July 1, 2001, through September 30, 2001
| Coverage Category |
Northeastern Health
Plan of NE Arizona |
Arizona Physician's IPA |
Prior Period Coverage |
| TANF <1 M/F |
$343.15 |
$331.67 |
$849.22 |
| TANF 1-13 M/F |
$78.99 |
$78.89 |
$38.77 |
| TANF 14-44 F |
$131.14 |
$137.57 |
$146.46 |
| TANF 14-44 M |
$101.47 |
$101.47 |
$77.78 |
| TANF 45+ M/F |
$238.86 |
$238.86 |
$227.98 |
| SSI w/ Med |
$191.05 |
$192.59 |
$14.40 |
| SSI w/o Med |
$332.38 |
$333.71 |
$44.14 |
| MN/MI |
$694.12 |
$694.12 |
$784.78 |
| SFP |
$24.34 |
$24.34 |
N/A |
| SOBRA KICK |
$4,994.91 |
$4,950.55 |
N/A |
| KIDSCARE <1 M/F |
$300.97 |
$300.97 |
N/A |
| KIDSCARE 1-13M/F |
$84.96 |
$84.96 |
N/A |
| KIDSCARE 14-18F |
$135.80 |
$135.80 |
N/A |
| KIDSCARE 14-18M |
$83.39 |
$83.39 |
N/A |
| KIDSCARE KICK |
$4,939.06 |
$4,950.55 |
N/A |
The MN/MI capitation rate is a daily rate.
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