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UNITED HEALTHGRE <br />WASHINGION MEOICAID AND WASHINMON BENEFIT PLANS FOR THE UNINSURED BEHAUORAI- HEALTH PROFESSIONAL REIMSURSEMENTSCHEDUI.E <br />l.lual n!6lng hciliq.ilq ps d4 onp h&lory @mp exam; .nd rdk'l d*Eion nikiru ol mde..c .onpbxiq <br />l.id.l .!6ins h.ility.:rq pq d., @np hLto$ enp er:mi and mdk.l deLion ntkin8 of ndcEl. conPtsriq <br />lcfioP <br />ss5 lhldal .luing 6.ilit.rr., p.r d:, conp hktory @mp e$n; and mda.l d*blon m.kinB ot nd€nle compkxiq <br />lntd.l nruinr 6.i1to ctrq pa daL comp htstoryj @np .ra6; and ddk.l d-kion mtlina of md€db comphxiq <br />l.iual n!6lng h.iliq c.rq per d4 conp hblory .omp ex.mi .nd 6dkal ddLlon n.tl.g of md€GE conphxiq <br />lx.serP <br />1t,91 <br />l.id.l n!6lng hciliq.:r., p.r d4 .onp hGlory; conp d.mi and Bdad d*don m.ri4 or md€nb conpbr'q <br />lnirial nuEh* hciliv.rs ps d., .oEp hnrory; comp .xrd) and ndkal d<kion mrtins of ndeEtc .omphriv r-" <br />hiuat nu6ine hcilO..re, per dir .omp htslory comp di6j and mdkd d*klon nali4 of mdaGb comphriV <br />loro/oP <br />724,92 <br />nital n!6ing 6.ilq.'re, p€r dr%.omp htslory; .o6p qr6i ad ndbal d**n mari4 ot mdent€ conphrq <br />nlUal nuElns h.lld..r€, pcr d.y,.onp hLrory .onp d.mj :d mdtal dFtrn mall.3 ot mdeEb .omFkxiry <br />nldal nucing 6.il&.,r€, p€r dr%.omp htslory; .omp errnj id ndt.t dftkbn maki.3 ot htd conplerB <br />lo13/' <br />nital nuGing 6.il& .are, p€r d.f, tump htslory; .omp drnj rd ndbal dedion makins or h'O conpterrq r-*137,15 <br />nital nuEins 6.illty ..r€, !€. dry, conD hGtory .onp d.hj .nd mdtal ddkn naling of hi$ compt.xiq <br />nital n!Eing h.ility ra.€, F.. d!r.onp hbbry .onp q.mj ..d hdkal d*nion ftaking ol hiS .ompl.xiq <br />nili:l nuGi.3 6cilq ctr€, pet d.t .omp hktory .onp dthj i.d ndhl dedion makins ot hrO .omprerq r*"*103.51 <br />nidil nuEins h.iljty c..q pe. dry, .onp hktory (omp qami rnd ndkrl dftkion making ot hi$ .ompl.xiV <br />nir:l nuEi.g h.iliry ca.q par dat .omp hbtot$ .omp qam; r.d mdhrl dk&lon making of hid compl.xiq r" <br />nit.l nuEing h.ild ca.e per day, .omp hLiory; comp damj .nd mdkJ d-6ion m:klng of hi$ .ompleiq lc&P <br />nl&l nuRing h.iliq carq per d.t .omp hktory 6mp €nn; .nd ndki d4kion makina or hiS .onpl.xiV <br />nltil nuEinr ft.i|to cars p.. d.t romp hktoryj .onp €ram; .nd ndki deciion nakina of hld .onpl.xiry <br />il@i;$hs iaciliry@€, Fr drr 2 or: p.obkn due hitory; poblen 6.us er.m; sr:i$tu d€tun n.kins <br />lGf/P <br />s,39 <br />iubelent nuuina fa.iliq a€, Fr d.r 2 of: p.obk6 tuue hktory; pmbleh bcus ex.m; .ts.ioM de4'on n.kn3 <br />r-* <br />iub!{r.nt nuding h.llity .aE, Fr d" 2 ot: probbn hut hitory; poblem 6cus ex.n; rtai$tud de.Lio. mtkh8 <br />f*" <br />,ubsquent nu6inBfaciliq.aE,tsrd.f, zofr ptobbm hGhhtory;pbbl€m fo.u5 errm;srai*&dd€c&io. m.lin! <br />1",^" <br />iu&qu.nt nuulng iaciliq car., Fr d.r 2 ot: probtsm &ue hitory; pobl€n 6.us ex.mi rt idtud decnbn o.lin8 <br />1,,*,, <br />.uBquenr nuFinBfdcilry.r'.,tsrd., tor: probbm &urhbrory;p'oblem b(ue drn;sbriFtudde(Bion m.hn3 <br />lu"n,", <br />,ubquent nuulnBla(iiq.rc,F' d.r 2ol: probkn kLihtrory;0'oblFn btus dadi stiidtuddelir.n maxi.g <br />l',",', <br />iublqu.nt nu6lnB h.ility c.r., Fr da, 2 ol: pbbhh tuut h&tory; pobl.m tocur dafrj 3hi$tud dedion mari.8 <br />l-,* <br />.uB$u.nl nunlnsfrcilq.ate,Ftdatr 2ol:p'obhm toushlrory;Dtoblem b.BArmj !bJghtud dedion n,rin8 <br />1., <br />,*,,, <br />;uhqqlnmiq6:iliryqre, ts' dc 2 ot pDblemlddhroryprcblf, lNu*4 *r$d d6'{o. dbry t"*-' <br />;ubaufll lMiq fNiliry cue F &n 2 o[ dF! pr.blm fNB n\: svdd probld fND sn los d.cnion tu3 r*" <br />iuhqdl Mis f..Jiry cile, F &t 2 ot sxpdd poblm leu n\: qvdd problm INB mc low hiion m$g <br />lcf/oP <br />5634 <br />;u&{Kr nufu Gcnity wq Fr S} 2 oF evdd pmbld rau h\; c$d troblfl IdE e4 low dNsDn Nrs r-" <br />rreqhl ffiiq bliliq cee, F 6! 2 ot e\pad prcblm rM h\i .gdd Pr.blm leE era los ddLion ftbs r*'" <br />nb@iq titly uq F &r 2 o[ e\pdd probld fNB L\i epJd p'oblfl leE {vr lotr JNbion tus <br />l"'gqtP <br />4t,52 42,S2 <br />iop <br />.uk<u.nl nurinsfrritqdc,F.drt 2 ol:d.b,hd hnbtrd€tiddrmj ndc.aremedn.rdeGlon m.rjn3 <br />iu&qu.nt no6i.C f..i$q oG, Fr da, 2 of: debihd hktry d.Eild .rid; mdeEle m€dical de.tion naling <br />@l nu6i.g f:.i{q dc, Fr da, 2 ofr del.ihd hkloryi &laild exrni md€Ele m€dical d..6ion nali.8 <br />lG,0/P <br />61,55 <br />,uBquenr nunlryfac'h\(ile,tsrd.9 2 of:d.L.hdhktqi del.ild <br />iu&qlenl .u6lq fi.iiry cie, tsr drt 2 ol: del.ihd hktq; d.hnd drm; md€El. m€di.al d..nron n:li.g <br />@nl nuEinsla.i$rycft,F.dar 2ol:d.blkdhktry; dabild.bn; mdeElem€diBld*ilon n.li.8 lr ee/oP 51.55 <br />,ubqucnr nurlnshusryor.,Frdrv, zof:d.b'hdhtrtory detrild <br />iuB<uent nor3ins lr.ifiV ot , F. d.r 2 of, d.blkd hhtory dehild dam; ndedb m€diol ddbn makl.8 <br />@ent nuGins fi.iliv crE, Fr drs 2 ol: d.l.ikd htrorv dettild €r.n; mdebE nedi@l ddbn m.ting <br />l2r <br />es/P <br />iuEqtr.nt nu6l.g h.irq or., F, ditr 2 of, deblkd hktory dehild exan; dd.dte medi€l decition nrkinS <br />iu&qtr.nt huGlns h.inv or., Fr irr 2 of, .onp hbbry .omp .x.o; nedical d..&ion m.kina of hish .omphxiq r** <br />'it{u.nt nuEins la.iliv or., Fr d., 2 oi: comP hLtorv .odp .ramj mcdidl d..Lion nakrns or hish .ompbxi! <br />lot3/oP <br />iu&qu.ntnur3lngl.rililyerc, Frdrn 2ot: conphklory.omp <br />iu&auenrnurrinrh.ilivorc, Frdir 2of: conp*lory.onpaah; h€dlol ddBlon ntrinsorhBh.onphiq <br />iubquentn.Bi.3f..iliryerc,tsld.r2of:conphklory.onp€Fmjm€didld..Blonnrti4olhi3s@npbxiq <br />u*smns tilnycare, Fr drr 2 ot: cdp hLlotyj @npsmi m€diol d.dnon m.kiryofhisfi dmphriq <br />lx4s/oP <br />,ubqucnl nursinsh.iiq..rc, Frd.r tol:.onp r- <br />iubqucnt n!6i.9 t ritq.rc, tsr d., 2 of: comp r"" <br />iukquc.t n!.sin3 ,.citq dq Fr d., 2 ot: comp <br />lr!es/P <br />iuk4u.nt nluing L(itq..n, Fr d.r 2 ol: comp hBbry; omp drn; nedrdl dc.*b. mari.8 or hish conpEdv