| PROVIDER | NAME | ||||||||
| 086401 | HELPMATES, Inc. | ||||||||
| Unit | S/A | ||||||||
| Srvc Cat | Service Desc | RU | FS | PA | Eff Date | Lap Date | Rate | Descr | Code |
| 13600000 | MED CHECK (LPN ONLY) | 5038 | 38 | Y | 7/1/2001 | 06/30/10 | 20.50 | Hour | 1360 |
| 13610000 | MED MONITOR (NON-MED STAFF) | 5038 | 38 | Y | 7/1/2001 | 06/30/10 | 16.50 | Hour | 1361 |
| 13620000 | REP PAYEE | 5038 | 38 | Y | 7/1/2001 | 06/30/10 | 100.00 | Event | 1362 |
| 13650000 | HELPMATES FSS GUARDIANSHIP | 5038 | 38 | Y | 7/1/2001 | 06/30/10 | 65.00 | HOUR | 1365 |
| 13660000 | HELPMATE/REPAYEE STARTUP FEE | 5038 | 38 | N | 7/1/2001 | 06/30/10 | 150.00 | EVENT | 1366 |
| 13670000 | HELPMATES FSS GUARD STARTUP | 5038 | 38 | Y | 7/1/2001 | 06/30/10 | 2530.00 | EVENT | 1367 |
| 15510000 | HOUSE SUP/SUP LIVING | 5038 | 38 | Y | 7/1/2001 | 06/30/10 | 8.25 | 30 min | 1551 |
| 13820000 | TELEPHONE MED MONITORING | 5038 | 38 | Y | 1/1/2004 | 6/30/2010 | 5.50 | EVENT | 1382 |
| 13820000 | TELEPHONE MED MONITORING | 5031 | 31 | Y | 1/1/2004 | 6/30/2010 | 5.50 | EVENT | 1382 |