| PROVIDER | NAME | ||||||||
| 017001 | LIFESTYLE SUPPORT SRVCS | ||||||||
| Unit | S/A | ||||||||
| Srvc Cat | Service Desc | RU | FS | PA | Eff Date | Lap Date | Rate | Descr | Code |
| 13730000 | FSS RESPITE | 5031 | 31 | Y | 7/1/2002 | 06/30/03 | 15.35 | HOUR | 1373 |
| 13730000 | FSS RESPITE | 5031 | 31 | Y | 7/1/2001 | 06/30/02 | 15.08 | Hour | 1373 |
| 13730000 | FSS RESPITE | 5035 | 35 | Y | 7/1/2002 | 06/30/03 | 15.35 | HOUR | 1373 |
| 13730000 | FSS RESPITE | 5035 | 35 | Y | 7/1/2003 | 06/30/2010 | 18.40 | Hour | 1373 |
| 13730000 | FSS RESPITE | 5038 | 38 | Y | 7/1/2001 | 06/30/02 | 15.08 | Hour | 1373 |
| 13730000 | FSS RESPITE | 5038 | 38 | Y | 7/1/2003 | 06/30/2010 | 18.40 | Hour | 1373 |
| 14500000 | RESIDENTIAL - Rate varies by Client | 5031 | 31 | Y | 7/1/2002 | 06/30/03 | 340.60 | DAY | 1450 |
| 14510000 | RESIDENTIAL - Rate varies by Client | 5035 | 35 | Y | 7/1/2001 | 06/30/02 | 391.71 | Day | 1451 |
| 14520000 | RESIDENTIAL - Rate varies by Client | 5031 | 31 | Y | 7/1/2002 | 06/30/03 | 320.71 | DAY | 1452 |
| 15640000 | LIFESTYLE/HS/SL | 5035 | 35 | Y | 7/1/2002 | 06/30/03 | 15.35 | HOUR | 1564 |
| 15640000 | LIFESTYLE/HS/SL | 5035 | 35 | Y | 7/1/2003 | 06/30/2010 | 18.40 | HOUR | 1564 |
| 15640000 | LIFESTYLE/HS/SL | 5038 | 38 | Y | 7/1/2002 | 06/30/03 | 15.35 | HOUR | 1564 |
| 15640000 | LIFESTYLE/HS/SL | 5038 | 38 | Y | 7/1/2003 | 6/30/2010 | 18.40 | HOUR | 1564 |