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["Program Name",null,null,null,null,"Provider ID",null,{"$f":"VLOOKUP(D1,List!A2:C149,2,FALSE)","v":{"$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:AV398)","v":0}]
["Report Period",null,null,"2020-01-01",null,"2020-12-31",null,null,null,{"$f":"IF($AN$1=\"\",SUM(J4:J397),SUMIF($E$4:$E$397,$AN$1,J4:J397))","v":0},{"$f":"IF($AN$1=\"\",SUM(K4:K397),SUMIF($E$4:$E$397,$AN$1,K4:K397))","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Annual Totals",{"$f":"IF($AN$1=\"\",SUM(AH4:AH397),SUMIF($E$4:$E$397,$AN$1,AH4:AH397))","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0]
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[2,null,null,null,"GH Group Home",null,null,null,null,{"$f":"SUMIF($E$4:$E$397,$E$401,J4:J398)","v":0},{"$f":"SUMIF($E$4:$E$397,$E$401,K4:K398)","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"SUMIF($E$4:$E$397,$E$401,V4:V398)","v":0},null,null,{"$f":"SUMIF($E$4:$E$397,$E$401,Y4:Y398)","v":0},null,null,null,null,null,null,{"$f":"SUMIF($E$4:$E$397,$E$401,AF4:AF398)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0]
[3,null,null,null,"GTH Group Training Home",null,null,null,null,{"$f":"SUMIF($E$4:$E$397,$E$402,J4:J397)","v":0},{"$f":"SUMIF($E$4:$E$397,$E$402,K4:K397)","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"SUMIF($E$4:$E$397,$E$402,V4:V397)","v":0},null,null,{"$f":"SUMIF($E$4:$E$397,$E$402,Y4:Y397)","v":0},null,null,null,null,null,null,{"$f":"SUMIF($E$4:$E$397,$E$402,AF4:AF397)","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. 1/2020)"]

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{"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":142,"n_cols":9,"rows_kept":142,"cut":false,"hidden":true,"merged":[]}
["Provider Name","Provider ID","Urban Designation",null,null,"Program Type","Service Code & RAC",null,"RM Responses"]
[]
["1N - Adult Guidance & Empowerment Service",111684901,"MSA",null,null,"SL Supported Living","SA716-3603 SL CORE",null,"Underpayment to be claimed"]
["1N - Alpha Supported Living (Spokane)",111320906,"MSA",null,null,"GH Group Home","SA716-3604 SL CP",null,"Underpayment will not be claimed, please adjust settlement"]
["1N - Ambitions - Spokane",111901906,"MSA",null,null,"GTH Group Training Home","SA716-3701 SL RCL",null,"Overpayment to be adjusted in P1"]
["1N - Ambitions - Wenatchee, Omak, Moses Lake",111901903,"MSA/NON-MSA",null,null,null,"SA716-3905 SL State",null,"Overpayment will not to be adjusted in P1 (explain why in column AE)"]
["1N - ARC of Spokane",111426502,"MSA",null,null,null,"SA722-3603 GH CORE",null,"COCA to be issued (Copy Attached)"]
["1N - Assisted Residential Services",111705601,"MSA",null,null,null,"SA722-3701 GH RCL",null,"COCA issued previously (Copy Attached)"]
["1N - Community Integrated Services",111425301,"MSA",null,null,null,"SA722-3905 GH State",null,"COCA not submitted by provider per DDA policy timelines"]
["1N - Community Visions",111530102,"MSA",null,null,null,"SA722-3603 GTH CORE"]
["1N - Dreamworks Residential",111913801,"NON-MSA",null,null,null,"SA722-3701 GTH RCL"]
["1N - Drive Services",111621401,"MSA",null,null,null,"SA722-3905 GTH State"]
["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 - Alpha Supported Living Services",111320901,"KING"]
["2S - Ambitions",111901902,"KING"]
["2S - Angeline House",111798601,"KING"]
["2S - Arc of King County",112013701,"KING"]
["2S - Banchero Disability Partners",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 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 - 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 - 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",214039501,"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 - CARR Clark",111533405,"MSA"]
["3S - CARR Thurston",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 - Northwest Supported Living - Clark",215510001,"MSA"]
["3S - Northwest Supported Living - Thurston",215510002,"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"]