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["Program Name",null,null,null,null,"Provider ID",null,{"$f":"VLOOKUP(D1,List!A2:C145,2,FALSE)","v":{"$error":"#N/A"}},null,null,null,"FOR PROVIDER USE ONLY\nDO NOT SUBMIT WITH COST REPORT",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ANNUAL SERVICES\n PAID BY PROGRAM TYPE",null,null,null,{"$f":"IF(AN1=\"\",\"\",AH2+AI2+AJ2)","v":""},null,null,"PROFESSIONAL SERVICES",null,null,null,"Professional Svs Paid Calculation",{"$f":"SUM(AV4:AV284)","v":0}]
["Report Period",null,null,"2019-01-01",null,"2019-12-31",null,null,null,{"$f":"IF($AN$1=\"\",SUM(J4:J283),SUMIF($E$4:$E$283,$AN$1,J4:J283))","v":0},{"$f":"IF($AN$1=\"\",SUM(K4:K283),SUMIF($E$4:$E$283,$AN$1,K4:K283))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Annual Totals",{"$f":"IF($AN$1=\"\",SUM(AH4:AH283),SUMIF($E$4:$E$283,$AN$1,AH4:AH283))","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0]
["Client Name (b) ","House or Cluster","Client P1 ID (c)","P1 Service Code/RAC (w)","Program Type","Rate Effective Date (d)","Actual Start Date (Overrides Rate Effective Date)","Rate End Date","Actual End Date (Overrides Rate End Date)","Resid Days Paid","Client Count","ISS Tier Level (e)","ISS Daily Tier Rate (f)","Prof Svs Hrs PCD 1 (g)","Prof Svs Hrly Rate 1 (h)","Prof Svs Hrs PCD 2 (i)","Prof Svs Hrly Rate 2 (j)","Prof Svs Hrs PCD 3","Prof Svs Hrly Rate 3","Prof Svs Hrs PCD 4","Prof Svs Hrly Rate 4","ISS Prof Svs Daily Rate","ISS CRST Tier Rate (l)","ISS Hold Harmless Rate (m)","Total ISS Daily Rate","Admin Tier Rate (o)","Admin Hold Harmless (p)","Admin CRST Tier Rate (q)","Admin Cert Rate (r)","Transportation Rate (s)","Other Non-ISS Rates (t)","Total Non-ISS Daily Rate","Total ISS & Non-ISS Daily Rate","Annual ISS Paid","Annual ISS CRST Paid","Annual ISS Hold Harmless Paid","Annual ISS Prof Svs Paid","Total Annual ISS Paid","Annual Admin Paid","Annual Admin Hold Harmless Paid","Annual Admin CRST Paid","Annual Admin Cert Paid","Annual Transportation Paid","Annual Other Non-ISS Paid","Total Annual Non-ISS Paid","Annual ISS & Non-ISS Paid","Total ISS & Non-ISS Paid per Client","Prof Svs Paid Calculation","Total Days Paid per Client"]
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[null,null,null,null,null,null,null,null,null,{"$f":"IF(F283>0,+IF(I283>0,I283,H283)-IF(G283>0,G283,F283)+1,0)","v":0},{"$f":"IF(C283<=0,\"\",IF(C283=C282,\"\",1))","v":""},null,null,null,null,null,null,0,0,0,0,0,null,null,0,null,null,null,null,null,null,{"$f":"SUM(Z283:AE283)","v":0},{"$f":"+Y283+AF283","v":0},{"$f":"M283*J283","v":0},{"$f":"W283*J283","v":0},{"$f":"X283*J283","v":0},{"$f":"V283*J283","v":0},{"$f":"$J283*Y283","v":0},{"$f":"$J283*Z283","v":0},{"$f":"$J283*AA283","v":0},{"$f":"$J283*AB283","v":0},{"$f":"$J283*AC283","v":0},{"$f":"J283*AD283","v":0},{"$f":"$J283*AE283","v":0},{"$f":"$J283*AF283","v":0},{"$f":"AL283+AS283","v":0},{"$f":"IF(A284=A283,0,SUMIF($A$4:$A$5046,$A283,AL$4:AL$5046))+IF(A284=A283,0,SUMIF($A$4:$A$5046,$A283,AS$4:AS$5046))","v":0},0,{"$f":"IF(A284=A283,0,SUMIF($A$4:$A$5046,$A283,J$4:J$5046))+IF(A284=A283,0,SUMIF($A$4:$A$5046,$A283))","v":0}]
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["Totals - Detail",null,null,null,null,null,null,null,null,{"$f":"SUBTOTAL(9,J4:J284)","v":0},{"$f":"SUBTOTAL(9,K4:K284)","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"SUBTOTAL(9,V4:V284)","v":0},null,null,{"$f":"SUBTOTAL(9,Y4:Y284)","v":0},null,null,null,null,null,null,{"$f":"SUBTOTAL(9,AF4:AF284)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,null,{"$f":"SUBTOTAL(9,AW4:AW284)","v":0}]
[1,null,null,null,"SL Supported Living",null,null,null,null,{"$f":"SUMIF($E$4:$E$283,$E$286,J4:J283)","v":0},{"$f":"SUMIF($E$4:$E$283,$E$286,K4:K283)","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"SUMIF($E$4:$E$283,$E$286,V4:V283)","v":0},null,null,{"$f":"SUMIF($E$4:$E$283,$E$286,Y4:Y283)","v":0},null,null,null,null,null,null,{"$f":"SUMIF($E$4:$E$283,$E$286,AF4:AF283)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0]
[2,null,null,null,"GH Group Home",null,null,null,null,{"$f":"SUMIF($E$4:$E$283,$E$287,J4:J284)","v":0},{"$f":"SUMIF($E$4:$E$283,$E$287,K4:K284)","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"SUMIF($E$4:$E$283,$E$287,V4:V284)","v":0},null,null,{"$f":"SUMIF($E$4:$E$283,$E$287,Y4:Y284)","v":0},null,null,null,null,null,null,{"$f":"SUMIF($E$4:$E$283,$E$287,AF4:AF284)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0]
[3,null,null,null,"GTH Group Training Home",null,null,null,null,{"$f":"SUMIF($E$4:$E$283,$E$288,J4:J283)","v":0},{"$f":"SUMIF($E$4:$E$283,$E$288,K4:K283)","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"SUMIF($E$4:$E$283,$E$288,V4:V283)","v":0},null,null,{"$f":"SUMIF($E$4:$E$283,$E$288,Y4:Y283)","v":0},null,null,null,null,null,null,{"$f":"SUMIF($E$4:$E$283,$E$288,AF4:AF283)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0]
["DSHS/DDA Schedule H Rate History (Rev. 12/2019)"]

{"sheet":"Reconciliation","index":1,"n_rows":10,"n_cols":34,"rows_kept":10,"cut":false,"hidden":true,"merged":[]}
["TCN","Procedure Code","REGION","Provider Name","Provider Number","RAC Code","Client Last Name","Client First Name","Client P1 Id","Service Month","Paid Units","Daily Rate","Paid Amt","Participation","Remittance","Remittance Paid Date","Schedule J Detail by Client Contracted Amount","Schedule J Detail by Client Contracted Days","Cost Variance","Days Variance","Sched J Rate","Sched J Days","Schedule J Total","Days Variance","Dollars Variance","Comments","Resource Manager Response","Resource Manager Comments","Action taken by Analyst"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUMIF('Schedule H - Rate History'!$C$4:$C$283,I1,'Schedule H - Rate History'!$AU$4:$AU$283)","v":0},{"$f":"SUMIF('Schedule H - Rate History'!$C$4:$C$283,I1,'Schedule H - Rate History'!$AW$4:$AW$283)","v":0},{"$f":"(M2+N2)-Q2","v":0},{"$f":"K2-R2","v":0},null,null,{"$f":"U2*V2","v":0},{"$f":"K2-V2","v":0},{"$f":"M2+N2-W2","v":0},null,null,null,null,"SA716 & SA722","Supported Living & Group Home",{"$f":"SUBTOTAL(9,#REF!)","v":{"$error":"#REF!"}},null,{"$f":"SUBTOTAL(9,#REF!)","v":{"$error":"#REF!"}}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUBTOTAL(9,V2)","v":0},{"$f":"SUBTOTAL(9,W2)","v":0},{"$f":"SUBTOTAL(9,X2)","v":0},{"$f":"SUBTOTAL(9,Y2)","v":0},null,null,null,null,"Provider1 Total",null,{"$f":"SUM(AF2:AF2)","v":{"$error":"#REF!"}},null,{"$f":"SUM(AH2:AH2)","v":{"$error":"#REF!"}}]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Subtotal",null,null,{"$f":"SUBTOTAL(9,X2:X3)","v":0},{"$f":"SUBTOTAL(9,Y2:Y3)","v":0},null,null,null,null,"Less overpayments",null,0,null,0]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Add underpayments",null,0,null,0]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Adjusted Total",null,{"$f":"SUM(AF2:AF2,AF5,AF6)","v":{"$error":"#REF!"}},null,{"$f":"SUM(AH2:AH2,AH5,AH6)","v":{"$error":"#REF!"}}]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Sched J Check",null,{"$f":"#REF!","v":{"$error":"#REF!"}},null,{"$f":"#REF!+#REF!","v":{"$error":"#REF!"}}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Difference",null,{"$f":"AF7-AF9","v":{"$error":"#REF!"}},null,{"$f":"AH7-AH9","v":{"$error":"#REF!"}}]

{"sheet":"Other Codes","index":2,"n_rows":1,"n_cols":16,"rows_kept":1,"cut":false,"hidden":true,"merged":[]}
["TCN","Procedure Code","REGION","Provider Name","Provider Number","RAC Code","Client Last Name","Client First Name","Client P1 Id","Service Month","Paid Units","Daily Rate","Paid Amt","Participation","Remittance","Remittance Paid Date"]

{"sheet":"List","index":3,"n_rows":145,"n_cols":9,"rows_kept":145,"cut":false,"hidden":true,"merged":[]}
["Provider","Provider ID a.","Urban Designation",null,null,"Program Type","Service Code & RAC",null,"RM Responses"]
[]
["1N - Aacres WA",111414301,"MSA",null,null,"SL Supported Living","SA716-3603 SL CORE",null,"Underpayment to be claimed"]
["1N - Aacres Spokane 2",111414310,"MSA",null,null,"GH Group Home","SA716-3604 SL CP",null,"Underpayment will not be claimed, please adjust settlement"]
["1N - Aacres Spokane 3",111414309,"MSA",null,null,"GTH Group Training Home","SA716-3701 SL RCL",null,"Overpayment to be adjusted in P1"]
["1N - Adult Guidance & Empowerment Service",111684901,"MSA",null,null,null,"SA716-3905 SL State",null,"Overpayment will not to be adjusted in P1 (explain why in column AE)"]
["1N - Alpha Supported Living (Spokane)",111320906,"MSA",null,null,null,"SA722-3603 GH CORE",null,"COCA to be issued (Copy Attached)"]
["1N - Ambitions - Spokane",111901906,"MSA",null,null,null,"SA722-3701 GH RCL",null,"COCA issued previously (Copy Attached)"]
["1N - Ambitions - Wenatchee, Omak, Moses Lake",111901903,"MSA/NON-MSA",null,null,null,"SA722-3905 GH State",null,"COCA not submitted by provider per DDA policy timelines"]
["1N - ARC of Spokane",111426502,"MSA",null,null,null,"SA722-3603 GTH CORE"]
["1N - Assisted Residential Services",111705601,"MSA",null,null,null,"SA722-3701 GTH RCL"]
["1N - Community Integrated Services",111425301,"MSA",null,null,null,"SA722-3905 GTH State"]
["1N - Community Visions",111530102,"MSA"]
["1N - Dreamworks Residential",111913801,"NON-MSA"]
["1N - Drive Services",111621401,"MSA"]
["1N - Excel Supported Living",111322002,"MSA"]
["1N - Grace Support Services",212120601,"MSA"]
["1N - Grant County Developmental Disabilities (DCL)",200012501,"NON-MSA"]
["1N - Hope Human Services (Spokane)",207150604,"MSA"]
["1N - Hope Supported Living",213504001,"MSA"]
["1N - Kaler House",111686001,"MSA"]
["1N - L.M.K.",111988202,"NON-MSA"]
["1N - Latah Services",111762501,"MSA"]
["1N - Living In Fulfilling Environment",111777301,"MSA"]
["1N - Mission Vista",111707401,"MSA"]
["1N - Parent's Cooperative Society for the Handicapped (Merry Glen)",111328901,"MSA"]
["1N - ResCare Spokane",111968514,"MSA"]
["1S - Alternative Residential Services",111625401,"MSA/NON-MSA"]
["1S - Ambitions - Kennewick",111901901,"MSA"]
["1S - Ambitions - Yakima",111901907,"MSA"]
["1S - Community Living",111962202,"MSA"]
["1S - Deaf Access Washington",111321901,"MSA"]
["1S - Elmview",111604101,"MSA/NON-MSA"]
["1S - Habilitat",111449601,"NON-MSA"]
["1S - Kittitas Interactive Management",111688701,"NON-MSA"]
["1S - Kittitas Interactive Management (Yakima)",111688702,"MSA"]
["1S - Reach Supported Living",209862801,"MSA"]
["1S - Reach Supported Living Walla Walla",209862802,"MSA"]
["1S - Tri-Cities Residential Services",111872501,"MSA"]
["1S - Valley Residential Services",111777901,"NON-MSA"]
["2N - Aacres",111414307,"MSA"]
["2N - Access Living",111675101,"MSA"]
["2N - All Heart Agency",111961601,"MSA"]
["2N - Alpha Supported Living Services",111320902,"MSA"]
["2N - Ambitions Whatcom",111901908,"MSA"]
["2N - Camelot Society",101955202,"MSA"]
["2N - Cascade Connections",111724102,"MSA"]
["2N - Evergreen Supported Living",111690301,"MSA"]
["2N - Holly Community Services",111765001,"MSA"]
["2N - La Casa de Esperanza ",111390801,"MSA"]
["2N - Puffin Island",111959501,"MSA"]
["2N - Quilceda Community Services",111321203,"MSA"]
["2N - Rehabco",111681901,"MSA"]
["2N - Rescare",111968512,"MSA"]
["2N - Sails",111805705,"MSA"]
["2N - Service Alternatives for WA",111513304,"MSA"]
["2N - Snohomish Supportive Living Services",111518901,"MSA"]
["2N - Soundview Association",111830201,"MSA"]
["2N - Steps Toward Independence",112034301,"MSA"]
["2N - Sunrise Services",203434610,"MSA"]
["2N - Village Community Services",111938301,"MSA"]
["2N - Volunteers of America",200494106,"MSA"]
["2S - Aacres",111414302,"KING"]
["2S - Alpha Supported Living Services",111320901,"KING"]
["2S - Ambitions",111901902,"KING"]
["2S - Arc of King County",112013701,"KING"]
["2S - Banchero Friends Services",111415001,"KING"]
["2S - Bethesda Lutheran Communities",111621301,"KING"]
["2S - Camelot Society",101955201,"KING"]
["2S - Cascade Community Services",111875001,"KING"]
["2S - Citizen Access Residential Resources",111533401,"KING"]
["2S - Community Integrated Services",111425302,"KING"]
["2S - Community Living",111962201,"KING"]
["2S - Destiny House Operations",111992801,"KING"]
["2S - Friendship House",111405501,"KING"]
["2S - Greenwood Home",111913301,"KING"]
["2S - Habilitation Services",208173701,"KING"]
["2S - Helping Hands for the Disabled",111736002,"KING"]
["2S - Helping Hands DBA Dahlia",111736003,"KING"]
["2S - Inglewood Residential and Community Services",111568401,"KING"]
["2S - Integrated Living Services",111789002,"KING"]
["2S - L'Arche Noah Sealth of Seattle",111798601,"KING"]
["2S - Life Skills Center",111499601,"KING"]
["2S - Maksu",111577901,"KING"]
["2S - Nellie Goodhue Group Homes",111800501,"KING"]
["2S - Parkview Services",111456901,"KING"]
["2S - Premier Care Services",111437001,"KING"]
["2S - Provail",101144803,"KING"]
["2S - Puget Sound Regional Services",111925301,"KING"]
["2S - Res-Care Washington",111968506,"KING"]
["2S - SAILS",111805704,"KING"]
["2S - Service Alternatives for WA",111513302,"KING"]
["2S - Shamrock Living Services",111958301,"KING"]
["2S - Shared Journeys",111515201,"KING"]
["2S - Stand Together",111753401,"KING"]
["2S - Tahoma Hills",111799101,"KING"]
["2S - Total Living Concept",111571101,"KING"]
["2S - United Friends Group Home",101601101,"KING"]
["2S - Volunteers of America",200494104,"KING"]
["3N - Aacres WA",111414304,"MSA"]
["3N - Ambitions, WA",111901904,"MSA"]
["3N - Communitas Group",102702801,"MSA"]
["3N - Community Alternatives for People with Autism (CAPA)",112026801,"MSA"]
["3N - Educational Programs in Home Living",111975401,"MSA"]
["3N - Group Action for Peninsula People",111703801,"MSA"]
["3N - Hope Human Services",207150601,"MSA"]
["3N - Kitsap Residences",111781001,"MSA"]
["3N - Kitsap Tenant Support Services",111715902,"MSA"]
["3N - L'Arche Tahoma Hope Community",111610303,"MSA"]
["3N - Life Force Services",111691201,"MSA"]
["3N - NW Services for Independent Living",111812601,"MSA"]
["3N - Options Unlimited",111904801,"MSA"]
["3N - PAM Group Home",111728401,"MSA"]
["3N - Puget Sound Assisted Living",111557601,"MSA"]
["3N - Res-Care Washington",111968504,"MSA"]
["3N - Self Determined Services ",111874501,"MSA"]
["3N - Service Alternatives for WA",111513305,"MSA"]
["3N - Tahoma Associates",111335302,"MSA"]
["3N - Valley Supported Living",111938101,"MSA"]
["3S - Aacres - Clark",111414303,"NON-MSA"]
["3S - Aacres - Thurston",111414308,"MSA"]
["3S - ABC Residential Services",555777999,"MSA"]
["3S - Adam's Place",214039510,"MSA"]
["3S - Ambitions",111901905,"MSA/NON-MSA"]
["3S - Another Option",111619102,"MSA"]
["3S - Arc of Clark County",102623403,"MSA"]
["3S - Brighton Enterprises - Clark",111686601,"MSA"]
["3S - Brighton Enterprises - Thurston",111686602,"MSA"]
["3S - CCH Individual Support Services",111909801,"NON-MSA"]
["3S - Citizen Access Residential Resources",111533403,"MSA"]
["3S - Community Resources",111977701,"MSA/NON-MSA"]
["3S - Exceptional Foresters",111551801,"MSA"]
["3S - Harbor Alternative Living Association",111349601,"NON-MSA"]
["3S - Hope Human Services",207150603,"MSA"]
["3S - Kitsap Tenant Support Services",111715901,"NON-MSA"]
["3S - Kokua",111492901,"MSA"]
["3S - Life Force Services - Clark",111691204,"MSA"]
["3S - Life Force Services - Thurston",111691202,"MSA"]
["3S - Life Works",111594402,"MSA"]
["3S - Placeone",111512001,"MSA"]
["3S - Reside Residential Care of Washington",111864101,"MSA"]
["3S - ROAR",111442501,"MSA"]
["3S - SOLO",111910501,"MSA"]
["3S - Twin Harbors Group Home Association",111669901,"NON-MSA"]
["3S - Vancare",111811201,"MSA"]