Attachment 6 South Dakota Pricing Schedule Final.pdf

PDF 10 KB Posted

Attached to
Q402--VISN 23 CNH Open and Continuous Medicaid Solicitation- Period of Performance: 05 March 2021 to 04 March 2023.
Solicitation number
36C26320R0126
Issued by

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S02 SOUTH DAKOTA PRICING SCHEDULE - FINAL

Level of Care-LOC C-M WT Direct Care Non-Direct

Medicaid VA Contract Daily Drug Costs

SE3

SE2

SE1

RAD

RAC

RAB

RAA

SSC

SSB

SSA

CC2

CC1

CB2

CB1

CA2

CA1

IB2

IB1

IA2

IA1

BB2

BB1

BA2

BA1

PE2

PE1

PD2

PD1

PC2

PC1

PB2

PB1

PA2

PA1

South Dakota Medicaid Rates

Insert Direct & Non-Direct Rates Here:

11/25/2020

Sheet1

File details come from the government source that posted it. Updated .