigan CMH $7,405.68 $41,772.28 $300,728.74 $377,949.28 $245,375.00 $69,545.63 $1,042,776.6123 1708119 00GL Gogebic County CMH $1,941.10 $8,306.76 $75,372.78 $86,952.80 $56,546.64 $23,896.53 $253,016.6124 1708128 00GP Huron Behavioral Health $1,919.61 $14,883.84 $89,089.65 $110,228.58 $84,032.76 $25,747.12 $325,901.5625 1708146 00HP St. Joseph County CMH $3,347.20 $21,410.34 $136,818.90 $139,617.18 $101,556.00 $29,776.12 $432,525.7426 1708164 00HO St. Clair County CMH $15,447.03 $87,373.37 $482,030.85 $534,086.28 $346,168.90 $76,923.45 $1,542,029.8827 1709690 00GA Allegan County CMH $6,568.49 $41,969.48 $218,286.63 $229,905.98 $177,252.17 $45,995.40 $719,978.1528 1710547 00HX Monroe County CMH $11,776.52 $53,999.96 $355,701.48 $358,979.79 $217,504.96 $57,066.12 $1,055,028.8329 1712229 00GV Lifeways CMH $15,530.35 $65,140.11 $398,257.60 $395,941.48 $263,777.28 $69,311.62 $1,207,958.4430 1712283 00GB Antrim-Kalkaska CMH $4,203.43 $20,516.30 $110,936.64 $141,351.95 $111,731.22 $29,979.20 $418,718.7431 1712372 00HL Pines Behavioral Health CMH $4,049.92 $18,534.96 $138,147.66 $128,952.96 $95,700.00 $28,964.32 $414,349.8232 1712407 00HN Shiawassee County CMH $4,781.79 $30,593.47 $147,926.40 $159,538.28 $89,059.23 $21,598.20 $453,497.3733 1712425 00HI Ottawa County CMH $12,402.72 $88,348.19 $438,129.79 $439,560.00 $253,236.27 $61,401.01 $1,293,077.98

MA DD Revenue by Provider ID by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DD Rev by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 51 of 58

34 1712452 00HA Muskegon County CMH $14,300.67 $61,901.70 $420,837.50 $474,269.40 $274,256.62 $66,384.72 $1,311,950.6135 1712461 00GZ Montcalm Center Behavl. Hlt $2,463.30 $9,891.21 $59,385.48 $66,783.29 $42,628.96 $10,079.54 $191,231.7836 1712541 00HQ Saginaw County CMH $18,050.40 $76,833.50 $425,094.54 $427,658.85 $227,163.90 $74,655.75 $1,249,456.9437 1715919 00GO Hiawatha Behavioral Health Authority $3,555.60 $18,090.55 $129,665.95 $169,562.90 $118,824.23 $32,382.28 $472,081.5138 1715928 00GQ Ionia County CMH $4,060.16 $28,204.36 $149,338.06 $140,748.27 $107,595.63 $24,142.40 $454,088.8839 1715955 00GN Gratiot County CMH $4,851.00 $25,161.50 $144,797.64 $151,766.38 $107,648.64 $32,170.32 $466,395.4840 1716175 00GF Berrien Mental Health $17,666.84 $61,454.25 $347,602.32 $398,855.60 $266,075.10 $86,996.25 $1,178,650.3641 1724945 00HJ Pathways CMH $10,668.07 $72,145.04 $415,041.93 $494,091.92 $328,856.16 $96,436.01 $1,417,239.1342 2920843 00HR Summit Pointe CMH $6,899.10 $30,453.75 $193,495.45 $207,744.00 $132,077.37 $37,070.88 $607,740.5543 3119549 00GJ Detroit-Wayne County CMH $210,309.48 $733,821.66 $4,807,611.21 $5,588,498.50 $3,633,796.92 $1,227,963.84 $16,202,001.6144 3140186 00HG Northpointe CMH $4,775.45 $23,249.19 $135,464.52 $177,255.26 $135,985.66 $44,440.81 $521,170.8945 3220732 00HV West Michigan CMH $4,327.88 $22,370.20 $128,535.00 $150,149.86 $112,630.83 $29,685.12 $447,698.8946 3396315 00GX Macomb County CA $36,798.72 $210,482.25 $1,356,572.42 $1,512,555.00 $1,020,529.51 $340,226.60 $4,477,164.5047 3402136 00GR Kalamazoo County CMH $20,028.28 $91,849.64 $554,763.96 $632,820.88 $373,588.45 $113,873.25 $1,786,924.4648 4344340 00GG Central Michigan CMH $29,750.10 $155,498.20 $952,862.56 $988,751.40 $682,815.00 $168,233.56 $2,977,910.8249

50

State Subtotals $742,446.79 $3,449,442.26 $21,233,756.82 $23,260,214.37 $15,101,624.43 $4,635,871.07 $68,423,355.74

Check Values $0.00

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DD Rev by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 52 of 58

MACap - Rates: 97f - qSummary recordcode02 by CA by County - Rev - DD

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1708100 00HE Northeast Michigan CMH 01 Alcona $1,171.52 $2,704.68 $33,500.87 $44,841.44 $41,843.75 $13,063.82 $137,126.082 1724945 00HJ Pathways CMH 02 Alger $871.71 $2,384.96 $31,688.49 $34,157.48 $29,419.73 $11,435.10 $109,957.473 1709690 00GA Allegan County CMH 03 Allegan $6,568.49 $41,969.48 $218,286.63 $229,905.98 $177,252.17 $45,995.40 $719,978.154 1708100 00HE Northeast Michigan CMH 04 Alpena $3,974.80 $26,145.24 $169,062.53 $209,793.88 $112,125.00 $30,738.40 $551,839.855 1712283 00GB Antrim-Kalkaska CMH 05 Antrim $1,836.45 $12,016.69 $57,747.84 $73,409.30 $49,130.04 $10,867.46 $205,007.786 1705322 00GE Bay-Arenac CMH 06 Arenac $1,425.98 $8,062.67 $58,752.72 $65,611.19 $50,078.60 $14,487.72 $198,418.887 1707962 00GI Copper County CMH 07 Baraga $419.40 $2,510.40 $19,524.60 $25,418.20 $28,166.88 $11,233.95 $87,273.438 1705260 00GD Barry County CMH 08 Barry $907.74 $6,123.81 $30,103.74 $38,993.28 $24,192.00 $5,389.57 $105,710.149 1705322 00GE Bay-Arenac CMH 09 Bay $9,132.34 $47,286.47 $341,217.72 $362,313.12 $220,051.26 $61,294.20 $1,041,295.1110 1705304 00GY Manistee-Benzie CMH 10 Benzie $2,202.84 $10,547.28 $71,779.05 $74,944.00 $66,539.20 $21,914.10 $247,926.4711 1716175 00GF Berrien Mental Health 11 Berrien $17,666.84 $61,454.25 $347,602.32 $398,855.60 $266,075.10 $86,996.25 $1,178,650.3612 1712372 00HL Pines Behavioral Health CMH 12 Branch $4,049.92 $18,534.96 $138,147.66 $128,952.96 $95,700.00 $28,964.32 $414,349.8213 2920843 00HR Summit Pointe CMH 13 Calhoun $6,899.10 $30,453.75 $193,495.45 $207,744.00 $132,077.37 $37,070.88 $607,740.5514 1706114 00HW Woodlands Behavioral Healthcare 14 Cass $3,738.96 $16,743.78 $102,287.64 $102,037.32 $72,384.30 $19,288.36 $316,480.3615 1707185 00HF Northern Michigan CMH 15 Charlevoix $1,647.24 $8,260.62 $54,409.08 $49,376.70 $46,178.46 $11,132.94 $171,005.0416 1707185 00HF Northern Michigan CMH 16 Cheboygan $2,082.36 $11,832.78 $72,352.50 $76,742.10 $58,553.08 $14,273.00 $235,835.8217 1715919 00GO Hiawatha Behavioral Health Authority 17 Chippewa $2,162.99 $14,046.78 $76,144.26 $109,450.30 $70,488.95 $19,864.76 $292,158.0418 4344340 00GG Central Michigan CMH 18 Clare $5,488.25 $22,835.40 $167,032.86 $210,788.76 $133,770.00 $30,240.33 $570,155.6019 1708001 00BJ CEI CMH 19 Clinton $1,562.62 $7,830.00 $54,807.84 $55,635.20 $25,403.04 $7,174.55 $152,413.2520 1707158 00HC North Central CMH 20 Crawford $1,102.75 $3,599.75 $26,877.60 $41,820.03 $19,465.00 $6,259.40 $99,124.5321 1724945 00HJ Pathways CMH 21 Delta $3,486.84 $26,234.56 $139,893.09 $169,993.04 $108,006.68 $31,255.94 $478,870.1522 3140186 00HG Northpointe CMH 22 Dickinson $2,083.25 $9,898.17 $57,288.96 $77,894.18 $45,121.10 $13,243.95 $205,529.6123 1708001 00BJ CEI CMH 23 Eaton $3,906.55 $16,182.00 $99,466.08 $85,191.40 $56,980.43 $12,180.05 $273,906.5124 1707185 00HF Northern Michigan CMH 24 Emmet $1,460.76 $9,153.66 $61,933.74 $69,603.30 $51,913.04 $13,702.08 $207,766.5825 1705233 0028 Genesee County Health Dept 25 Genesee $50,363.30 $184,208.94 $1,183,686.34 $1,184,586.48 $645,119.05 $192,659.67 $3,440,623.7826 4344340 00GG Central Michigan CMH 26 Gladwin $2,649.50 $14,408.05 $109,240.90 $121,692.48 $91,140.00 $20,160.22 $359,291.1527 1708119 00GL Gogebic County CMH 27 Gogebic $1,941.10 $8,306.76 $75,372.78 $86,952.80 $56,546.64 $23,896.53 $253,016.6128 1705251 00GM Great Lakes CMH 28 Grand Traverse $4,636.80 $22,898.70 $137,620.95 $154,755.72 $100,466.94 $26,349.84 $446,728.9529 1715955 00GN Gratiot County CMH 29 Gratiot $4,851.00 $25,161.50 $144,797.64 $151,766.38 $107,648.64 $32,170.32 $466,395.4830 1712229 00GV Lifeways CMH 30 Hillsdale $3,332.34 $14,918.71 $81,949.16 $79,896.74 $64,896.00 $18,886.00 $263,878.9531 1707962 00GI Copper County CMH 31 Houghton $2,516.40 $16,819.68 $100,226.28 $123,746.50 $107,237.76 $35,948.64 $386,495.26

MA DD Revenue by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DD Rev by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 53 of 58

MACap - Rates: 97f - qSummary recordcode02 by CA by County - Rev - DD

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

MA DD Revenue by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

32 1708128 00GP Huron Behavioral Health 32 Huron $1,919.61 $14,883.84 $89,089.65 $110,228.58 $84,032.76 $25,747.12 $325,901.5633 1708001 00BJ CEI CMH 33 Ingham $17,370.52 $86,260.50 $469,249.84 $503,150.84 $288,606.76 $82,590.75 $1,447,229.2134 1715928 00GQ Ionia County CMH 34 Ionia $4,060.16 $28,204.36 $149,338.06 $140,748.27 $107,595.63 $24,142.40 $454,088.8835 1706830 00GC AuSable Valley CMH 35 Iosco $1,309.74 $5,667.00 $43,486.84 $54,056.21 $36,159.92 $7,535.32 $148,215.0336 3140186 00HG Northpointe CMH 36 Iron $1,153.80 $5,524.56 $31,031.52 $42,320.46 $41,386.94 $11,772.40 $133,189.6837 4344340 00GG Central Michigan CMH 37 Isabella $7,040.10 $35,068.65 $201,567.08 $164,429.72 $118,702.50 $33,368.64 $560,176.6938 1712229 00GV Lifeways CMH 38 Jackson $12,198.01 $50,221.40 $316,308.44 $316,044.74 $198,881.28 $50,425.62 $944,079.4939 3402136 00GR Kalamazoo County CMH 39 Kalamazoo $20,028.28 $91,849.64 $554,763.96 $632,820.88 $373,588.45 $113,873.25 $1,786,924.4640 1712283 00GB Antrim-Kalkaska CMH 40 Kalkaska $2,366.98 $8,499.61 $53,188.80 $67,942.65 $62,601.18 $19,111.74 $213,710.9641 1705430 00GS Kent County CMH 41 Kent $43,384.08 $194,256.18 $956,622.05 $926,692.52 $533,183.04 $174,561.48 $2,828,699.3542 1707962 00GI Copper County CMH 42 Keweenaw $244.65 $251.04 $5,206.56 $6,689.00 $7,126.56 $2,888.73 $22,406.5443 3220732 00HV West Michigan CMH 43 Lake $1,027.24 $5,683.24 $34,171.50 $52,520.23 $34,655.64 $9,740.43 $137,798.2844 1705242 00GT Lapeer County CMH 44 Lapeer $3,385.57 $25,486.65 $186,070.15 $174,067.11 $117,221.92 $42,324.15 $548,555.5545 1705251 00GM Great Lakes CMH 45 Leelanau $1,072.26 $3,955.23 $18,349.46 $20,523.16 $14,633.84 $4,524.72 $63,058.6746 1705270 00GU Lenawee County CMH 46 Lenawee $7,449.12 $36,305.01 $240,537.91 $208,750.68 $151,828.29 $37,190.02 $682,061.0347 1707167 00GW Livingston County CMH 47 Livingston $4,200.81 $40,226.84 $190,072.78 $177,199.95 $107,880.84 $22,398.12 $541,979.3448 1724945 00HJ Pathways CMH 48 Luce $1,618.89 $6,558.64 $34,007.16 $50,839.04 $38,688.96 $19,058.50 $150,771.1949 1715919 00GO Hiawatha Behavioral Health Authority 49 Mackinac $681.49 $1,064.15 $18,760.18 $29,489.20 $18,125.73 $4,081.80 $72,202.5550 3396315 00GX Macomb County CA 50 Macomb $36,798.72 $210,482.25 $1,356,572.42 $1,512,555.00 $1,020,529.51 $340,226.60 $4,477,164.5051 1705304 00GY Manistee-Benzie CMH 51 Manistee $3,181.88 $18,457.74 $141,279.40 $167,453.00 $147,930.90 $25,847.40 $504,150.3252 1724945 00HJ Pathways CMH 52 Marquette $4,690.63 $36,966.88 $209,453.19 $239,102.36 $152,740.79 $34,686.47 $677,640.3253 3220732 00HV West Michigan CMH 53 Mason $1,549.28 $9,069.00 $46,711.50 $42,209.51 $32,530.53 $8,348.94 $140,418.7654 4344340 00GG Central Michigan CMH 54 Mecosta $5,563.95 $26,369.45 $147,299.02 $157,186.12 $102,532.50 $28,849.97 $467,801.0155 3140186 00HG Northpointe CMH 55 Menominee $1,538.40 $7,826.46 $47,144.04 $57,040.62 $49,477.62 $19,424.46 $182,451.6056 4344340 00GG Central Michigan CMH 56 Midland $5,980.30 $39,961.95 $229,053.50 $236,141.36 $152,512.50 $28,849.97 $692,499.5857 1707158 00HC North Central CMH 57 Missaukee $0.0058 1710547 00HX Monroe County CMH 58 Monroe $11,776.52 $53,999.96 $355,701.48 $358,979.79 $217,504.96 $57,066.12 $1,055,028.8359 1712461 00GZ Montcalm Center Behavl. Hlt 59 Montcalm $2,463.30 $9,891.21 $59,385.48 $66,783.29 $42,628.96 $10,079.54 $191,231.7860 1708100 00HE Northeast Michigan CMH 60 Montmorency $1,129.68 $6,310.92 $35,059.05 $60,055.50 $47,937.50 $14,600.74 $165,093.3961 1712452 00HA Muskegon County CMH 61 Muskegon $14,300.67 $61,901.70 $420,837.50 $474,269.40 $274,256.62 $66,384.72 $1,311,950.6162 1708066 00HB Newaygo County CMH 62 Newaygo $2,300.56 $11,090.00 $72,162.50 $99,284.64 $59,214.45 $14,179.00 $258,231.15

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DD Rev by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 54 of 58

MACap - Rates: 97f - qSummary recordcode02 by CA by County - Rev - DD

Provider ID Agent ID Provider Name Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

MA DD Revenue by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

63 1705289 0058 Oakland County CMHA 63 Oakland $51,969.68 $316,068.06 $2,059,636.59 $2,124,460.80 $1,431,254.60 $550,088.76 $6,533,478.4964 3220732 00HV West Michigan CMH 64 Oceana $1,751.36 $7,617.96 $47,652.00 $55,420.12 $45,444.66 $11,595.75 $169,481.8565 1706830 00GC AuSable Valley CMH 65 Ogemaw $899.46 $7,593.78 $33,790.45 $65,229.84 $38,151.78 $9,419.15 $155,084.4666 1707962 00GI Copper County CMH 66 Ontonagon $629.10 $3,514.56 $24,731.16 $34,782.80 $24,433.92 $11,233.95 $99,325.4967 4344340 00GG Central Michigan CMH 67 Osceola $3,028.00 $16,854.70 $98,669.20 $98,512.96 $84,157.50 $26,764.43 $327,986.7968 1706830 00GC AuSable Valley CMH 68 Oscoda $568.08 $1,473.42 $16,454.48 $28,689.05 $14,862.34 $2,898.20 $64,945.5769 1707185 00HF Northern Michigan CMH 69 Otsego $1,989.12 $10,046.70 $50,357.34 $60,679.80 $34,709.30 $9,420.18 $167,202.4470 1712425 00HI Ottawa County CMH 70 Ottawa $12,402.72 $88,348.19 $438,129.79 $439,560.00 $253,236.27 $61,401.01 $1,293,077.9871 1708100 00HE Northeast Michigan CMH 71 Presque Isle $1,129.68 $6,611.44 $63,106.29 $63,258.46 $43,468.75 $11,142.67 $188,717.2972 1707158 00HC North Central CMH 72 Roscommon $1,664.15 $7,631.47 $61,221.20 $75,582.99 $48,857.15 $10,309.60 $205,266.5673 1712541 00HQ Saginaw County CMH 73 Saginaw $18,050.40 $76,833.50 $425,094.54 $427,658.85 $227,163.90 $74,655.75 $1,249,456.9474 1708164 00HO St. Clair County CMH 74 St. Clair $15,447.03 $87,373.37 $482,030.85 $534,086.28 $346,168.90 $76,923.45 $1,542,029.8875 1708146 00HP St. Joseph County CMH 75 St. Joseph $3,347.20 $21,410.34 $136,818.90 $139,617.18 $101,556.00 $29,776.12 $432,525.7476 1706849 00HM Sanilac County CMH 76 Sanilac $7,286.55 $41,079.29 $246,550.72 $337,367.25 $254,080.48 $71,229.51 $957,593.8077 1715919 00GO Hiawatha Behavioral Health Authority 77 Schoolcraft $711.12 $2,979.62 $34,761.51 $30,623.40 $30,209.55 $8,435.72 $107,720.9278 1712407 00HN Shiawassee County CMH 78 Shiawassee $4,781.79 $30,593.47 $147,926.40 $159,538.28 $89,059.23 $21,598.20 $453,497.3779 1707130 00HS Tuscola County CMH 79 Tuscola $7,014.00 $35,699.60 $189,580.52 $194,848.48 $134,270.55 $31,288.50 $592,701.6580 1705298 00HT Van Buren County CMH 80 Van Buren $4,141.28 $19,130.48 $110,245.95 $129,654.72 $98,103.90 $28,183.28 $389,459.6181 1707176 00HU Washtenaw County CMH 81 Washtenaw $14,874.95 $85,685.03 $501,390.68 $565,203.96 $305,809.79 $101,668.43 $1,574,632.8482 3119549 00GJ Detroit-Wayne County CMH 82 Wayne $210,309.48 $733,821.66 $4,807,611.21 $5,588,498.50 $3,633,796.92 $1,227,963.84 $16,202,001.6183 1707158 00HC North Central CMH 83 Wexford $2,526.30 $13,247.08 $89,218.70 $110,496.96 $74,161.65 $17,857.70 $307,508.3984 $0.0085

$742,446.79 $3,449,442.26 $21,233,756.82 $23,260,214.37 $15,101,624.43 $4,635,871.07 $68,423,355.74Check Values $0.00

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, DD Rev by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 55 of 58

MACap - Rates: 97g - qSummary recordcode02 by CMHA - Rev - SA

Provider ID Agent ID CA_ProviderName 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 1705233 00HZ Genesee County Health Dept $5,780.12 $8,027.10 $54,951.31 $48,205.55 $11,727.34 $481.04 129,172.46$ 2 1705289 00IF Oakland County Health Div $5,933.97 $8,037.12 $55,616.08 $52,036.77 $15,522.97 $1,232.56 138,379.47$ 3 1705430 00ID Mink Substance Abuse Coordinating Agency $7,163.31 $10,317.35 $56,558.52 $45,456.72 $11,568.83 $665.94 131,730.67$ 4 1707176 00HU Washtenaw County CMH $1,851.24 $3,003.59 $17,494.23 $17,890.19 $4,640.46 $286.02 45,165.73$ 5 1707962 00IL Western U.P. SAS $1,220.55 $1,842.05 $9,920.37 $9,353.74 $2,745.12 $266.20 25,348.03$ 6 1708001 00IC Mid-South CA $7,308.44 $10,273.64 $60,356.43 $51,772.01 $14,527.06 $754.47 144,992.05$ 7 1708164 00II St. Clair County Health Dept. CA $2,296.35 $3,372.76 $19,086.76 $17,076.00 $4,957.36 $284.85 47,074.08$ 8 1710547 00IH Southeast MI Community Alliance $10,762.43 $13,144.45 $94,324.77 $102,331.80 $30,299.46 $1,541.76 252,404.67$ 9 1712452 00IB Lakeshore CA $6,343.05 $9,400.96 $54,136.21 $49,060.78 $14,173.08 $838.75 133,952.83$ 10 1712541 00IG Saginaw County Health Dept $4,581.68 $7,766.64 $50,875.58 $50,573.03 $13,527.89 $696.36 128,021.18$ 11 1724945 00HY Eastern U.P. Substance Abuse $1,383.27 $2,375.18 $12,692.17 $11,361.72 $3,218.46 $250.11 31,280.91$ 12 3119549 00XO Detroit Health Department $29,320.42 $32,325.09 $232,412.65 $255,811.46 $80,440.98 $3,374.21 633,684.81$ 13 3396315 00GX Macomb County CA $4,502.55 $6,283.84 $42,349.63 $41,500.35 $11,506.55 $830.62 106,973.54$ 14 3402136 00GR Kalamazoo County CMH $3,788.52 $5,706.03 $32,660.66 $26,165.04 $6,780.06 $371.36 75,471.67$ 15 4344340 00IE Northern Michigan CA $6,072.68 $9,379.23 $54,253.42 $49,884.82 $14,328.92 $754.80 134,673.87$ 16 -$

State Subtotals 98,308.58$ 131,255.03$ 847,688.79$ 828,479.98$ 239,964.54$ 12,629.05$ 2,158,325.97$

Check Values -$

MA SA Revenue by Provider ID by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, SA Rev by Provider

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 56 of 58

MACap - Rates: 96h - qSummary recordcode02 by CA by County - Pop - SA

Provider ID Agent ID CA_ProviderName Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

1 4344340 00IE Northern Michigan CA 01 Alcona $74.10 $92.36 $744.12 $683.93 $227.85 $13.12 $1,835.482 1724945 00HY Eastern U.P. Substance Abuse 02 Alger $52.28 $81.91 $600.66 $504.73 $172.96 $16.02 $1,428.563 1712452 00IB Lakeshore CA 03 Allegan $596.47 $856.48 $4,513.03 $4,081.16 $1,418.22 $88.99 $11,554.354 4344340 00IE Northern Michigan CA 04 Alpena $220.36 $429.37 $2,559.42 $2,770.02 $627.33 $35.12 $6,641.625 4344340 00IE Northern Michigan CA 05 Antrim $150.34 $193.84 $842.59 $944.00 $281.48 $18.72 $2,430.976 4344340 00IE Northern Michigan CA 06 Arenac $136.38 $217.74 $1,395.59 $1,295.84 $392.63 $20.40 $3,458.587 1707962 00IL Western U.P. SAS 07 Baraga $102.60 $146.49 $702.61 $535.14 $259.03 $17.71 $1,763.588 3402136 00GR Kalamazoo County CMH 08 Barry $362.76 $636.45 $3,173.74 $2,880.12 $680.76 $40.04 $7,773.879 1712541 00IG Saginaw County Health Dept 09 Bay $1,013.04 $1,911.69 $13,668.22 $14,072.28 $4,125.58 $240.03 $35,030.8410 4344340 00IE Northern Michigan CA 10 Benzie $102.24 $126.80 $740.96 $648.97 $247.29 $15.04 $1,881.3011 1712452 00IB Lakeshore CA 11 Berrien $1,793.05 $2,467.58 $14,459.13 $12,704.28 $3,905.57 $228.91 $35,558.5212 3402136 00GR Kalamazoo County CMH 12 Branch $452.16 $612.48 $3,975.94 $2,726.59 $802.74 $47.74 $8,617.6513 1708001 00IC Mid-South CA 13 Calhoun $1,284.18 $1,824.57 $11,048.51 $10,181.24 $2,969.44 $139.05 $27,446.9914 1712452 00IB Lakeshore CA 14 Cass $432.78 $621.66 $4,005.99 $3,166.10 $921.46 $57.53 $9,205.5215 4344340 00IE Northern Michigan CA 15 Charlevoix $163.58 $205.30 $1,110.58 $842.69 $341.22 $22.08 $2,685.4516 4344340 00IE Northern Michigan CA 16 Cheboygan $230.64 $308.44 $1,829.94 $1,406.05 $431.94 $29.44 $4,236.4517 1724945 00HY Eastern U.P. Substance Abuse 17 Chippewa $305.89 $444.94 $2,281.42 $2,168.35 $568.85 $34.92 $5,804.3718 4344340 00IE Northern Michigan CA 18 Clare $297.94 $496.15 $3,242.26 $3,104.54 $811.67 $31.36 $7,983.9219 1708001 00IC Mid-South CA 19 Clinton $256.42 $306.78 $1,946.11 $1,712.01 $357.38 $25.83 $4,604.5320 4344340 00IE Northern Michigan CA 20 Crawford $128.42 $162.84 $1,007.04 $1,136.75 $234.27 $12.64 $2,681.9621 1724945 00HY Eastern U.P. Substance Abuse 21 Delta $282.78 $498.68 $2,621.08 $2,512.55 $629.82 $53.19 $6,598.1022 1707962 00IL Western U.P. SAS 22 Dickinson $270.00 $419.58 $2,162.98 $1,970.33 $447.45 $47.63 $5,317.9723 1708001 00IC Mid-South CA 23 Eaton $479.16 $656.17 $3,923.63 $2,892.51 $836.74 $52.11 $8,840.3224 4344340 00IE Northern Michigan CA 24 Emmet $158.44 $258.66 $1,200.45 $1,241.46 $378.68 $32.08 $3,269.7725 1705233 00HZ Genesee County Health Dept 25 Genesee $5,780.12 $8,027.10 $54,951.31 $48,205.55 $11,727.34 $481.04 $129,172.4626 4344340 00IE Northern Michigan CA 26 Gladwin $209.12 $288.42 $1,870.28 $1,754.00 $560.74 $26.56 $4,709.1227 1707962 00IL Western U.P. SAS 27 Gogebic $220.20 $334.65 $1,894.28 $1,778.96 $427.08 $50.16 $4,705.3328 4344340 00IE Northern Michigan CA 28 Grand Traverse $414.10 $540.74 $2,939.65 $2,937.36 $807.29 $50.40 $7,689.5429 1708001 00IC Mid-South CA 29 Gratiot $267.66 $440.87 $2,526.85 $2,242.26 $703.40 $52.56 $6,233.6030 1708001 00IC Mid-South CA 30 Hillsdale $326.76 $488.95 $2,697.35 $2,215.95 $816.94 $40.68 $6,586.6331 1707962 00IL Western U.P. SAS 31 Houghton $380.55 $575.53 $3,082.94 $2,965.58 $949.74 $75.46 $8,029.80

MA SA Population by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, SA Rev by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 57 of 58

MACap - Rates: 96h - qSummary recordcode02 by CA by County - Pop - SA

Provider ID Agent ID CA_ProviderName Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

MA SA Population by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

32 1708164 00II St. Clair County Health Dept. CA 32 Huron $211.74 $347.33 $1,946.00 $2,045.23 $657.26 $45.09 $5,252.6533 1708001 00IC Mid-South CA 33 Ingham $2,349.40 $3,266.33 $18,912.57 $16,196.56 $4,195.92 $202.14 $45,122.9234 1705430 00ID Mink Substance Abuse Coordinating Agency 34 Ionia $457.91 $788.55 $4,023.02 $3,045.12 $971.38 $44.55 $9,330.5335 4344340 00IE Northern Michigan CA 35 Iosco $215.40 $308.86 $1,986.83 $2,010.84 $536.98 $29.52 $5,088.4336 1707962 00IL Western U.P. SAS 36 Iron $141.15 $231.12 $1,212.67 $1,168.59 $384.38 $46.09 $3,184.0037 4344340 00IE Northern Michigan CA 37 Isabella $338.70 $655.11 $3,533.57 $2,517.07 $724.90 $32.48 $7,801.8338 1708001 00IC Mid-South CA 38 Jackson $1,317.68 $1,671.00 $9,925.33 $8,640.50 $2,475.13 $119.61 $24,149.2539 3402136 00GR Kalamazoo County CMH 39 Kalamazoo $2,249.52 $3,439.33 $19,654.58 $16,456.71 $4,109.04 $219.78 $46,128.9640 4344340 00IE Northern Michigan CA 40 Kalkaska $148.24 $182.86 $1,069.76 $988.67 $353.81 $17.60 $2,760.9441 1705430 00ID Mink Substance Abuse Coordinating Agency 41 Kent $5,582.13 $7,954.04 $43,413.55 $33,530.76 $8,227.65 $499.84 $99,207.9742 1707962 00IL Western U.P. SAS 42 Keweenaw $24.30 $31.15 $168.62 $150.46 $66.30 $7.04 $447.8743 4344340 00IE Northern Michigan CA 43 Lake $132.04 $198.84 $1,368.34 $1,620.32 $480.14 $19.36 $3,819.0444 1708164 00II St. Clair County Health Dept. CA 44 Lapeer $346.15 $492.62 $3,174.50 $2,500.86 $689.83 $47.52 $7,251.4845 4344340 00IE Northern Michigan CA 45 Leelanau $89.58 $108.23 $567.34 $477.91 $124.85 $9.92 $1,377.8346 1708001 00IC Mid-South CA 46 Lenawee $582.32 $852.82 $5,180.23 $4,144.43 $1,303.19 $68.76 $12,131.7547 1707176 00HU Washtenaw County CMH 47 Livingston $406.60 $668.29 $3,559.97 $3,305.81 $891.40 $61.18 $8,893.2548 1724945 00HY Eastern U.P. Substance Abuse 48 Luce $83.24 $120.82 $798.30 $654.16 $219.37 $15.39 $1,891.2849 1724945 00HY Eastern U.P. Substance Abuse 49 Mackinac $70.86 $91.94 $516.50 $578.81 $144.57 $13.50 $1,416.1850 3396315 00GX Macomb County CA 50 Macomb $4,502.55 $6,283.84 $42,349.63 $41,500.35 $11,506.55 $830.62 $106,973.5451 4344340 00IE Northern Michigan CA 51 Manistee $168.00 $259.55 $1,531.16 $1,517.07 $565.43 $26.80 $4,068.0152 1724945 00HY Eastern U.P. Substance Abuse 52 Marquette $355.75 $725.69 $3,771.52 $3,207.02 $878.00 $64.26 $9,002.2453 4344340 00IE Northern Michigan CA 53 Mason $229.46 $377.90 $2,026.89 $1,538.76 $451.32 $28.16 $4,652.4954 4344340 00IE Northern Michigan CA 54 Mecosta $317.86 $618.86 $3,089.96 $2,391.16 $633.81 $32.08 $7,083.7355 1724945 00HY Eastern U.P. Substance Abuse 55 Menominee $151.90 $280.82 $1,280.00 $1,094.64 $369.91 $33.93 $3,211.2056 4344340 00IE Northern Michigan CA 56 Midland $471.64 $673.66 $4,135.52 $3,382.09 $950.53 $44.88 $9,658.3257 4344340 00IE Northern Michigan CA 57 Missaukee $16.10 $16.1058 1710547 00IH Southeast MI Community Alliance 58 Monroe $853.89 $1,280.40 $8,600.46 $8,163.90 $2,407.88 $139.52 $21,446.0559 1705430 00ID Mink Substance Abuse Coordinating Agency 59 Montcalm $603.27 $845.36 $4,874.44 $4,329.00 $1,224.37 $61.93 $11,938.3760 4344340 00IE Northern Michigan CA 60 Montmorency $78.44 $136.60 $632.83 $822.30 $265.99 $15.04 $1,951.2061 1712452 00IB Lakeshore CA 61 Muskegon $1,876.45 $2,921.31 $17,521.41 $16,914.14 $4,479.42 $218.57 $43,931.3062 1705430 00ID Mink Substance Abuse Coordinating Agency 62 Newaygo $520.00 $729.40 $4,247.51 $4,551.84 $1,145.43 $59.62 $11,253.80

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, SA Rev by County

MDCH - Monthly Medicaid Capitation Audit/Summary 2/12/02 6:35 AM Page 58 of 58

MACap - Rates: 96h - qSummary recordcode02 by CA by County - Pop - SA

Provider ID Agent ID CA_ProviderName Co ID County Name 0 - 17 18 - 25 26 - 39 40 - 49 50 - 64 65+ Total

MA SA Population by Provider ID by County by Age Group 12-Feb-2002 06:322001-12

Capitation Revenue by Age Group

63 1705289 00IF Oakland County Health Div 63 Oakland $5,933.97 $8,037.12 $55,616.08 $52,036.77 $15,522.97 $1,232.56 $138,379.4764 4344340 00IE Northern Michigan CA 64 Oceana $271.58 $419.76 $2,419.75 $2,132.71 $656.34 $24.00 $5,924.1465 4344340 00IE Northern Michigan CA 65 Ogemaw $185.60 $337.31 $1,741.79 $2,165.39 $557.90 $30.08 $5,018.0766 1707962 00IL Western U.P. SAS 66 Ontonagon $81.75 $103.53 $696.27 $784.68 $211.14 $22.11 $1,899.4867 4344340 00IE Northern Michigan CA 67 Osceola $207.04 $335.15 $1,918.28 $1,480.01 $524.39 $20.80 $4,485.6768 4344340 00IE Northern Michigan CA 68 Oscoda $74.08 $114.69 $741.44 $994.98 $222.05 $12.00 $2,159.2469 4344340 00IE Northern Michigan CA 69 Otsego $171.62 $249.93 $1,414.62 $1,138.37 $260.93 $13.44 $3,248.9170 1712452 00IB Lakeshore CA 70 Ottawa $872.85 $1,310.41 $6,736.79 $5,712.62 $1,445.21 $124.74 $16,202.6271 4344340 00IE Northern Michigan CA 71 Presque Isle $80.90 $136.42 $805.11 $751.25 $234.70 $17.28 $2,025.6672 4344340 00IE Northern Michigan CA 72 Roscommon $216.52 $335.95 $2,462.58 $2,226.41 $571.17 $28.24 $5,840.8773 1712541 00IG Saginaw County Health Dept 73 Saginaw $3,568.64 $5,854.95 $37,207.36 $36,500.75 $9,402.31 $456.33 $92,990.3474 1708164 00II St. Clair County Health Dept. CA 74 St. Clair $1,025.60 $1,508.60 $8,351.56 $7,381.49 $2,036.04 $101.70 $20,404.9975 3402136 00GR Kalamazoo County CMH 75 St. Joseph $724.08 $1,017.77 $5,856.40 $4,101.62 $1,187.52 $63.80 $12,951.1976 1708164 00II St. Clair County Health Dept. CA 76 Sanilac $286.10 $437.39 $2,346.82 $2,437.46 $781.38 $46.26 $6,335.4177 1724945 00HY Eastern U.P. Substance Abuse 77 Schoolcraft $80.57 $130.38 $822.69 $641.46 $234.98 $18.90 $1,928.9878 1708001 00IC Mid-South CA 78 Shiawassee $444.86 $766.15 $4,195.85 $3,546.55 $868.92 $53.73 $9,876.0679 1708164 00II St. Clair County Health Dept. CA 79 Tuscola $426.76 $586.82 $3,267.88 $2,710.96 $792.85 $44.28 $7,829.5580 1712452 00IB Lakeshore CA 80 Van Buren $771.45 $1,223.52 $6,899.86 $6,482.48 $2,003.20 $120.01 $17,500.5281 1707176 00HU Washtenaw County CMH 81 Washtenaw $1,444.64 $2,335.30 $13,934.26 $14,584.38 $3,749.06 $224.84 $36,272.4882 1710547 00IH Southeast MI Community Alliance 82 Wayne $9,908.54 $11,864.05 $85,724.31 $94,167.90 $27,891.58 $1,402.24 $230,958.6283 3119549 00XO Detroit Health Department 82 Wayne $29,320.42 $32,325.09 $232,412.65 $255,811.46 $80,440.98 $3,374.21 $633,684.8184 4344340 00IE Northern Michigan CA 83 Wexford $374.22 $608.89 $3,324.77 $2,963.90 $871.29 $46.16 $8,189.2385

$98,308.58 $131,255.03 $847,688.79 $828,479.98 $239,964.54 $12,629.05 $2,158,325.97Check Values $0.00

Dale K. Howe - Confidential MACap State - 2001-12 - Final.XLS, SA Rev by County