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2016 School-Based Medicaid Arkansas State Profile€¦ · Occupational Therapy Speech Therapy...

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$5,065,517.38 $9,358,040.67 $11,019,000.33 $1,615,189.13 $24,315.04 $10,864.96 $1,586,284.88 $28,684,921.83 Physical Therapy Occupational Therapy Speech Therapy Personal Care SBMH Audiology EPSDT Direct Funds ARMAC Total (Q1+Q2+Q3+Q4) Total Reimbursement (ARMAC Total + Direct Funds) = Report Date: 10/25/2016 at 10:59:33AM 2016 School-Based Medicaid Arkansas State Profile ADM 478,467 $15,545,275.21 $44,230,197.04
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Page 1: 2016 School-Based Medicaid Arkansas State Profile€¦ · Occupational Therapy Speech Therapy Personal Care SBMH Audiology EPSDT Direct Funds ARMAC Total (Q1+Q2+Q3+Q4) Total Reimbursement

$5,065,517.38

$9,358,040.67

$11,019,000.33

$1,615,189.13

$24,315.04

$10,864.96

$1,586,284.88

$28,684,921.83

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

Report Date: 10/25/2016 at 10:59:33AM

2016 School-Based Medicaid Arkansas State Profile

ADM 478,467

$15,545,275.21

$44,230,197.04

Page 2: 2016 School-Based Medicaid Arkansas State Profile€¦ · Occupational Therapy Speech Therapy Personal Care SBMH Audiology EPSDT Direct Funds ARMAC Total (Q1+Q2+Q3+Q4) Total Reimbursement

Report Date: 10/25/2016 at 10:59:33AM

ACADEMIC PLUS CHARTER SCHOOL

2016 School-Based Medicaid Profile

6040

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$2,698.24

$9,239.92

$14,886.16

$0.00

$0.00

$0.00

$0.00

$26,824.32

70.62%

ADM 853

$20,458.94

$47,283.26

Page 1 of 271

Page 3: 2016 School-Based Medicaid Arkansas State Profile€¦ · Occupational Therapy Speech Therapy Personal Care SBMH Audiology EPSDT Direct Funds ARMAC Total (Q1+Q2+Q3+Q4) Total Reimbursement

Report Date: 10/25/2016 at 10:59:33AM

ALMA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1701

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$50,822.40

$135,012.32

$52,029.08

$0.00

$0.00

$0.00

$7,910.02

$245,773.82

62.09%

ADM 3,212

$112,383.58

$358,157.40

Page 2 of 271

Page 4: 2016 School-Based Medicaid Arkansas State Profile€¦ · Occupational Therapy Speech Therapy Personal Care SBMH Audiology EPSDT Direct Funds ARMAC Total (Q1+Q2+Q3+Q4) Total Reimbursement

Report Date: 10/25/2016 at 10:59:33AM

ALPENA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0501

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$2,023.68

$13,209.82

$1,785.52

$15,590.99

$0.00

$0.00

$3,346.64

$35,956.65

61.70%

ADM 500

$19,299.59

$55,256.24

Page 3 of 271

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Report Date: 10/25/2016 at 10:59:33AM

AR SCHOOL FOR THE BLIND

2016 School-Based Medicaid Profile

6091

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$52,531.62

$72,606.08

$35,543.44

$75.42

$0.00

$0.00

$494.18

$161,250.74

70.62%

ADM 77

$62,443.69

$223,694.43

Page 4 of 271

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Report Date: 10/25/2016 at 10:59:33AM

AR SCHOOL FOR THE DEAF

2016 School-Based Medicaid Profile

6092

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$11,946.24

$17,779.52

$785.36

$0.00

$0.00

$0.00

$661.76

$31,172.88

70.62%

ADM 113

$60,520.75

$91,693.63

Page 5 of 271

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Report Date: 10/25/2016 at 10:59:33AM

ARCH FORD EDUCATION SERVICE CO-OP

2016 School-Based Medicaid Profile

1520

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$8,348.96

$15,433.32

$151,090.10

$0.00

$0.00

$0.00

$0.00

$174,872.38

56.47%

ADM 682

$41,555.16

$216,427.54

Page 6 of 271

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Report Date: 10/25/2016 at 10:59:33AM

ARKADELPHIA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1002

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$28,984.30

$40,502.52

$42,356.36

$0.00

$0.00

$0.00

$4,997.12

$116,840.30

77.92%

ADM 1,896

$50,963.04

$167,803.34

Page 7 of 271

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Report Date: 10/25/2016 at 10:59:33AM

ARKANSAS ARTS ACADEMY

2016 School-Based Medicaid Profile

0440

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

48.78%

ADM 774

$13,292.24

$13,292.24

Page 8 of 271

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Report Date: 10/25/2016 at 10:59:33AM

ARKANSAS RIVER EDUCATION SERVICE CO-OP

2016 School-Based Medicaid Profile

3520

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$1,459.92

$4,870.12

$23,142.58

$0.00

$0.00

$0.00

$144.24

$29,616.86

63.95%

ADM 366

$26,206.91

$55,823.77

Page 9 of 271

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Report Date: 10/25/2016 at 10:59:33AM

ARKANSAS VIRTUAL CHARTER SCHOOL

2016 School-Based Medicaid Profile

6043

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$1,740.80

$957.44

$0.00

$0.00

$0.00

$0.00

$2,698.24

70.62%

ADM 1,812

$57,248.68

$59,946.92

Page 10 of 271

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Report Date: 10/25/2016 at 10:59:33AM

ARMOREL SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4701

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$7,233.72

$5,554.00

$0.00

$0.00

$0.00

$0.00

$0.00

$12,787.72

82.61%

ADM 404

$13,921.96

$26,709.68

Page 11 of 271

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Report Date: 10/25/2016 at 10:59:33AM

ASHDOWN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4101

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$15,882.94

$22,741.30

$32,208.14

$50,551.55

$0.00

$0.00

$5,602.92

$126,986.85

68.25%

ADM 1,426

$43,446.94

$170,433.79

Page 12 of 271

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Report Date: 10/25/2016 at 10:59:33AM

ATKINS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5801

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$40,162.88

$72,104.16

$173,109.23

$0.00

$0.00

$0.00

$4,180.12

$289,556.39

62.59%

ADM 1,007

$11,790.46

$301,346.85

Page 13 of 271

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Report Date: 10/25/2016 at 10:59:33AM

AUGUSTA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7401

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$19,170.36

$56,817.28

$0.00

$0.00

$0.00

$263.06

$76,250.70

81.63%

ADM 376

$7,944.96

$84,195.66

Page 14 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BALD KNOB SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7301

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$28,412.34

$92,010.32

$41,440.00

$0.00

$0.00

$0.00

$0.00

$161,862.66

64.23%

ADM 1,240

$38,070.32

$199,932.98

Page 15 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BARTON-LEXA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5401

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$6,283.92

$24,474.44

$0.00

$0.00

$0.00

$0.00

$4,508.78

$35,267.14

83.32%

ADM 806

$24,743.68

$60,010.82

Page 16 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BATESVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3201

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$52,921.18

$73,331.12

$82,892.82

$0.00

$0.00

$0.00

$13,474.82

$222,619.94

67.57%

ADM 2,978

$153,225.68

$375,845.62

Page 17 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BAUXITE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6301

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$11,609.92

$34,511.80

$1,369.72

$0.00

$0.00

$0.00

$0.00

$47,491.44

51.45%

ADM 1,634

$18,349.74

$65,841.18

Page 18 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BAY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1601

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$3,648.20

$16,229.28

$36,175.74

$0.00

$0.00

$0.00

$0.00

$56,053.22

61.67%

ADM 577

$15,209.40

$71,262.62

Page 19 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BEARDEN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5201

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$5,254.80

$15,520.80

$26,211.54

$0.00

$0.00

$0.00

$0.00

$46,987.14

74.38%

ADM 483

$28,906.13

$75,893.27

Page 20 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BEEBE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7302

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$26,482.12

$54,418.80

$13,942.16

$0.00

$0.00

$0.00

$15,102.30

$109,945.38

64.23%

ADM 3,280

$71,413.95

$181,359.33

Page 21 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BENTON SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6302

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$948.72

$0.00

$863.00

$5,916.28

$0.00

$0.00

$18,253.88

$25,981.88

51.45%

ADM 5,045

$115,156.23

$141,138.11

Page 22 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BENTONVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0401

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$59,304.98

$126,634.20

$174,766.90

$115,616.97

$0.00

$0.00

$23,859.18

$500,182.23

48.78%

ADM 16,060

$533,852.88

$1,034,035.11

Page 23 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BERGMAN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0502

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$17,534.14

$24,289.76

$9,734.62

$0.00

$0.00

$0.00

$3,860.74

$55,419.26

61.70%

ADM 1,079

$32,394.06

$87,813.32

Page 24 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BERRYVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0801

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$20,216.96

$29,285.04

$48,839.02

$8,338.78

$0.00

$0.00

$8,504.48

$115,184.28

79.26%

ADM 2,009

$74,039.00

$189,223.28

Page 25 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BISMARCK SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3001

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$12,375.08

$39,533.00

$31,239.50

$9,926.11

$0.00

$0.00

$3,031.38

$96,105.07

65.09%

ADM 967

$22,796.36

$118,901.43

Page 26 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BLEVINS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2901

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$15,037.76

$14,495.56

$17,257.86

$0.00

$0.00

$0.00

$0.00

$46,791.18

83.89%

ADM 480

$11,949.60

$58,740.78

Page 27 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BLYTHEVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4702

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$33,846.67

$31,302.00

$116,215.76

$0.00

$0.00

$0.00

$23,795.30

$205,159.73

82.61%

ADM 2,238

$180,344.32

$385,504.05

Page 28 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BOONEVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4201

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$32,997.68

$104,924.88

$24,096.52

$0.00

$1,340.68

$0.00

$1,566.00

$164,925.76

76.24%

ADM 1,229

$50,311.74

$215,237.50

Page 29 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BRADFORD SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7303

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$2,611.20

$65,783.86

$0.00

$0.00

$0.00

$2,583.90

$70,978.96

64.23%

ADM 434

$21,352.09

$92,331.05

Page 30 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BRINKLEY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4801

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$13,617.96

$21,938.28

$0.00

$0.00

$0.00

$0.00

$0.00

$35,556.24

88.88%

ADM 536

$23,661.81

$59,218.05

Page 31 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BROOKLAND SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1603

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$20,838.36

$107,343.16

$3,545.10

$0.00

$0.00

$0.00

$6,695.34

$138,421.96

61.67%

ADM 2,207

$71,964.34

$210,386.30

Page 32 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BRYANT SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6303

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$65,046.17

$213,379.24

$17,184.18

$4.19

$19,279.16

$0.00

$34,392.26

$349,285.20

51.45%

ADM 8,969

$272,781.04

$622,066.24

Page 33 of 271

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Report Date: 10/25/2016 at 10:59:33AM

BUFFALO IS. CENTRAL SCH. DISTRICT

2016 School-Based Medicaid Profile

1605

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$47,955.04

$31,693.68

$9,740.94

$0.00

$0.00

$0.00

$0.00

$89,389.66

61.67%

ADM 767

$21,960.55

$111,350.21

Page 34 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CABOT SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4304

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$137,438.68

$242,833.60

$164,924.71

$84,995.10

$0.00

$0.00

$22,132.82

$652,324.91

46.56%

ADM 10,058

$287,296.71

$939,621.62

Page 35 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CADDO HILLS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4901

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$735.44

$435.20

$5,099.84

$0.00

$0.00

$0.00

$0.00

$6,270.48

91.13%

ADM 578

$41,178.13

$47,448.61

Page 36 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CALICO ROCK SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3301

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$5,890.18

$7,844.42

$0.00

$0.00

$0.00

$3,163.94

$16,898.54

73.13%

ADM 419

$17,274.97

$34,173.51

Page 37 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CAMDEN FAIRVIEW SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5204

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$19,818.60

$76,553.68

$21,816.19

$31,138.09

$0.00

$0.00

$19,217.50

$168,544.06

74.38%

ADM 2,554

$125,462.07

$294,006.13

Page 38 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CARLISLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4303

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$14,405.12

$4,204.04

$0.00

$0.00

$0.00

$0.00

$18,609.16

46.56%

ADM 670

$19,225.76

$37,834.92

Page 39 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CAVE CITY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6802

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$20,334.24

$54,516.64

$46,556.22

$0.00

$0.00

$0.00

$0.00

$121,407.10

72.00%

ADM 1,261

$30,810.75

$152,217.85

Page 40 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CEDAR RIDGE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3212

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$42,267.72

$35,937.48

$18,797.12

$0.00

$0.00

$0.00

$4,775.96

$101,778.28

67.57%

ADM 850

$25,118.96

$126,897.24

Page 41 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CEDARVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1702

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$2,924.92

$0.00

$0.00

$0.00

$2,341.78

$5,266.70

62.09%

ADM 830

$42,074.57

$47,341.27

Page 42 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CENTERPOINT SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5502

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$1,670.40

$24,436.48

$38,508.76

$0.00

$0.00

$0.00

$4,916.42

$69,532.06

65.55%

ADM 961

$23,780.86

$93,312.92

Page 43 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CHARLESTON SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2402

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$14,298.96

$14,611.36

$9,392.42

$2,689.98

$0.00

$0.00

$1,653.92

$42,646.64

59.48%

ADM 882

$29,410.16

$72,056.80

Page 44 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CLARENDON SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4802

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$2,717.14

$11,400.54

$0.00

$0.00

$0.00

$0.00

$0.00

$14,117.68

88.88%

ADM 513

$26,702.27

$40,819.95

Page 45 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CLARKSVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3601

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$108,421.84

$65,305.26

$46,413.12

$63,416.63

$0.00

$0.00

$13,595.02

$297,151.87

72.09%

ADM 2,682

$87,638.97

$384,790.84

Page 46 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CLEVELAND COUNTY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1305

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$9,018.06

$23,005.64

$4,771.36

$13,466.66

$0.00

$0.00

$4,015.28

$54,277.00

57.67%

ADM 870

$16,887.23

$71,164.23

Page 47 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CLINTON SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7102

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$13,578.24

$60,713.52

$36,001.04

$4,473.41

$0.00

$0.00

$4,639.62

$119,405.83

73.51%

ADM 1,297

$74,775.45

$194,181.28

Page 48 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CONCORD SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1201

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$18,902.28

$46,552.12

$15,219.18

$5,497.28

$0.00

$0.00

$72.12

$86,242.98

71.45%

ADM 435

$22,659.83

$108,902.81

Page 49 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CONWAY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2301

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$39,366.52

$54,324.08

$206,099.66

$112,387.67

$0.00

$0.00

$35,597.34

$447,775.27

52.11%

ADM 9,734

$294,918.92

$742,694.19

Page 50 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CORNING SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1101

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$13,962.76

$77,830.28

$0.00

$0.00

$0.00

$5,819.62

$97,612.66

67.79%

ADM 933

$17,346.00

$114,958.66

Page 51 of 271

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Report Date: 10/25/2016 at 10:59:33AM

Cossatot River

2016 School-Based Medicaid Profile

5707

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$8,666.73

$8,154.40

$6,061.92

$972.00

$0.00

$315.88

$4,522.86

$28,693.79

69.56%

ADM 1,066

$30,954.16

$59,647.95

Page 52 of 271

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Report Date: 10/25/2016 at 10:59:33AM

COTTER SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0302

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$28,431.32

$39,698.92

$2,900.20

$1,806.25

$0.00

$0.00

$2,852.80

$75,689.49

68.31%

ADM 680

$33,027.80

$108,717.29

Page 53 of 271

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Report Date: 10/25/2016 at 10:59:33AM

COUNTY LINE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2403

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$7,761.28

$10,748.28

$9,113.70

$2,752.83

$0.00

$0.00

$0.00

$30,376.09

59.48%

ADM 461

$23,795.02

$54,171.11

Page 54 of 271

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Report Date: 10/25/2016 at 10:59:33AM

Covenant Keepers

2016 School-Based Medicaid Profile

6044

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

70.62%

ADM 171

$17,406.81

$17,406.81

Page 55 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CROSS COUNTY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1901

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$23,009.04

$23,872.68

$28,490.08

$19,842.21

$0.00

$0.00

$1,752.48

$96,966.49

62.61%

ADM 626

$28,574.49

$125,540.98

Page 56 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CROSSETT SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0201

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$26,843.32

$54,551.50

$24,049.10

$35,929.25

$0.00

$0.00

$4,938.74

$146,311.91

71.20%

ADM 1,720

$49,862.86

$196,174.77

Page 57 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CROWLEY'S RIDGE EDUCATIONAL CO-OP

2016 School-Based Medicaid Profile

5620

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$70,110.58

$0.00

$0.00

$0.00

$0.00

$70,110.58

67.86%

ADM 529

$19,988.72

$90,099.30

Page 58 of 271

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Report Date: 10/25/2016 at 10:59:33AM

CUTTER-MORNING STAR SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2601

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$4,472.84

$28,291.52

$68,982.56

$0.00

$0.00

$0.00

$3,818.50

$105,565.42

73.14%

ADM 583

$32,691.90

$138,257.32

Page 59 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DANVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7503

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$48,770.94

$60,406.62

$96,181.09

$4,131.34

$0.00

$0.00

$0.00

$209,489.99

67.71%

ADM 849

$23,486.54

$232,976.53

Page 60 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DARDANELLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7504

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$29,733.64

$73,828.64

$85,810.40

$0.00

$0.00

$0.00

$0.00

$189,372.68

67.71%

ADM 2,093

$86,659.12

$276,031.80

Page 61 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DAWSON EDUCATION SERVICE CO-OP

2016 School-Based Medicaid Profile

1020

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$1,026.60

$8,396.20

$75,623.76

$0.00

$0.00

$0.00

$0.00

$85,046.56

60.82%

ADM 400

$36,253.29

$121,299.85

Page 62 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DECATUR SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0402

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$3,307.52

$5,803.76

$5,468.98

$3,514.50

$0.00

$49.50

$1,592.10

$19,736.36

48.78%

ADM 585

$12,753.35

$32,489.71

Page 63 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DEER/MT. JUDEA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5106

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$2,047.82

$2,047.82

72.82%

ADM 349

$23,467.30

$25,515.12

Page 64 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DEQUEEN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6701

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$12,998.04

$12,811.52

$42,299.25

$0.00

$0.00

$0.00

$6,155.14

$74,263.95

80.25%

ADM 2,431

$68,625.26

$142,889.21

Page 65 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DEQUEEN/MENA EDUCATIONAL CO-OP

2016 School-Based Medicaid Profile

6720

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$4,705.11

$9,337.40

$83,576.49

$0.00

$0.00

$1,397.58

$0.00

$99,016.58

68.05%

ADM 271

$27,072.58

$126,089.16

Page 66 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DERMOTT SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0901

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$783.00

$0.00

$8,760.64

$328.50

$0.00

$0.00

$0.00

$9,872.14

100.00%

ADM 373

$17,511.81

$27,383.95

Page 67 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DES ARC SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5901

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$7,665.44

$10,241.56

$0.00

$0.00

$0.00

$1,917.32

$19,824.32

71.13%

ADM 515

$16,614.39

$36,438.71

Page 68 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DEWITT SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0101

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$21,018.32

$3,895.78

$0.00

$0.00

$455.72

$25,369.82

73.10%

ADM 1,258

$44,462.16

$69,831.98

Page 69 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DIERKS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3102

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$3,184.20

$0.00

$8,440.16

$0.00

$0.00

$82.50

$0.00

$11,706.86

62.86%

ADM 553

$21,032.70

$32,739.56

Page 70 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DOLLARWAY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3502

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$51,708.91

$0.00

$0.00

$0.00

$6,534.62

$58,243.53

80.80%

ADM 1,192

$73,405.50

$131,649.03

Page 71 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DOVER SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5802

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$35,980.24

$63,032.96

$158,098.60

$0.00

$0.00

$0.00

$6,520.88

$263,632.68

62.59%

ADM 1,404

$52,254.65

$315,887.33

Page 72 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DREW CENTRAL SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2202

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$17,382.40

$40,409.54

$49,592.20

$41,937.90

$0.00

$0.00

$849.62

$150,171.66

65.89%

ADM 955

$23,880.97

$174,052.63

Page 73 of 271

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Report Date: 10/25/2016 at 10:59:33AM

DUMAS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2104

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$7,381.04

$22,178.86

$18,715.97

$0.00

$0.00

$0.00

$7,374.28

$55,650.15

72.62%

ADM 1,358

$32,333.46

$87,983.61

Page 74 of 271

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Report Date: 10/25/2016 at 10:59:33AM

Earle School District

2016 School-Based Medicaid Profile

1802

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$2,659.52

$7,780.24

$1,914.88

$0.00

$0.00

$0.00

$0.00

$12,354.64

73.46%

ADM 606

$29,305.33

$41,659.97

Page 75 of 271

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Report Date: 10/25/2016 at 10:59:33AM

EAST END SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5301

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$26,737.52

$34,910.93

$61,202.84

$0.00

$0.00

$0.00

$5,682.94

$128,534.23

64.54%

ADM 668

$25,449.06

$153,983.29

Page 76 of 271

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Report Date: 10/25/2016 at 10:59:33AM

EAST POINSETT CO. SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5608

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$18,832.88

$22,549.12

$99,062.06

$0.00

$0.00

$0.00

$2,045.76

$142,489.82

78.81%

ADM 683

$34,236.15

$176,725.97

Page 77 of 271

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Report Date: 10/25/2016 at 10:59:33AM

EL DORADO SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7001

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$38,165.60

$43,993.52

$79,236.48

$98,687.71

$0.00

$0.00

$11,647.82

$271,731.13

63.45%

ADM 4,522

$156,985.92

$428,717.05

Page 78 of 271

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Report Date: 10/25/2016 at 10:59:33AM

ELKINS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7201

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$5,446.64

$6,219.68

$11,333.04

$0.00

$0.00

$0.00

$1,513.80

$24,513.16

53.99%

ADM 1,131

$28,490.92

$53,004.08

Page 79 of 271

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Report Date: 10/25/2016 at 10:59:33AM

EMERSON-TAYLOR-BRADLEY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1408

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$3,967.24

$9,069.92

$2,365.64

$0.00

$0.00

$0.00

$0.00

$15,402.80

61.19%

ADM 986

$10,861.76

$26,264.56

Page 80 of 271

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Report Date: 10/25/2016 at 10:59:33AM

ENGLAND SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4302

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$1,653.76

$49,422.49

$0.00

$0.00

$0.00

$78.30

$51,154.55

46.56%

ADM 757

$19,540.43

$70,694.98

Page 81 of 271

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Report Date: 10/25/2016 at 10:59:33AM

eSTEM Charter Public School

2016 School-Based Medicaid Profile

6047

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$4,961.28

$5,773.95

$30,383.36

$0.00

$0.00

$0.00

$2,830.48

$43,949.07

70.62%

ADM 1,462

$29,911.10

$73,860.17

Page 82 of 271

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Report Date: 10/25/2016 at 10:59:33AM

EUREKA SPRINGS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0802

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$12,673.82

$19,818.66

$14,706.96

$0.00

$0.00

$0.00

$2,021.72

$49,221.16

79.26%

ADM 625

$42,000.63

$91,221.79

Page 83 of 271

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Report Date: 10/25/2016 at 10:59:33AM

Exalt Academy of SouthWest LR

2016 School-Based Medicaid Profile

6055

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$1,914.88

$2,797.12

$5,222.40

$0.00

$0.00

$0.00

$0.00

$9,934.40

70.62%

ADM 233

$16,724.07

$26,658.47

Page 84 of 271

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Report Date: 10/25/2016 at 10:59:33AM

FARMINGTON SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7202

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$9,516.02

$10,870.80

$27,344.80

$0.00

$0.00

$0.00

$3,135.78

$50,867.40

53.99%

ADM 2,366

$60,775.37

$111,642.77

Page 85 of 271

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Report Date: 10/25/2016 at 10:59:33AM

FAYETTEVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7203

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$34,154.60

$13,192.12

$109,933.46

$0.00

$0.00

$734.68

$16,520.62

$174,535.48

53.99%

ADM 9,652

$364,573.06

$539,108.54

Page 86 of 271

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Report Date: 10/25/2016 at 10:59:33AM

FLIPPIN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4501

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$22,350.80

$44,386.20

$0.00

$12,648.54

$0.00

$0.00

$10,317.74

$89,703.28

98.16%

ADM 820

$48,878.60

$138,581.88

Page 87 of 271

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Report Date: 10/25/2016 at 10:59:33AM

FORDYCE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2002

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$18,028.56

$25,429.80

$9,572.44

$5,364.82

$0.00

$0.00

$3,681.82

$62,077.44

100.00%

ADM 806

$33,181.20

$95,258.64

Page 88 of 271

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Report Date: 10/25/2016 at 10:59:33AM

FOREMAN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4102

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$1,531.20

$6,934.08

$5,842.56

$0.00

$0.00

$0.00

$0.00

$14,307.84

68.25%

ADM 481

$18,420.26

$32,728.10

Page 89 of 271

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Report Date: 10/25/2016 at 10:59:33AM

FORREST CITY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6201

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$20,701.14

$53,633.46

$27,113.66

$28,690.46

$0.00

$0.00

$0.00

$130,138.72

100.00%

ADM 2,478

$111,802.16

$241,940.88

Page 90 of 271

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Report Date: 10/25/2016 at 10:59:33AM

FORT SMITH SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6601

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$5,470.80

$37,040.60

$99,973.86

$0.00

$982.68

$0.00

$87,084.16

$230,552.10

68.52%

ADM 14,383

$635,907.10

$866,459.20

Page 91 of 271

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Report Date: 10/25/2016 at 10:59:33AM

FOUKE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4603

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$948.32

$4,160.00

$6,279.66

$11,894.32

$0.00

$0.00

$3,768.36

$27,050.66

79.06%

ADM 1,048

$24,052.64

$51,103.30

Page 92 of 271

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Report Date: 10/25/2016 at 10:59:33AM

FOUNTAIN LAKE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2602

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$44,311.24

$63,931.44

$59,786.96

$10,001.53

$0.00

$1,322.92

$7,077.22

$186,431.31

73.14%

ADM 1,357

$38,327.38

$224,758.69

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Report Date: 10/25/2016 at 10:59:33AM

GENOA CENTRAL SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4602

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$69.60

$6,680.32

$10,121.48

$0.00

$0.00

$0.00

$1,925.22

$18,796.62

79.06%

ADM 1,143

$41,587.15

$60,383.77

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Report Date: 10/25/2016 at 10:59:33AM

GENTRY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0403

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$17,421.76

$29,099.94

$18,937.48

$39,052.68

$0.00

$509.86

$5,063.40

$110,085.12

48.78%

ADM 1,446

$32,723.10

$142,808.22

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Report Date: 10/25/2016 at 10:59:33AM

GLEN ROSE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3002

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$12,271.32

$23,833.88

$17,609.80

$11,137.02

$0.00

$0.00

$2,409.44

$67,261.46

65.09%

ADM 1,008

$22,368.12

$89,629.58

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Report Date: 10/25/2016 at 10:59:33AM

GOSNELL SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4708

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$466.86

$13,965.28

$7,951.80

$0.00

$0.00

$0.00

$1,553.98

$23,937.92

82.61%

ADM 1,299

$23,855.86

$47,793.78

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Report Date: 10/25/2016 at 10:59:33AM

GRAVETTE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0404

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$25,059.20

$31,959.04

$17,458.12

$15,084.34

$0.00

$0.00

$4,846.02

$94,406.72

48.78%

ADM 1,809

$40,518.31

$134,925.03

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Report Date: 10/25/2016 at 10:59:33AM

Great Rivers Educational Co-op

2016 School-Based Medicaid Profile

5420

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$7,314.96

$0.00

$0.00

$0.00

$0.00

$7,314.96

67.09%

ADM 396

$30,366.83

$37,681.79

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Report Date: 10/25/2016 at 10:59:33AM

GREEN FOREST SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0803

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$16,729.12

$43,988.43

$43,833.10

$59,227.74

$0.00

$0.00

$2,665.98

$166,444.37

79.26%

ADM 1,200

$60,962.78

$227,407.15

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Report Date: 10/25/2016 at 10:59:33AM

GREENBRIER SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2303

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$15,908.48

$79,471.04

$62,460.24

$19,977.92

$0.00

$336.20

$9,127.10

$187,280.98

52.11%

ADM 3,393

$79,112.26

$266,393.24

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Report Date: 10/25/2016 at 10:59:33AM

GREENE COUNTY TECH SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2807

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$65,549.92

$133,272.88

$153,695.50

$0.00

$0.00

$0.00

$14,091.60

$366,609.90

68.19%

ADM 3,619

$186,999.60

$553,609.50

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Report Date: 10/25/2016 at 10:59:33AM

GREENLAND SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7204

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$3,288.84

$6,865.26

$13,836.86

$0.00

$0.00

$0.00

$1,379.18

$25,370.14

53.99%

ADM 849

$25,600.91

$50,971.05

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Report Date: 10/25/2016 at 10:59:33AM

GREENWOOD SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6602

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$20,993.00

$73,841.36

$117,425.76

$6,359.48

$707.04

$985.08

$5,437.70

$225,749.42

68.52%

ADM 3,630

$107,570.09

$333,319.51

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Report Date: 10/25/2016 at 10:59:33AM

GURDON SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1003

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$4,003.84

$15,019.12

$18,909.08

$10,609.08

$0.00

$0.00

$2,739.82

$51,280.94

77.92%

ADM 711

$37,776.56

$89,057.50

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Report Date: 10/25/2016 at 10:59:33AM

GUY-PERKINS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2304

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$10,378.88

$61,307.17

$21,011.24

$0.00

$0.00

$0.00

$1,867.18

$94,564.47

52.11%

ADM 368

$13,986.89

$108,551.36

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Report Date: 10/25/2016 at 10:59:33AM

HACKETT SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6603

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$5,794.20

$0.00

$22,240.64

$7,177.47

$0.00

$0.00

$3,477.82

$38,690.13

68.52%

ADM 861

$36,256.06

$74,946.19

Page 107 of 271

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Report Date: 10/25/2016 at 10:59:33AM

HAMBURG SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0203

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$15,246.56

$37,489.96

$23,669.88

$25,965.43

$0.00

$0.00

$6,017.08

$108,388.91

71.20%

ADM 1,893

$29,505.92

$137,894.83

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Report Date: 10/25/2016 at 10:59:33AM

HAMPTON SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0701

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$6,960.00

$15,821.06

$29,376.20

$0.00

$0.00

$0.00

$2,252.50

$54,409.76

79.84%

ADM 546

$16,494.63

$70,904.39

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Report Date: 10/25/2016 at 10:59:33AM

HARMONY GROVE SCHOOL DISTRICT (OUACHITA)

2016 School-Based Medicaid Profile

5205

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$5,802.92

$24,277.08

$14,285.42

$0.00

$0.00

$0.00

$4,800.00

$49,165.42

74.38%

ADM 967

$31,420.57

$80,585.99

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Report Date: 10/25/2016 at 10:59:33AM

HARMONY GROVE SCHOOL DISTRICT (SALINE)

2016 School-Based Medicaid Profile

6304

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$3,514.80

$17,600.44

$12,766.75

$0.00

$0.00

$0.00

$2,388.84

$36,270.83

51.45%

ADM 1,167

$25,103.91

$61,374.74

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Report Date: 10/25/2016 at 10:59:33AM

HARRISBURG SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5602

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$35,194.53

$58,089.92

$60,104.12

$0.00

$0.00

$0.00

$5,006.74

$158,395.31

78.81%

ADM 1,229

$64,086.41

$222,481.72

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Report Date: 10/25/2016 at 10:59:33AM

HARRISON SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0503

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$32,105.72

$92,767.52

$61,606.42

$58,401.34

$2,005.48

$0.00

$15,805.30

$262,691.78

61.70%

ADM 2,668

$90,691.44

$353,383.22

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Report Date: 10/25/2016 at 10:59:33AM

HAZEN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5903

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$13,671.04

$32,665.60

$117,711.24

$0.00

$0.00

$0.00

$0.00

$164,047.88

71.13%

ADM 643

$15,079.15

$179,127.03

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Report Date: 10/25/2016 at 10:59:33AM

HEBER SPRINGS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1202

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$52,564.40

$157,208.83

$21,544.50

$456.71

$0.00

$0.00

$8,771.32

$246,255.20

71.45%

ADM 1,742

$63,174.40

$309,429.60

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Report Date: 10/25/2016 at 10:59:33AM

HECTOR SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5803

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$22,553.60

$38,294.92

$62,181.12

$0.00

$0.00

$0.00

$0.00

$123,029.64

62.59%

ADM 576

$8,609.69

$131,639.33

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Report Date: 10/25/2016 at 10:59:33AM

HELENA/ W.HELENA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5403

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$23,129.32

$4,764.64

$0.00

$0.00

$0.00

$12,574.72

$40,468.68

83.32%

ADM 1,425

$21,394.26

$61,862.94

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Report Date: 10/25/2016 at 10:59:33AM

HERMITAGE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0601

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$11,632.36

$5,020.68

$28,795.59

$0.00

$0.00

$2,489.46

$47,938.09

75.09%

ADM 418

$15,992.25

$63,930.34

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Report Date: 10/25/2016 at 10:59:33AM

HIGHLAND SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6804

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$36,995.60

$42,344.80

$18,167.04

$9,729.18

$0.00

$0.00

$365.40

$107,602.02

72.00%

ADM 1,565

$54,687.04

$162,289.06

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Report Date: 10/25/2016 at 10:59:33AM

HILLCREST SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3809

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$3,655.68

$6,961.80

$13,206.68

$0.00

$0.00

$3,242.24

$27,066.40

65.14%

ADM 408

$12,621.93

$39,688.33

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Report Date: 10/25/2016 at 10:59:33AM

HOPE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2903

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$25,238.16

$18,653.96

$29,416.59

$9,304.62

$0.00

$0.00

$0.00

$82,613.33

83.89%

ADM 2,492

$36,633.67

$119,247.00

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Report Date: 10/25/2016 at 10:59:33AM

HORATIO SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6703

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$1,711.56

$6,954.60

$33,747.66

$0.00

$0.00

$0.00

$4,804.12

$47,217.94

80.25%

ADM 840

$31,205.22

$78,423.16

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Report Date: 10/25/2016 at 10:59:33AM

HOT SPRINGS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2603

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$47,272.70

$69,606.50

$92,342.48

$0.00

$0.00

$0.00

$26,098.64

$235,320.32

73.14%

ADM 3,642

$135,396.00

$370,716.32

Page 123 of 271

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Report Date: 10/25/2016 at 10:59:33AM

HOXIE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3804

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$24,242.52

$44,802.71

$21,833.32

$37,561.53

$0.00

$0.00

$0.00

$128,440.08

65.14%

ADM 826

$23,442.37

$151,882.45

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Report Date: 10/25/2016 at 10:59:33AM

HUNTSVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4401

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$10,096.64

$5,005.96

$5,195.15

$0.00

$0.00

$0.00

$13,365.26

$33,663.01

79.14%

ADM 2,286

$62,503.65

$96,166.66

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Report Date: 10/25/2016 at 10:59:33AM

IMBODEN CHARTER SCHOOL DIST

2016 School-Based Medicaid Profile

3840

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$2,403.24

$6,630.36

$0.00

$0.00

$0.00

$0.00

$9,033.60

59.49%

ADM 44

$0.00

$9,033.60

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Report Date: 10/25/2016 at 10:59:33AM

IZARD CO. CONS. SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3306

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$12,298.36

$2,437.12

$23,819.86

$0.00

$0.00

$0.00

$0.00

$38,555.34

73.13%

ADM 488

$27,112.02

$65,667.36

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Report Date: 10/25/2016 at 10:59:33AM

JACKSON CO. SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3405

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$14,252.28

$15,516.96

$0.00

$0.00

$0.00

$0.00

$0.00

$29,769.24

88.88%

ADM 875

$10,716.24

$40,485.48

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Report Date: 10/25/2016 at 10:59:33AM

JACKSONVILLE LIGHT HOUSE CHARTER SCHOOL

2016 School-Based Medicaid Profile

6050

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$4,611.84

$174.08

$0.00

$0.00

$0.00

$0.00

$4,785.92

70.62%

ADM 1,004

$36,099.58

$40,885.50

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Report Date: 10/25/2016 at 10:59:33AM

JASPER SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5102

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$9,248.68

$12,444.68

$19,984.18

$994.50

$0.00

$0.00

$4,767.02

$47,439.06

72.82%

ADM 859

$70,690.67

$118,129.73

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Report Date: 10/25/2016 at 10:59:33AM

JESSIEVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2604

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$16,640.60

$51,537.28

$32,887.60

$0.00

$0.00

$300.30

$2,282.72

$103,648.50

73.14%

ADM 898

$20,466.32

$124,114.82

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Report Date: 10/25/2016 at 10:59:33AM

JONESBORO SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1608

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$122,447.62

$225,143.92

$136,897.04

$0.00

$0.00

$0.00

$25,895.32

$510,383.90

61.67%

ADM 5,918

$166,041.54

$676,425.44

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Report Date: 10/25/2016 at 10:59:33AM

JUNCTION CITY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7003

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$11,791.86

$8,595.20

$0.00

$0.00

$0.00

$2,021.72

$22,408.78

63.45%

ADM 660

$23,368.29

$45,777.07

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Report Date: 10/25/2016 at 10:59:33AM

KIPP: DELTA COLLEGE PREP SCHOOL

2016 School-Based Medicaid Profile

5440

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$23.76

$32,851.20

$17,255.02

$0.00

$0.00

$0.00

$17,537.84

$67,667.82

83.32%

ADM 1,411

$10,951.65

$78,619.47

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Report Date: 10/25/2016 at 10:59:33AM

KIRBY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5503

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$2,915.84

$4,336.16

$0.00

$0.00

$0.00

$1,427.26

$8,679.26

65.55%

ADM 329

$11,612.73

$20,291.99

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Report Date: 10/25/2016 at 10:59:33AM

LAFAYETTE COUNTY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3704

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$1,781.16

$493.60

$0.00

$0.00

$0.00

$2,668.38

$4,943.14

100.00%

ADM 628

$19,379.71

$24,322.85

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Report Date: 10/25/2016 at 10:59:33AM

LAKE HAMILTON SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2605

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$29,612.34

$102,805.12

$102,281.76

$293.30

$0.00

$236.78

$18,240.14

$253,469.44

73.14%

ADM 4,378

$128,760.94

$382,230.38

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Report Date: 10/25/2016 at 10:59:33AM

LAKESIDE SCHOOL DISTRICT (CHICOT)

2016 School-Based Medicaid Profile

0903

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$2,062.08

$10,484.20

$8,175.42

$0.00

$0.00

$0.00

$4,596.00

$25,317.70

100.00%

ADM 1,060

$16,723.83

$42,041.53

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Report Date: 10/25/2016 at 10:59:33AM

LAKESIDE SCHOOL DISTRICT (GARLAND)

2016 School-Based Medicaid Profile

2606

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$54,281.84

$50,435.26

$99,346.28

$0.00

$0.00

$0.00

$0.00

$204,063.38

73.14%

ADM 3,391

$123,594.62

$327,658.00

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Report Date: 10/25/2016 at 10:59:33AM

LAMAR SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3604

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$24,415.64

$22,157.12

$96,466.44

$3,044.40

$0.00

$0.00

$7,352.30

$153,435.90

72.09%

ADM 1,255

$55,703.92

$209,139.82

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Report Date: 10/25/2016 at 10:59:33AM

LAVACA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6605

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$12,070.92

$37,632.80

$68,986.88

$1,923.21

$0.00

$0.00

$2,467.14

$123,080.95

68.52%

ADM 838

$31,957.10

$155,038.05

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Report Date: 10/25/2016 at 10:59:33AM

LAWRENCE COUNTY

2016 School-Based Medicaid Profile

3810

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$65,088.24

$33,392.96

$9,409.80

$0.00

$0.00

$0.00

$7,030.52

$114,921.52

65.14%

ADM 970

$17,251.72

$132,173.24

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Report Date: 10/25/2016 at 10:59:33AM

LEAD HILL SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0506

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$3,634.80

$10,104.40

$478.84

$0.00

$0.00

$0.00

$2,312.94

$16,530.98

61.70%

ADM 369

$17,488.07

$34,019.05

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Report Date: 10/25/2016 at 10:59:33AM

LEE COUNTY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3904

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$20,235.56

$147.92

$0.00

$0.00

$0.00

$0.00

$0.00

$20,383.48

100.00%

ADM 781

$20,535.02

$40,918.50

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Report Date: 10/25/2016 at 10:59:33AM

Lighthouse Academies of Central Arkansas

2016 School-Based Medicaid Profile

6056

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

70.62%

ADM 297

$4,303.31

$4,303.31

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Report Date: 10/25/2016 at 10:59:33AM

LINCOLN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7205

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$9,677.39

$6,921.30

$21,814.88

$0.00

$0.00

$0.00

$2,242.54

$40,656.11

53.99%

ADM 1,203

$31,165.39

$71,821.50

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Report Date: 10/25/2016 at 10:59:33AM

LISA ACADEMY CHARTER SCHOOL

2016 School-Based Medicaid Profile

6041

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$1,827.04

$7,307.36

$40,804.39

$0.00

$0.00

$0.00

$0.00

$49,938.79

70.62%

ADM 1,525

$44,828.57

$94,767.36

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Report Date: 10/25/2016 at 10:59:33AM

LITTLE ROCK PREPARATORY ACADEMY CHARTER SCHOOL

2016 School-Based Medicaid Profile

6049

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$3,462.88

$9,485.28

$0.00

$0.00

$0.00

$0.00

$12,948.16

70.62%

ADM 430

$28,739.43

$41,687.59

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Report Date: 10/25/2016 at 10:59:33AM

LITTLE ROCK SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6001

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$23,126.20

$97,255.48

$244,490.72

$3,569.08

$0.00

$0.00

$80,918.96

$449,360.44

70.62%

ADM 23,164

$760,487.76

$1,209,848.20

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Report Date: 10/25/2016 at 10:59:33AM

LONOKE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4301

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$37,282.72

$42,692.72

$67,962.88

$0.00

$0.00

$0.00

$52.20

$147,990.52

46.56%

ADM 1,748

$38,404.48

$186,395.00

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Report Date: 10/25/2016 at 10:59:33AM

MAGAZINE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4202

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$18,038.66

$12,740.80

$32,998.08

$0.00

$0.00

$0.00

$3,854.56

$67,632.10

76.24%

ADM 546

$31,580.21

$99,212.31

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Report Date: 10/25/2016 at 10:59:33AM

MAGNET COVE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3003

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$16,919.36

$16,825.80

$11,006.50

$1,256.49

$0.00

$0.00

$2,131.96

$48,140.11

65.09%

ADM 679

$21,844.32

$69,984.43

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Report Date: 10/25/2016 at 10:59:33AM

MAGNOLIA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1402

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$13,482.88

$31,699.84

$35,656.99

$0.00

$0.00

$0.00

$0.00

$80,839.71

61.19%

ADM 2,871

$61,014.37

$141,854.08

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Report Date: 10/25/2016 at 10:59:33AM

MALVERN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3004

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$63,345.47

$144,862.78

$255,849.30

$18,485.81

$0.00

$0.00

$14,620.12

$497,163.48

65.09%

ADM 2,025

$82,917.68

$580,081.16

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Report Date: 10/25/2016 at 10:59:33AM

MAMMOTH SPRING SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2501

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$15,939.24

$33,380.64

$0.00

$0.00

$0.00

$0.00

$0.00

$49,319.88

78.74%

ADM 449

$15,833.18

$65,153.06

Page 155 of 271

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Report Date: 10/25/2016 at 10:59:33AM

MANILA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4712

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$2,985.76

$5,885.12

$6,603.96

$0.00

$0.00

$0.00

$4,793.48

$20,268.32

82.61%

ADM 1,063

$41,004.52

$61,272.84

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Report Date: 10/25/2016 at 10:59:33AM

MANSFIELD SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6606

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$15,892.48

$13,983.84

$0.00

$0.00

$0.00

$3,025.54

$32,901.86

68.52%

ADM 831

$34,344.55

$67,246.41

Page 157 of 271

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Report Date: 10/25/2016 at 10:59:33AM

MARION SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1804

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$38,698.56

$25,752.56

$34,286.22

$4,246.22

$0.00

$0.00

$14,867.40

$117,850.96

73.46%

ADM 1,804

$191,207.55

$309,058.51

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Report Date: 10/25/2016 at 10:59:33AM

MARKED TREE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5604

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$6,953.48

$12,320.00

$72,260.78

$0.00

$0.00

$0.00

$3,896.80

$95,431.06

78.81%

ADM 564

$33,527.52

$128,958.58

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Report Date: 10/25/2016 at 10:59:33AM

MARMADUKE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2803

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$59,592.34

$40,314.92

$190.08

$15,962.20

$0.00

$0.00

$3,234.34

$119,293.88

68.19%

ADM 744

$10,809.50

$130,103.38

Page 160 of 271

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Report Date: 10/25/2016 at 10:59:33AM

MARVELL SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5404

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$14,695.76

$10,268.56

$27,261.84

$0.00

$0.00

$0.00

$0.00

$52,226.16

83.32%

ADM 361

$19,730.05

$71,956.21

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Report Date: 10/25/2016 at 10:59:33AM

MAYFLOWER SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2305

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$12,937.83

$34,711.60

$30,884.48

$0.00

$0.00

$0.00

$0.00

$78,533.91

52.11%

ADM 1,090

$50,833.74

$129,367.65

Page 162 of 271

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Report Date: 10/25/2016 at 10:59:33AM

MAYNARD SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6102

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$8,280.64

$7,625.80

$0.00

$0.00

$0.00

$3,172.18

$19,078.62

85.15%

ADM 444

$25,233.93

$44,312.55

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Report Date: 10/25/2016 at 10:59:33AM

MCCRORY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7403

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$45,509.76

$62,984.32

$0.00

$0.00

$0.00

$0.00

$108,494.08

81.63%

ADM 603

$16,319.96

$124,814.04

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Report Date: 10/25/2016 at 10:59:33AM

MCGEHEE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2105

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$5,456.24

$18,146.70

$6,343.04

$0.00

$0.00

$0.00

$5,495.08

$35,441.06

72.62%

ADM 1,167

$19,044.00

$54,485.06

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Report Date: 10/25/2016 at 10:59:33AM

MELBOURNE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3302

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$3,161.12

$6,294.76

$12,616.78

$0.00

$0.00

$0.00

$3,445.20

$25,517.86

73.13%

ADM 871

$22,775.09

$48,292.95

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Report Date: 10/25/2016 at 10:59:33AM

MENA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5703

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$29,345.27

$40,583.36

$57,417.32

$0.00

$0.00

$0.00

$8,923.46

$136,269.41

69.56%

ADM 1,763

$20,288.29

$156,557.70

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Report Date: 10/25/2016 at 10:59:33AM

MIDLAND SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3211

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$50,850.63

$54,901.52

$0.00

$0.00

$0.00

$2,830.82

$108,582.97

67.57%

ADM 517

$14,502.92

$123,085.89

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Report Date: 10/25/2016 at 10:59:33AM

MINERAL SPRINGS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3104

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$4,789.84

$5,241.12

$11,300.12

$0.00

$0.00

$0.00

$0.00

$21,331.08

62.86%

ADM 411

$18,169.39

$39,500.47

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Report Date: 10/25/2016 at 10:59:33AM

MONTICELLO SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2203

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$10,218.78

$21,663.58

$24,863.04

$26,027.80

$0.00

$0.00

$7,996.22

$90,769.42

65.89%

ADM 2,059

$89,238.96

$180,008.38

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Report Date: 10/25/2016 at 10:59:33AM

MOUNT IDA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4902

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$9,087.36

$8,191.66

$16,134.46

$0.00

$0.00

$0.00

$2,699.98

$36,113.46

91.13%

ADM 474

$33,303.01

$69,416.47

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Report Date: 10/25/2016 at 10:59:33AM

MOUNTAIN HOME SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0303

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$96,363.48

$117,426.56

$100,224.56

$0.00

$0.00

$0.00

$14,161.66

$328,176.26

68.31%

ADM 3,919

$110,272.58

$438,448.84

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Report Date: 10/25/2016 at 10:59:33AM

MOUNTAIN PINE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2607

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$10,638.64

$36,965.76

$101,504.72

$0.00

$0.00

$0.00

$0.00

$149,109.12

73.14%

ADM 513

$15,579.37

$164,688.49

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Report Date: 10/25/2016 at 10:59:33AM

MOUNTAIN VIEW SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6901

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$15,358.68

$105,005.21

$24,750.84

$0.00

$0.00

$0.00

$10,636.08

$155,750.81

82.28%

ADM 1,660

$69,714.90

$225,465.71

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Report Date: 10/25/2016 at 10:59:33AM

MOUNTAINBURG SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1703

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$725.52

$0.00

$0.00

$0.00

$0.00

$725.52

62.09%

ADM 666

$26,362.04

$27,087.56

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Report Date: 10/25/2016 at 10:59:33AM

MT. VERNON/ENOLA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2306

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$6,369.32

$16,381.44

$11,740.48

$737.44

$0.00

$0.00

$704.70

$35,933.38

52.11%

ADM 512

$17,492.09

$53,425.47

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Report Date: 10/25/2016 at 10:59:33AM

MULBERRY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1704

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$1,996.32

$19,847.24

$0.00

$0.00

$0.00

$0.00

$0.00

$21,843.56

62.09%

ADM 359

$10,695.66

$32,539.22

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Report Date: 10/25/2016 at 10:59:33AM

N. LITTLE ROCK SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6002

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$69,722.73

$96,646.44

$165,345.22

$6,049.12

$0.00

$330.18

$29,338.14

$367,431.83

70.62%

ADM 8,413

$251,824.27

$619,256.10

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Report Date: 10/25/2016 at 10:59:33AM

NASHVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3105

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$28,666.28

$16,530.68

$18,949.90

$0.00

$0.00

$0.00

$9,375.74

$73,522.60

62.86%

ADM 1,909

$51,800.88

$125,323.48

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Report Date: 10/25/2016 at 10:59:33AM

NEMO VISTA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1503

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$2,196.54

$18,611.52

$48,985.96

$0.00

$0.00

$0.00

$809.10

$70,603.12

71.70%

ADM 423

$18,215.97

$88,819.09

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Report Date: 10/25/2016 at 10:59:33AM

NETTLETON SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1611

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$62,148.20

$138,103.79

$126,941.88

$0.00

$0.00

$0.00

$12,176.00

$339,369.87

61.67%

ADM 3,306

$115,496.17

$454,866.04

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Report Date: 10/25/2016 at 10:59:33AM

NEVADA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5008

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$7,650.68

$7,508.18

$2,009.00

$0.00

$0.00

$0.00

$1,459.54

$18,627.40

74.14%

ADM 418

$15,059.32

$33,686.72

Page 182 of 271

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Report Date: 10/25/2016 at 10:59:33AM

NEWPORT SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3403

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$44,698.20

$84,273.76

$92,806.18

$0.00

$0.00

$0.00

$7,150.72

$228,928.86

88.88%

ADM 1,208

$121,239.42

$350,168.28

Page 183 of 271

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Report Date: 10/25/2016 at 10:59:33AM

NORFORK SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0304

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$11,989.24

$17,352.36

$5,997.68

$8,163.80

$0.00

$0.00

$0.00

$43,503.08

68.31%

ADM 426

$15,299.18

$58,802.26

Page 184 of 271

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Report Date: 10/25/2016 at 10:59:33AM

NORTH CENTRAL ARKANSAS EDUCATION SERVICE CENTER

2016 School-Based Medicaid Profile

3320

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$9,730.96

$13,415.20

$28,616.00

$0.00

$0.00

$0.00

$0.00

$51,762.16

67.10%

ADM 377

$26,784.67

$78,546.83

Page 185 of 271

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Report Date: 10/25/2016 at 10:59:33AM

NORTHEAST ARKANSAS EDUCATION SERVICE CENTER

2016 School-Based Medicaid Profile

3820

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$19,291.36

-$768.54

$0.00

$0.00

$0.00

$0.00

$18,522.82

68.37%

ADM 194

$16,385.55

$34,908.37

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Report Date: 10/25/2016 at 10:59:33AM

NorthWest Arkansas Classical Academy

2016 School-Based Medicaid Profile

0442

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

48.78%

ADM 551

$0.00

$0.00

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Report Date: 10/25/2016 at 10:59:33AM

NORTHWEST ARKANSAS EDUCATION SERVICE CENTER

2016 School-Based Medicaid Profile

7221

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$2,480.33

$17,088.84

$104,182.40

$0.00

$0.00

$0.00

$0.00

$123,751.57

49.11%

ADM 427

$10,369.08

$134,120.65

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Report Date: 10/25/2016 at 10:59:33AM

OMAHA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0504

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$3,459.68

$10,717.60

$373.76

$0.00

$0.00

$0.00

$2,266.58

$16,817.62

61.70%

ADM 403

$17,994.12

$34,811.74

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Report Date: 10/25/2016 at 10:59:33AM

OSCEOLA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4713

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$16,534.84

$98.88

$67,775.66

$0.00

$0.00

$0.00

$0.00

$84,409.38

82.61%

ADM 1,236

$35,068.67

$119,478.05

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Report Date: 10/25/2016 at 10:59:33AM

OUACHITA RIVER SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5706

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$174.08

$10,272.80

$0.00

$0.00

$0.00

$3,476.80

$13,923.68

69.56%

ADM 718

$31,653.91

$45,577.59

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Report Date: 10/25/2016 at 10:59:33AM

OUACHITA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3005

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$197.76

$4,158.08

$6,458.90

$0.00

$0.00

$0.00

$0.00

$10,814.74

65.09%

ADM 513

$21,523.38

$32,338.12

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Report Date: 10/25/2016 at 10:59:33AM

Ozark Montessori Academy

2016 School-Based Medicaid Profile

7241

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

53.99%

ADM 136

$0.00

$0.00

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Report Date: 10/25/2016 at 10:59:33AM

OZARK MOUNTAIN SCHOOL DISTRICT (SEARCY)

2016 School-Based Medicaid Profile

6505

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$31,060.24

$51,972.52

$10,602.06

$39,614.22

$0.00

$0.00

$4,990.94

$138,239.98

59.12%

ADM 665

$29,006.43

$167,246.41

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Report Date: 10/25/2016 at 10:59:33AM

OZARK SCHOOL DISTRICT (FRANKLIN)

2016 School-Based Medicaid Profile

2404

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$6,846.56

$97,998.02

$42,242.98

$0.00

$0.00

$0.00

$0.00

$147,087.56

59.48%

ADM 1,832

$47,520.19

$194,607.75

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Report Date: 10/25/2016 at 10:59:33AM

OZARK UNLIMITED RESOURCES CO-OP

2016 School-Based Medicaid Profile

0520

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$28,097.20

$0.00

$0.00

$0.00

$0.00

$28,097.20

69.50%

ADM 211

$26,141.22

$54,238.42

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Report Date: 10/25/2016 at 10:59:33AM

PALESTINE-WHEATLEY SCH. DISTRICT

2016 School-Based Medicaid Profile

6205

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$6,967.52

$18,654.96

$1,566.72

$0.00

$0.00

$0.00

$0.00

$27,189.20

100.00%

ADM 768

$25,373.62

$52,562.82

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Report Date: 10/25/2016 at 10:59:33AM

PANGBURN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7309

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$1,635.64

$64,997.80

$0.00

$0.00

$0.00

$1,023.74

$67,657.18

64.23%

ADM 733

$47,343.07

$115,000.25

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Report Date: 10/25/2016 at 10:59:33AM

PARAGOULD SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2808

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$99,712.40

$99,019.32

$29,231.40

$0.00

$0.00

$219.04

$35,845.28

$264,027.44

68.19%

ADM 3,057

$83,228.01

$347,255.45

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Report Date: 10/25/2016 at 10:59:33AM

PARIS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4203

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$16,007.36

$57,884.36

$52,046.16

$14,673.21

$0.00

$214.80

$3,635.78

$144,461.67

76.24%

ADM 1,098

$40,292.22

$184,753.89

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Report Date: 10/25/2016 at 10:59:33AM

PARKERS CHAPEL SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7007

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$9,934.44

$14,095.71

$27,722.24

$0.00

$0.00

$0.00

$0.00

$51,752.39

63.45%

ADM 787

$26,018.75

$77,771.14

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Report Date: 10/25/2016 at 10:59:33AM

PEA RIDGE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0407

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$26,599.72

$41,968.76

$12,424.50

$0.00

$0.00

$0.00

$3,768.36

$84,761.34

48.78%

ADM 1,930

$50,644.80

$135,406.14

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Report Date: 10/25/2016 at 10:59:33AM

PERRYVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5303

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$9,149.84

$30,116.54

$27,593.44

$0.00

$0.00

$0.00

$4,848.42

$71,708.24

64.54%

ADM 952

$17,321.77

$89,030.01

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Report Date: 10/25/2016 at 10:59:33AM

PIGGOTT SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1104

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$53,869.08

$20,455.22

$0.00

$703.92

$0.00

$0.00

$144.58

$75,172.80

67.79%

ADM 909

$29,331.36

$104,504.16

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Report Date: 10/25/2016 at 10:59:33AM

PINE BLUFF SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3505

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$3,512.86

$4,917.76

$11,387.10

$0.00

$0.00

$0.00

$18,831.48

$38,649.20

80.80%

ADM 4,016

$108,654.60

$147,303.80

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Report Date: 10/25/2016 at 10:59:33AM

PineBluff Lighthouse Charter School

2016 School-Based Medicaid Profile

3541

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$348.16

$0.00

$0.00

$0.00

$0.00

$348.16

80.80%

ADM 343

$17,510.82

$17,858.98

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Report Date: 10/25/2016 at 10:59:33AM

POCAHONTAS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6103

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$46,040.40

$77,511.34

$34,784.74

$1,575.44

$0.00

$0.00

$0.00

$159,911.92

85.15%

ADM 1,911

$77,535.55

$237,447.47

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Report Date: 10/25/2016 at 10:59:33AM

POTTSVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5804

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$65,729.21

$69,879.68

$103,907.40

$0.00

$0.00

$0.00

$5,519.12

$245,035.41

62.59%

ADM 1,699

$67,702.66

$312,738.07

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Report Date: 10/25/2016 at 10:59:33AM

POYEN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2703

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$1,918.04

$19,921.92

$15,114.96

$0.00

$0.00

$0.00

$1,628.16

$38,583.08

33.22%

ADM 568

$11,190.64

$49,773.72

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Report Date: 10/25/2016 at 10:59:33AM

PRAIRIE GROVE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7206

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$8,495.42

$7,366.76

$21,020.24

$0.00

$0.00

$0.00

$2,401.20

$39,283.62

53.99%

ADM 1,881

$60,388.16

$99,671.78

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Report Date: 10/25/2016 at 10:59:33AM

Premier High School of Little Rock

2016 School-Based Medicaid Profile

6053

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

70.62%

ADM 116

$0.00

$0.00

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Report Date: 10/25/2016 at 10:59:33AM

PRESCOTT SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5006

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$8,543.16

$15,594.20

$23,338.96

$0.00

$0.00

$0.00

$4,085.68

$51,562.00

74.14%

ADM 999

$37,078.88

$88,640.88

Page 212 of 271

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Report Date: 10/25/2016 at 10:59:33AM

PULASKI CO. SPEC. SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6003

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$59,180.78

$96,761.92

$241,999.24

$0.00

$0.00

$2,949.36

$57,407.82

$458,299.12

70.62%

ADM 16,562

$464,409.39

$922,708.51

Page 213 of 271

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Report Date: 10/25/2016 at 10:59:33AM

Quest Middle School of PineBluff

2016 School-Based Medicaid Profile

3542

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

80.80%

ADM 89

$0.00

$0.00

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Report Date: 10/25/2016 at 10:59:33AM

Quest Middle School West Little Rock

2016 School-Based Medicaid Profile

6054

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

70.62%

ADM 231

$0.00

$0.00

Page 215 of 271

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Report Date: 10/25/2016 at 10:59:33AM

QUITMAN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1203

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$7,934.40

$42,526.72

$25,141.22

$0.00

$0.00

$0.00

$2,545.78

$78,148.12

71.45%

ADM 631

$20,694.46

$98,842.58

Page 216 of 271

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Report Date: 10/25/2016 at 10:59:33AM

RECTOR SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1106

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$5,233.48

$4,797.72

$0.00

$346.50

$0.00

$0.00

$2,033.74

$12,411.44

67.79%

ADM 611

$5,779.32

$18,190.76

Page 217 of 271

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Report Date: 10/25/2016 at 10:59:33AM

RIVERCREST

2016 School-Based Medicaid Profile

4706

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$16,279.84

$24,069.64

$39,086.70

$0.00

$0.00

$0.00

$1,618.20

$81,054.38

82.61%

ADM 1,252

$35,955.65

$117,010.03

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Report Date: 10/25/2016 at 10:59:33AM

RIVERSIDE SCHOOL DISTRICT (CRAIGHEAD)

2016 School-Based Medicaid Profile

1613

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$10,729.76

$10,229.28

$19,590.80

$953.86

$0.00

$0.00

$182.70

$41,686.40

61.67%

ADM 818

$17,530.32

$59,216.72

Page 219 of 271

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Report Date: 10/25/2016 at 10:59:33AM

RIVERVIEW SCHOOL DISTRICT (WHITE)

2016 School-Based Medicaid Profile

7307

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$3,888.12

$21,805.44

$33,434.86

$0.00

$0.00

$0.00

$4,256.36

$63,384.78

64.23%

ADM 1,345

$43,496.87

$106,881.65

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Report Date: 10/25/2016 at 10:59:33AM

Rockbridge Montessori

2016 School-Based Medicaid Profile

6057

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$197.76

$0.00

$0.00

$0.00

$0.00

$0.00

$197.76

70.62%

ADM 111

$0.00

$197.76

Page 221 of 271

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Report Date: 10/25/2016 at 10:59:33AM

ROGERS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0405

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$53,825.44

$17,747.28

$57,428.26

$7,193.85

$0.00

$0.00

$42,048.50

$178,243.33

48.78%

ADM 15,077

$224,544.71

$402,788.04

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Report Date: 10/25/2016 at 10:59:33AM

ROSE BUD SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7310

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$20,645.24

$65,729.20

$61,467.86

$6,440.96

$0.00

$0.00

$1,112.32

$155,395.58

64.23%

ADM 837

$21,756.88

$177,152.46

Page 223 of 271

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Report Date: 10/25/2016 at 10:59:33AM

RUSSELLVILLE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5805

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$122,739.04

$175,846.72

$52,759.70

$10,047.63

$0.00

$0.00

$18,801.98

$380,195.07

62.59%

ADM 5,240

$134,095.37

$514,290.44

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Report Date: 10/25/2016 at 10:59:33AM

SALEM SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2502

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$6,177.00

$19,906.40

$4,330.24

$0.00

$0.00

$0.00

$0.00

$30,413.64

78.74%

ADM 793

$15,276.20

$45,689.84

Page 225 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SCRANTON SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4204

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$2,674.08

$7,501.72

$2,297.68

$0.00

$0.00

$0.00

$1,879.20

$14,352.68

76.24%

ADM 409

$14,258.72

$28,611.40

Page 226 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SEARCY COUNTY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6502

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$42,023.68

$28,166.50

$0.00

$0.00

$0.00

$22,539.76

$92,729.94

59.12%

ADM 828

$19,931.66

$112,661.60

Page 227 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SEARCY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7311

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$130,248.75

$318,764.81

$305,896.87

$0.00

$0.00

$0.00

$90.32

$755,000.75

64.23%

ADM 4,146

$38,948.21

$793,948.96

Page 228 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SHERIDAN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2705

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$54,717.04

$100,403.34

$72,742.48

$0.00

$0.00

$0.00

$6,883.88

$234,746.74

33.22%

ADM 4,130

$67,965.82

$302,712.56

Page 229 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SHIRLEY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7104

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$10,853.56

$98.92

$0.00

$0.00

$0.00

$1,676.24

$12,628.72

73.51%

ADM 383

$24,714.65

$37,343.37

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Report Date: 10/25/2016 at 10:59:33AM

SIATECH High School

2016 School-Based Medicaid Profile

6052

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

70.62%

ADM 166

$12,961.45

$12,961.45

Page 231 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SILOAM SPRINGS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0406

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$111,662.54

$67,691.92

$111,727.68

$64,884.60

$0.00

$0.00

$22,864.64

$378,831.38

48.78%

ADM 4,139

$82,604.33

$461,435.71

Page 232 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SLOAN-HENDRIX SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3806

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$14,091.24

$9,030.60

$0.00

$0.00

$0.00

$0.00

$5,631.08

$28,752.92

65.14%

ADM 718

$10,274.79

$39,027.71

Page 233 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SMACKOVER-NORPHLET SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7008

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$12,994.96

$34,765.26

$22,807.20

$0.00

$0.00

$0.00

$5,942.90

$76,510.32

63.45%

ADM 1,160

$60,586.85

$137,097.17

Page 234 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SO. CONWAY CO. SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1507

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$65,621.12

$168,698.18

$256,897.20

$12,799.07

$0.00

$0.00

$4,683.58

$508,699.15

71.70%

ADM 2,205

$72,322.61

$581,021.76

Page 235 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SOUTH CENTRAL SERVICE CO-OP

2016 School-Based Medicaid Profile

5220

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$8,507.48

$18,994.04

$48,708.61

$0.00

$0.00

$0.00

$0.00

$76,210.13

63.87%

ADM 258

$34,895.16

$111,105.29

Page 236 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SOUTH PIKE COUNTY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5504

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$16,414.72

$19,685.30

$9,450.92

$0.00

$0.00

$0.00

$3,760.12

$49,311.06

65.55%

ADM 705

$34,540.48

$83,851.54

Page 237 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SOUTH SIDE SCHOOL DISTRICT (VANBUREN)

2016 School-Based Medicaid Profile

7105

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$10,428.96

$27,132.08

$4,852.64

$0.00

$0.00

$0.00

$977.72

$43,391.40

73.51%

ADM 491

$38,416.46

$81,807.86

Page 238 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SOUTHEAST ARKANSAS EDUCATIONAL SERVICE CO-OP

2016 School-Based Medicaid Profile

2220

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$6,681.60

$4,783.98

$86,798.80

$0.00

$0.00

$880.30

$0.00

$99,144.68

58.53%

ADM 660

$33,434.07

$132,578.75

Page 239 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SOUTHSIDE SCHOOL DISTRICT (INDEPENDENCE)

2016 School-Based Medicaid Profile

3209

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$19,238.76

$61,355.64

$39,435.98

$0.00

$0.00

$0.00

$8,625.02

$128,655.40

67.57%

ADM 1,726

$77,654.00

$206,309.40

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Report Date: 10/25/2016 at 10:59:33AM

SOUTHWEST ARKANSAS EDUCATIONAL CO-OP

2016 School-Based Medicaid Profile

2920

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$14,391.90

$0.00

$0.00

$0.00

$0.00

$14,391.90

75.70%

ADM 299

$30,711.58

$45,103.48

Page 241 of 271

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Report Date: 10/25/2016 at 10:59:33AM

SPRING HILL SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2906

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$10,551.12

$11,974.84

$6,484.60

$0.00

$0.00

$0.00

$1,991.84

$31,002.40

83.89%

ADM 555

$13,530.65

$44,533.05

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Report Date: 10/25/2016 at 10:59:33AM

SPRINGDALE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7207

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$6,943.84

$38,322.32

$77,891.48

$69,822.25

$0.00

$0.00

$81,227.20

$274,207.09

53.99%

ADM 21,260

$439,694.30

$713,901.39

Page 243 of 271

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Report Date: 10/25/2016 at 10:59:33AM

STAR CITY SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4003

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$14,900.88

$34,154.06

$41,545.70

$18,672.58

$0.00

$0.00

$8,008.24

$117,281.46

79.99%

ADM 1,562

$63,915.58

$181,197.04

Page 244 of 271

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Report Date: 10/25/2016 at 10:59:33AM

STRONG-HUTTIG SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7009

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$17,811.80

$36,724.58

$26,542.88

$0.00

$0.00

$0.00

$0.00

$81,079.26

63.45%

ADM 313

$15,858.51

$96,937.77

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Report Date: 10/25/2016 at 10:59:33AM

STUTTGART SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0104

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$46,124.30

$0.00

$0.00

$0.00

$4,346.68

$50,470.98

73.10%

ADM 1,634

$65,104.74

$115,575.72

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Report Date: 10/25/2016 at 10:59:33AM

TEXARKANA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4605

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$13,703.40

$39,298.16

$22,437.66

$21,871.07

$0.00

$0.00

$12,171.88

$109,482.17

79.06%

ADM 4,270

$181,975.01

$291,457.18

Page 247 of 271

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Report Date: 10/25/2016 at 10:59:33AM

TRUMANN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

5605

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$73,799.88

$65,108.28

$108,586.08

$0.00

$0.00

$0.00

$11,232.62

$258,726.86

78.81%

ADM 1,614

$63,807.61

$322,534.47

Page 248 of 271

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Report Date: 10/25/2016 at 10:59:33AM

TWO RIVERS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7510

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$28,756.20

$47,827.52

$95,296.32

$0.00

$0.00

$0.00

$4,426.70

$176,306.74

67.71%

ADM 815

$31,524.35

$207,831.09

Page 249 of 271

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Report Date: 10/25/2016 at 10:59:33AM

VALLEY SPRINGS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0505

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$16,425.92

$34,340.80

$24,406.44

$238.83

$0.00

$0.00

$5,599.14

$81,011.13

61.70%

ADM 893

$36,318.96

$117,330.09

Page 250 of 271

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Report Date: 10/25/2016 at 10:59:33AM

VALLEY VIEW SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1612

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$55,282.96

$46,035.38

$58,037.32

$1,793.25

$0.00

$0.00

$11,467.86

$172,616.77

61.67%

ADM 2,709

$72,452.94

$245,069.71

Page 251 of 271

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Report Date: 10/25/2016 at 10:59:33AM

VAN BUREN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1705

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$46,466.48

$19,401.16

$202,285.57

$0.00

$0.00

$0.00

$16,524.74

$284,677.95

62.09%

ADM 5,818

$89,146.40

$373,824.35

Page 252 of 271

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Report Date: 10/25/2016 at 10:59:33AM

VILONIA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2307

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$29,569.76

$68,330.88

$126,477.80

$17,739.63

$0.00

$0.00

$9,439.62

$251,557.69

52.11%

ADM 3,230

$119,720.99

$371,278.68

Page 253 of 271

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Report Date: 10/25/2016 at 10:59:33AM

VIOLA SCHOOL DISTRICT

2016 School-Based Medicaid Profile

2503

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$2,945.04

$16,751.20

$3,665.48

$2,639.92

$0.00

$0.00

$1,433.44

$27,435.08

78.74%

ADM 410

$13,530.02

$40,965.10

Page 254 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WALDRON SCHOOL DISTRICT

2016 School-Based Medicaid Profile

6401

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$18,675.00

$17,437.44

$41,869.73

$0.00

$0.00

$0.00

$17,597.24

$95,579.41

90.33%

ADM 1,450

$71,534.78

$167,114.19

Page 255 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WARREN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

0602

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$10,179.20

$28,333.20

$32,413.98

$56,897.52

$0.00

$0.00

$5,918.52

$133,742.42

75.09%

ADM 1,626

$45,261.42

$179,003.84

Page 256 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WATSON CHAPEL SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3509

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$4,864.32

$11,546.56

$39,664.46

$0.00

$0.00

$0.00

$5,458.68

$61,534.02

80.80%

ADM 2,605

$54,426.06

$115,960.08

Page 257 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WEST FORK SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7208

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$7,069.30

$9,473.78

$16,755.10

$0.00

$0.00

$0.00

$1,029.92

$34,328.10

53.99%

ADM 1,088

$27,127.17

$61,455.27

Page 258 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WEST MEMPHIS SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1803

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$27,935.78

$30,447.12

$67,656.14

$0.00

$0.00

$0.00

$15,299.08

$141,338.12

73.46%

ADM 5,621

$197,781.91

$339,120.03

Page 259 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WESTERN ARKANSAS CO-OP

2016 School-Based Medicaid Profile

2420

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$447.08

$0.00

$0.00

$0.00

$0.00

$447.08

64.32%

ADM 206

$25,010.98

$25,458.06

Page 260 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WESTERN YELL CO. SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7509

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$12,420.84

$23,029.32

$36,366.84

$0.00

$0.00

$0.00

$1,552.26

$73,369.26

67.71%

ADM 392

$11,552.65

$84,921.91

Page 261 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WESTSIDE CONS. SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1602

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$39,296.01

$60,972.47

$14,104.92

$976.50

$0.00

$0.00

$2,529.64

$117,879.54

61.67%

ADM 1,718

$31,918.34

$149,797.88

Page 262 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WESTSIDE SCHOOL DISTRICT (CLEBURNE)

2016 School-Based Medicaid Profile

1204

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$3,288.56

$28,226.24

$38,326.58

$0.00

$0.00

$0.00

$1,312.90

$71,154.28

71.45%

ADM 461

$17,927.80

$89,082.08

Page 263 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WESTSIDE SCHOOL DISTRICT (JOHNSON)

2016 School-Based Medicaid Profile

3606

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$5,205.12

$11,855.87

$11,271.68

$0.00

$0.00

$0.00

$3,602.48

$31,935.15

72.09%

ADM 665

$21,407.25

$53,342.40

Page 264 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WHITE CO. CENTRAL SCHOOL DISTRICT

2016 School-Based Medicaid Profile

7304

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$0.00

$10,594.10

$0.00

$0.00

$0.00

$2,370.98

$12,965.08

64.23%

ADM 720

$26,990.82

$39,955.90

Page 265 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WHITE HALL SCHOOL DISTRICT

2016 School-Based Medicaid Profile

3510

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$4,642.72

$65,682.96

$33,391.28

$0.00

$0.00

$0.00

$78.30

$103,795.26

80.80%

ADM 2,880

$127,197.63

$230,992.89

Page 266 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WILBUR D. MILLS EDUCATION SERVICE CO-OP

2016 School-Based Medicaid Profile

7320

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$2,777.54

$12,057.84

$161,213.18

$0.00

$0.00

$0.00

$0.00

$176,048.56

53.10%

ADM 357

$30,719.96

$206,768.52

Page 267 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WONDERVIEW SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1505

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$4,755.52

$16,952.96

$41,721.76

$0.00

$0.00

$0.00

$2,339.04

$65,769.28

71.70%

ADM 424

$27,374.02

$93,143.30

Page 268 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WOODLAWN SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1304

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$0.00

$356.80

$12,729.10

$0.00

$0.00

$0.00

$1,869.24

$14,955.14

57.67%

ADM 552

$19,455.53

$34,410.67

Page 269 of 271

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Report Date: 10/25/2016 at 10:59:33AM

WYNNE SCHOOL DISTRICT

2016 School-Based Medicaid Profile

1905

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$81,904.38

$130,921.04

$66,453.82

$14,062.26

$0.00

$0.00

$9,569.78

$302,911.28

62.61%

ADM 2,667

$53,158.44

$356,069.72

Page 270 of 271

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Report Date: 10/25/2016 at 10:59:33AM

YELLVILLE-SUMMIT SCHOOL DISTRICT

2016 School-Based Medicaid Profile

4502

Physical Therapy

Occupational Therapy

Speech Therapy

Personal Care

SBMH

Audiology

EPSDT

Direct Funds

Medicaid Rate

ARMAC Total (Q1+Q2+Q3+Q4)

Total Reimbursement (ARMAC Total + Direct Funds) =

$4,059.20

-$478.96

$3,606.27

$1,958.83

$0.00

$0.00

$4,771.84

$13,917.18

98.16%

ADM 717

$31,284.31

$45,201.49

Page 271 of 271


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