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{"sheet":"Instructions","index":0,"n_rows":10,"n_cols":3,"rows_kept":10,"cut":false,"hidden":false,"merged":[]}
[]
[]
[]
["Instructions"]
[]
["The pro-forma financial statement is an integral component of any business plan. It represents a projection of revenue and expenses (or cash flow) that a business can expect to generate and incur during one or more fiscal years.\n\nNew and existing school-based health centers (SBHCs) can complete this pro-forma statement to better understand their financial standing and the factors that affect long-term program sustainability, as well as assess the implications of proposed structural changes such as an expansion of services, inclusion of new patient populations, or transition to a new medical sponsoring agency."]
[]
["Before geting started please make sure to:"]
["      1. Enable the Macros on this Microsoft excel worksheet. ",null," "]
["      2. Download the accompanying instructions manual. "]

{"sheet":"Data Input","index":1,"n_rows":132,"n_cols":6,"rows_kept":132,"cut":false,"hidden":false,"merged":[]}
["Data Input Sheet"]
["Identifying Information"]
["School Name"]
["SBHC Name"]
["Sponsor Name"]
["Sponsor Type","FQHC","Click in cell to select from list"]
[]
["Student Utilization","Year 1","Year 2","Year 3","Year 4"]
["Student Population",0,0,0,0]
["# of users",{"$f":"B9*0.5","v":0},{"$f":"C9*0.6","v":0},{"$f":"D9*0.65","v":0},{"$f":"E9*0.7","v":0}]
["# of visits/yr",{"$f":"B10*3.1","v":0},{"$f":"C10*3.1","v":0},{"$f":"D10*3.1","v":0},{"$f":"E10*3.1","v":0}]
["Utilization %",{"$f":"B10/B9","v":{"$error":"#DIV/0!"}},{"$f":"C10/C9","v":{"$error":"#DIV/0!"}},{"$f":"D10/D9","v":{"$error":"#DIV/0!"}},{"$f":"E10/E9","v":{"$error":"#DIV/0!"}}]
[]
["Community Utilization","Year 1","Year 2","Year 3","Year 4"]
["Eligible Community Population",0,0,0,0]
["# of users",{"$f":"B15*0.5","v":0},{"$f":"C15*0.6","v":0},{"$f":"D15*0.65","v":0},{"$f":"E15*0.7","v":0}]
["# of visits/yr",{"$f":"B16*3.1","v":0},{"$f":"C16*3.1","v":0},{"$f":"D16*3.1","v":0},{"$f":"E16*3.1","v":0}]
["Utilization %",{"$f":"B16/B15","v":{"$error":"#DIV/0!"}},{"$f":"C16/C15","v":{"$error":"#DIV/0!"}},{"$f":"D16/D15","v":{"$error":"#DIV/0!"}},{"$f":"E16/E15","v":{"$error":"#DIV/0!"}}]
[]
["Mix of Care","Year 1","Year 2","Year 3","Year 4"]
["Medical, Immunization, Other",0,0,0,0]
["Dental",0,0,0,0]
["Behavioral Health",0,0,0,0]
["Other",0,0,0,0]
["Total",{"$f":"SUM(B21:B24)","v":0},{"$f":"SUM(C21:C24)","v":0},{"$f":"SUM(D21:D24)","v":0},{"$f":"SUM(E21:E24)","v":0},{"$f":"IF(B25<>1,\"cell value must equal 100%\",IF(C25<>1,\"cell value must equal 100%\",IF(D25<>1,\"cell value must equal 100%\",IF(E25<>1,\"cell value must equal 100%\",\"\"))))","v":"cell value must equal 100%"}]
[]
["Types of Insurance Coverage","Year 1","Year 2","Year 3","Year 4"]
["Medicaid",0,0,0,0]
["Medicare",0,0,0,0]
["CHIP",0,0,0,0]
["Private Insurance",0,0,0,0]
["Other/Gov't"]
["Self-Pay"]
["Total",{"$f":"SUM(B28:B33)","v":0},{"$f":"SUM(C28:C33)","v":0},{"$f":"SUM(D28:D33)","v":0},{"$f":"SUM(E28:E33)","v":0},{"$f":"IF(B34<>1,\"cell value must equal 100%\",IF(C34<>1,\"cell value must equal 100%\",IF(D34<>1,\"cell value must equal 100%\",IF(E34<>1,\"cell value must equal 100%\",\"\"))))","v":"cell value must equal 100%"}]
[]
["Avg Billable Amt per Visit","Year 1","Year 2","Year 3","Year 4"]
["Medical"]
["Dental"]
["Behavioral Health"]
["Other"]
[]
[]
["Reimbursement Rates %","Year 1","Year 2","Year 3","Year 4"]
["Medicaid"]
["Medicare"]
["CHIP"]
["Private Insurance"]
["Other/Gov't"]
["Self-Pay"]
[]
["% of Claims Denied"]
[]
["Other Revenue Sources (annual amt)"]
["Grants and Contributions "]
["Community Benefit"]
["Gov't/Other"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["Column1"]
["Urban Non-FQHC"]
["Rural Non-FQHC"]
["Urban FQHC"]
["Rural FQHC"]
[]
["Column 1"]
["Select position from pull-down list"]
["FQHC"]
["Local Health Department"]
["Hospital/Medical Center"]
["Mental Health Agency"]
["Private, Non-profit"]
["Rural Health Center"]
["School System"]
["Tribal Government"]
["University"]
[]
[]
[]
[]
["Column1"]
["Select position from pull-down list"]
["Accountant/Financial Manager       "]
["Administrative Assistant/Secretary/Receptionist   "]
["Assistant Director         "]
["Business Manager           "]
["Case Manager"]
["Community Health Worker    "]
["Counselor (Mental Health or Substance Abuse)      "]
["Data Entry Clerk           "]
["Data Manager/Analyst       "]
["Dental Assistant           "]
["Dental Hygienist        "]
["Dentist     "]
["Deputy Director           "]
["Director    "]
["Health Aide"]
["Health Education Coordinator       "]
["Health Educator            "]
["Medical Assistant          "]
["Medical Director           "]
["Medical/Billing Clerk      "]
["Nurse Practitioner         "]
["Nurse, LPN  "]
["Nurse, RN   "]
["Nutritionist"]
["Outreach Coordinator       "]
["Parent Volunteer           "]
["Pediatrician"]
["Physician Assistant        "]
["Primary Care Physician     "]
["Program Manager            "]
["Psychiatrist"]
["Psychologist"]
["Social Worker"]
["Student Intern      "]

{"sheet":"Staffing Input","index":2,"n_rows":37,"n_cols":5,"rows_kept":37,"cut":false,"hidden":false,"merged":[]}
[]
[{"$f":"'Data Input'!B3","v":0}]
[]
[]
["Staffing Sheet"]
[]
["Positions & Salaries for Base Year","$/Hour","Hrs/Week","Wks/Year","Total Salary"]
["Select position from pull-down list",null,null,null,{"$f":"B8*C8*D8","v":0}]
["Input position or select from pull-down list",null,null,null,{"$f":"B9*C9*D9","v":0}]
["Input position or select from pull-down list",null,null,null,0]
["Input position or select from pull-down list",0,0,0,{"$f":"B11*C11*D11","v":0}]
["Input position or select from pull-down list",0,0,0,0]
["Input position or select from pull-down list",0,0,0,{"$f":"B13*C13*D13","v":0}]
["Input position or select from pull-down list",0,0,0,0]
["Input position or select from pull-down list",0,0,0,0]
["Input position or select from pull-down list",0,0,0,0]
[]
[null,"Year 1","Year 2","Year 3","Year 4"]
["Benefits"]
["Annual Salary Increase"]
[]
[null,"Summary"]
[null,"Year 1","Year 2","Year 3","Year 4"]
[{"$f":"A8","v":"Select position from pull-down list"},{"$f":"E8","v":0},{"$f":"B24*(1+$C$20)","v":0},{"$f":"C24*(1+$D$20)","v":0},{"$f":"D24*(1+$E$20)","v":0}]
[{"$f":"A9","v":"Input position or select from pull-down list"},0,{"$f":"B25*(1+$C$20)","v":0},0,0]
["Input position or select from pull-down list",0,0,0,0]
["Input position or select from pull-down list",0,0,0,0]
["Input position or select from pull-down list",0,0,0,0]
["Input position or select from pull-down list",0,0,0,0]
["Input position or select from pull-down list",0,0,0,0]
["Input position or select from pull-down list",0,0,0,0]
["Input position or select from pull-down list",0,0,0,0]
["Total Salaries",{"$f":"SUM(B24:B32)","v":0},{"$f":"SUM(C24:C32)","v":0},{"$f":"SUM(D24:D32)","v":0},{"$f":"SUM(E24:E32)","v":0}]
[]
["Benefits",{"$f":"B33*B19","v":0},{"$f":"C33*C19","v":0},{"$f":"D33*D19","v":0},{"$f":"E33*E19","v":0}]
[]
["Total Salaries & Benefits",{"$f":"B33+B35","v":0},{"$f":"C33+C35","v":0},{"$f":"D33+D35","v":0},{"$f":"E33+E35","v":0}]

{"sheet":"Other Costs Input","index":3,"n_rows":29,"n_cols":5,"rows_kept":29,"cut":false,"hidden":false,"merged":[]}
[]
[{"$f":"'Data Input'!B3","v":0}]
[]
["Schedule of Program, Administrative and Other Costs"]
[]
[null,"Year 1","Year 2","Year 3","Year 4"]
[]
["Consultants",0,0,0,0]
["Medical Supplies",0,0,0,0]
["Lab Services",0,0,0,0]
["Pharmacy Costs",0,0,0,0]
["Education Materials",0,0,0,0]
["Program Costs",{"$f":"SUM(B8:B12)","v":0},{"$f":"SUM(C8:C12)","v":0},{"$f":"SUM(D8:D12)","v":0},{"$f":"SUM(E8:E12)","v":0}]
[]
["Office Supplies",0,0,0,0]
["Minor Equipment/Furniture",0,0,0,0]
["Travel/Education/Training",0,0,0,0]
["Phone/Cell/Internet",0,0,0,0]
["Lease, Rent & Utilities",0,0,0,0]
["Licenses/Memberships",0,0,0,0]
["Information Technology",0,0,0,0]
["Malpractice Insurance",0,0,0,0]
["Depreciation",0,0,0,0]
["Miscellaneous Other",0,0,0,0]
["Indirect Other",0,0,0,0]
["Administrative Costs",{"$f":"SUM(B15:B25)","v":0},{"$f":"SUM(C15:C25)","v":0},0,0]
[]
[]
["Total Other Costs",{"$f":"B13+B26","v":0},{"$f":"C13+C26","v":0},0,0]

{"sheet":"In-Kind Input","index":4,"n_rows":35,"n_cols":5,"rows_kept":35,"cut":false,"hidden":false,"merged":[]}
[]
[{"$f":"'Data Input'!B3","v":0}]
[]
["Program, Administrative and Other Costs provided In-Kind"]
[]
[null,"Year 1","Year 2","Year 3","Year 4"]
["Select position from pull-down list",0,0,0,0]
["Select position from pull-down list",0,0,0,0]
["Select position from pull-down list",0,0,0,0]
["Enter Position",0,0,0,0]
["Enter Position",0,0,0,0]
["Staffing Costs",{"$f":"SUM(B7:B11)","v":0},{"$f":"SUM(C7:C11)","v":0},{"$f":"SUM(D7:D11)","v":0},{"$f":"SUM(E7:E11)","v":0}]
[]
["Consultants",0,0,0,0]
["Medical Supplies",0,0,0,0]
["Lab Services",0,0,0,0]
["Pharmacy Costs",0,0,0,0]
["Education Materials",0,0,0,0]
["Program Costs",{"$f":"SUM(B14:B18)","v":0},{"$f":"SUM(C14:C18)","v":0},{"$f":"SUM(D14:D18)","v":0},{"$f":"SUM(E14:E18)","v":0}]
[]
["Office Supplies",0,0,0,0]
["Minor Equipment/Furniture",0,0,0,0]
["Travel/Education/Training",0,0,0,0]
["Phone/Cell/Internet",0,0,0,0]
["Lease, Rent & Utilities",0,0,0,0]
["Licenses/Memberships",0,0,0,0]
["Information Technology",0,0,0,0]
["Malpractice Insurance",0,0,0,0]
["Depreciation",0,0,0,0]
["Miscellaneous Other",0,0,0,0]
["Indirect Other",0,0,0,0]
["Administrative Costs",{"$f":"SUM(B21:B31)","v":0},{"$f":"SUM(C21:C31)","v":0},0,0]
[]
[]
["Total Other In-Kind Costs",{"$f":"B12+B19+B32","v":0},{"$f":"C12+C19+C32","v":0},0,0]

{"sheet":"Income Statement","index":5,"n_rows":102,"n_cols":6,"rows_kept":102,"cut":false,"hidden":false,"merged":[]}
[{"$f":"'Data Input'!B3","v":0}]
["Cash-Basis Income Statement"]
[]
[null,null,"Year 1","Year 2","Year 3","Year 4"]
["# Visits by Type of Care"]
["Medical",null,{"$f":"'Data Input'!B$11*'Data Input'!B21","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C21","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D21","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E21","v":0}]
["Dental",null,{"$f":"'Data Input'!B$11*'Data Input'!B22","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C22","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D22","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E22","v":0}]
["Behavioral Health",null,{"$f":"'Data Input'!B$11*'Data Input'!B23","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C23","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D23","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E23","v":0}]
["Other",null,{"$f":"'Data Input'!B$11*'Data Input'!B24","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C24","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D24","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E24","v":0}]
["Total",null,{"$f":"SUM(C6:C9)","v":0},{"$f":"SUM(D6:D9)","v":0},{"$f":"SUM(E6:E9)","v":0},{"$f":"SUM(F6:F9)","v":0}]
[null,null,{"$f":"C10-'Data Input'!B11","v":0},{"$f":"D10-'Data Input'!C11","v":0},{"$f":"E10-'Data Input'!D11","v":0},{"$f":"F10-'Data Input'!E11","v":0}]
["# Visits by Insurance Type"]
["Medicaid",null,{"$f":"'Data Input'!B$11*'Data Input'!B28","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C28","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D28","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E28","v":0}]
["Medicare",null,{"$f":"'Data Input'!B$11*'Data Input'!B29","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C29","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D29","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E29","v":0}]
["CHIP",null,{"$f":"'Data Input'!B$11*'Data Input'!B30","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C30","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D30","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E30","v":0}]
["Private Insurance",null,{"$f":"'Data Input'!B$11*'Data Input'!B31","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C31","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D31","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E31","v":0}]
["Other/Gov't",null,{"$f":"'Data Input'!B$11*'Data Input'!B32","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C32","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D32","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E32","v":0}]
["Self-Pay",null,{"$f":"'Data Input'!B$11*'Data Input'!B33","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C33","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D33","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E33","v":0}]
["Total",null,{"$f":"SUM(C13:C18)","v":0},{"$f":"SUM(D13:D18)","v":0},{"$f":"SUM(E13:E18)","v":0},{"$f":"SUM(F13:F18)","v":0}]
[null,null,{"$f":"C19-C10","v":0},{"$f":"D19-D10","v":0},{"$f":"E19-E10","v":0},{"$f":"F19-F10","v":0}]
["Medical visits by Insurance Type"]
["Medicaid",null,{"$f":"'Data Input'!B$11*'Data Input'!B$21*'Data Input'!B28","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$21*'Data Input'!C28","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$21*'Data Input'!D28","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$21*'Data Input'!E28","v":0}]
["Medicare",null,{"$f":"'Data Input'!B$11*'Data Input'!B$21*'Data Input'!B29","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$21*'Data Input'!C29","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$21*'Data Input'!D29","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$21*'Data Input'!E29","v":0}]
["CHIP",null,{"$f":"'Data Input'!B$11*'Data Input'!B$21*'Data Input'!B30","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$21*'Data Input'!C30","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$21*'Data Input'!D30","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$21*'Data Input'!E30","v":0}]
["Private Insurance",null,{"$f":"'Data Input'!B$11*'Data Input'!B$21*'Data Input'!B31","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$21*'Data Input'!C31","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$21*'Data Input'!D31","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$21*'Data Input'!E31","v":0}]
["Other/Gov't",null,{"$f":"'Data Input'!B$11*'Data Input'!B$21*'Data Input'!B32","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$21*'Data Input'!C32","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$21*'Data Input'!D32","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$21*'Data Input'!E32","v":0}]
["Self-Pay",null,{"$f":"'Data Input'!B$11*'Data Input'!B$21*'Data Input'!B33","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$21*'Data Input'!C33","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$21*'Data Input'!D33","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$21*'Data Input'!E33","v":0}]
["Total",null,{"$f":"SUM(C22:C27)","v":0},{"$f":"SUM(D22:D27)","v":0},{"$f":"SUM(E22:E27)","v":0},{"$f":"SUM(F22:F27)","v":0}]
[null,null,{"$f":"C28-C6","v":0},{"$f":"D28-D6","v":0},{"$f":"E28-E6","v":0},{"$f":"F28-F6","v":0}]
["Dental visits by Insurance Type"]
["Medicaid",null,{"$f":"'Data Input'!B$11*'Data Input'!B$22*'Data Input'!B28","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$22*'Data Input'!C28","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$22*'Data Input'!D28","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$22*'Data Input'!E28","v":0}]
["Medicare",null,{"$f":"'Data Input'!B$11*'Data Input'!B$22*'Data Input'!B29","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$22*'Data Input'!C29","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$22*'Data Input'!D29","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$22*'Data Input'!E29","v":0}]
["CHIP",null,{"$f":"'Data Input'!B$11*'Data Input'!B$22*'Data Input'!B30","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$22*'Data Input'!C30","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$22*'Data Input'!D30","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$22*'Data Input'!E30","v":0}]
["Private Insurance",null,{"$f":"'Data Input'!B$11*'Data Input'!B$22*'Data Input'!B31","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$22*'Data Input'!C31","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$22*'Data Input'!D31","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$22*'Data Input'!E31","v":0}]
["Other/Gov't",null,{"$f":"'Data Input'!B$11*'Data Input'!B$22*'Data Input'!B32","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$22*'Data Input'!C32","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$22*'Data Input'!D32","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$22*'Data Input'!E32","v":0}]
["Self-Pay",null,{"$f":"'Data Input'!B$11*'Data Input'!B$22*'Data Input'!B33","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$22*'Data Input'!C33","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$22*'Data Input'!D33","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$22*'Data Input'!E33","v":0}]
["Total",null,{"$f":"SUM(C31:C36)","v":0},{"$f":"SUM(D31:D36)","v":0},{"$f":"SUM(E31:E36)","v":0},{"$f":"SUM(F31:F36)","v":0}]
[null,null,{"$f":"C37-C7","v":0},{"$f":"D37-D7","v":0},{"$f":"E37-E7","v":0},{"$f":"F37-F7","v":0}]
["Behavioral Health visits by Insurance Type"]
["Medicaid",null,{"$f":"'Data Input'!B$11*'Data Input'!B$23*'Data Input'!B28","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$23*'Data Input'!C28","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$23*'Data Input'!D28","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$23*'Data Input'!E28","v":0}]
["Medicare",null,{"$f":"'Data Input'!B$11*'Data Input'!B$23*'Data Input'!B29","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$23*'Data Input'!C29","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$23*'Data Input'!D29","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$23*'Data Input'!E29","v":0}]
["CHIP",null,{"$f":"'Data Input'!B$11*'Data Input'!B$23*'Data Input'!B30","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$23*'Data Input'!C30","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$23*'Data Input'!D30","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$23*'Data Input'!E30","v":0}]
["Private Insurance",null,{"$f":"'Data Input'!B$11*'Data Input'!B$23*'Data Input'!B31","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$23*'Data Input'!C31","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$23*'Data Input'!D31","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$23*'Data Input'!E31","v":0}]
["Other/Gov't",null,{"$f":"'Data Input'!B$11*'Data Input'!B$23*'Data Input'!B32","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$23*'Data Input'!C32","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$23*'Data Input'!D32","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$23*'Data Input'!E32","v":0}]
["Self-Pay",null,{"$f":"'Data Input'!B$11*'Data Input'!B$23*'Data Input'!B33","v":0},{"$f":"'Data Input'!C$11*'Data Input'!C$23*'Data Input'!C33","v":0},{"$f":"'Data Input'!D$11*'Data Input'!D$23*'Data Input'!D33","v":0},{"$f":"'Data Input'!E$11*'Data Input'!E$23*'Data Input'!E33","v":0}]
["Total",null,{"$f":"SUM(C40:C45)","v":0},{"$f":"SUM(D40:D45)","v":0},{"$f":"SUM(E40:E45)","v":0},{"$f":"SUM(F40:F45)","v":0}]
[null,null,{"$f":"C46-C8","v":0},{"$f":"D46-D8","v":0},{"$f":"E46-E8","v":0},{"$f":"F46-F8","v":0}]
[]
["Revenue"]
["Grants & Contributions Revenue",null,{"$f":"'Data Input'!B54","v":0},{"$f":"'Data Input'!C54","v":0},{"$f":"'Data Input'!D54","v":0},{"$f":"'Data Input'!E54","v":0}]
["In-Kind Revenue",null,{"$f":"'In-Kind Input'!B35","v":0},{"$f":"'In-Kind Input'!C35","v":0},{"$f":"'In-Kind Input'!D35","v":0},{"$f":"'In-Kind Input'!E35","v":0}]
["Community Benefit",null,{"$f":"'Data Input'!B55","v":0},{"$f":"'Data Input'!C55","v":0},{"$f":"'Data Input'!D55","v":0},{"$f":"'Data Input'!E55","v":0}]
["Gov't/Other Revenue",null,{"$f":"'Data Input'!B56","v":0},{"$f":"'Data Input'!C56","v":0},{"$f":"'Data Input'!D56","v":0},{"$f":"'Data Input'!E56","v":0}]
["Total Non-Patient Revenue",null,{"$f":"SUM(C50:C53)","v":0},{"$f":"SUM(D50:D53)","v":0},{"$f":"SUM(E50:E53)","v":0},{"$f":"SUM(F50:F53)","v":0}]
[]
["Gross Patient Revenue"]
["Medicaid",null,{"$f":"C22*'Data Input'!B$37+'Income Statement'!C31*'Data Input'!B$38+'Income Statement'!C40*'Data Input'!B$39","v":0},{"$f":"D22*'Data Input'!C$37+'Income Statement'!D31*'Data Input'!C$38+'Income Statement'!D40*'Data Input'!C$39","v":0},{"$f":"E22*'Data Input'!D$37+'Income Statement'!E31*'Data Input'!D$38+'Income Statement'!E40*'Data Input'!D$39","v":0},{"$f":"F22*'Data Input'!E$37+'Income Statement'!F31*'Data Input'!E$38+'Income Statement'!F40*'Data Input'!E$39","v":0}]
["Medicare",null,{"$f":"C23*'Data Input'!B$37+'Income Statement'!C32*'Data Input'!B$38+'Income Statement'!C41*'Data Input'!B$39","v":0},{"$f":"D23*'Data Input'!C$37+'Income Statement'!D32*'Data Input'!C$38+'Income Statement'!D41*'Data Input'!C$39","v":0},{"$f":"E23*'Data Input'!D$37+'Income Statement'!E32*'Data Input'!D$38+'Income Statement'!E41*'Data Input'!D$39","v":0},{"$f":"F23*'Data Input'!E$37+'Income Statement'!F32*'Data Input'!E$38+'Income Statement'!F41*'Data Input'!E$39","v":0}]
["CHIP",null,{"$f":"C24*'Data Input'!B$37+'Income Statement'!C33*'Data Input'!B$38+'Income Statement'!C42*'Data Input'!B$39","v":0},{"$f":"D24*'Data Input'!C$37+'Income Statement'!D33*'Data Input'!C$38+'Income Statement'!D42*'Data Input'!C$39","v":0},{"$f":"E24*'Data Input'!D$37+'Income Statement'!E33*'Data Input'!D$38+'Income Statement'!E42*'Data Input'!D$39","v":0},{"$f":"F24*'Data Input'!E$37+'Income Statement'!F33*'Data Input'!E$38+'Income Statement'!F42*'Data Input'!E$39","v":0}]
["Private Insurance",null,{"$f":"C25*'Data Input'!B$37+'Income Statement'!C34*'Data Input'!B$38+'Income Statement'!C43*'Data Input'!B$39","v":0},{"$f":"D25*'Data Input'!C$37+'Income Statement'!D34*'Data Input'!C$38+'Income Statement'!D43*'Data Input'!C$39","v":0},{"$f":"E25*'Data Input'!D$37+'Income Statement'!E34*'Data Input'!D$38+'Income Statement'!E43*'Data Input'!D$39","v":0},{"$f":"F25*'Data Input'!E$37+'Income Statement'!F34*'Data Input'!E$38+'Income Statement'!F43*'Data Input'!E$39","v":0}]
["Other/Gov't",null,{"$f":"C26*'Data Input'!B$37+'Income Statement'!C35*'Data Input'!B$38+'Income Statement'!C44*'Data Input'!B$39","v":0},{"$f":"D26*'Data Input'!C$37+'Income Statement'!D35*'Data Input'!C$38+'Income Statement'!D44*'Data Input'!C$39","v":0},{"$f":"E26*'Data Input'!D$37+'Income Statement'!E35*'Data Input'!D$38+'Income Statement'!E44*'Data Input'!D$39","v":0},{"$f":"F26*'Data Input'!E$37+'Income Statement'!F35*'Data Input'!E$38+'Income Statement'!F44*'Data Input'!E$39","v":0}]
["Self-Pay",null,{"$f":"C27*'Data Input'!B$37+'Income Statement'!C36*'Data Input'!B$38+'Income Statement'!C45*'Data Input'!B$39","v":0},{"$f":"D27*'Data Input'!C$37+'Income Statement'!D36*'Data Input'!C$38+'Income Statement'!D45*'Data Input'!C$39","v":0},{"$f":"E27*'Data Input'!D$37+'Income Statement'!E36*'Data Input'!D$38+'Income Statement'!E45*'Data Input'!D$39","v":0},{"$f":"F27*'Data Input'!E$37+'Income Statement'!F36*'Data Input'!E$38+'Income Statement'!F45*'Data Input'!E$39","v":0}]
["Total Gross Patient Revenue",null,{"$f":"SUM(C57:C62)","v":0},{"$f":"SUM(D57:D62)","v":0},{"$f":"SUM(E57:E62)","v":0},{"$f":"SUM(F57:F62)","v":0}]
[]
["Unreimbursed Portion"]
["Medicaid",null,{"$f":"-C57*(1-'Data Input'!B44)","v":0},{"$f":"-D57*(1-'Data Input'!C44)","v":0},{"$f":"-E57*(1-'Data Input'!D44)","v":0},{"$f":"-F57*(1-'Data Input'!E44)","v":0}]
["Medicare",null,{"$f":"-C58*(1-'Data Input'!B45)","v":0},{"$f":"-D58*(1-'Data Input'!C45)","v":0},{"$f":"-E58*(1-'Data Input'!D45)","v":0},{"$f":"-F58*(1-'Data Input'!E45)","v":0}]
["CHIP",null,{"$f":"-C59*(1-'Data Input'!B46)","v":0},{"$f":"-D59*(1-'Data Input'!C46)","v":0},{"$f":"-E59*(1-'Data Input'!D46)","v":0},{"$f":"-F59*(1-'Data Input'!E46)","v":0}]
["Private Insurance",null,{"$f":"-C60*(1-'Data Input'!B47)","v":0},{"$f":"-D60*(1-'Data Input'!C47)","v":0},{"$f":"-E60*(1-'Data Input'!D47)","v":0},{"$f":"-F60*(1-'Data Input'!E47)","v":0}]
["Other/Gov't",null,{"$f":"-C61*(1-'Data Input'!B48)","v":0},{"$f":"-D61*(1-'Data Input'!C48)","v":0},{"$f":"-E61*(1-'Data Input'!D48)","v":0},{"$f":"-F61*(1-'Data Input'!E48)","v":0}]
["Self-Pay",null,{"$f":"-C62*(1-'Data Input'!B49)","v":0},{"$f":"-D62*(1-'Data Input'!C49)","v":0},{"$f":"-E62*(1-'Data Input'!D49)","v":0},{"$f":"-F62*(1-'Data Input'!E49)","v":0}]
["Total Unreimbursed Portion",null,{"$f":"SUM(C66:C71)","v":0},{"$f":"SUM(D66:D71)","v":0},{"$f":"SUM(E66:E71)","v":0},{"$f":"SUM(F66:F71)","v":0}]
[]
["Net Patient Revenue"]
["Medicaid",null,{"$f":"C57+C66","v":0},0,0,0]
["Medicare",null,0,0,0,0]
["CHIP",null,{"$f":"C59+C68","v":0},0,0,0]
["Private Insurance",null,0,0,0,0]
["Other/Gov't",null,0,0,0,0]
["Self-Pay",null,0,0,0,0]
["Total Net Patient Revenue",null,{"$f":"SUM(C75:C80)","v":0},{"$f":"SUM(D75:D80)","v":0},{"$f":"SUM(E75:E80)","v":0},{"$f":"SUM(F75:F80)","v":0}]
[]
["Minus Denied Claims",null,{"$f":"C81*'Data Input'!B51*-1","v":0},{"$f":"D81*'Data Input'!C51*-1","v":0},{"$f":"E81*'Data Input'!D51*-1","v":0},{"$f":"F81*'Data Input'!E51*-1","v":0}]
[]
["Total Revenue",null,{"$f":"C54+C81+C83","v":0},{"$f":"D54+D81+D83","v":0},0,0]
[]
["Expenses"]
["Salaries & Benefits",null,{"$f":"'Staffing Input'!B37","v":0},{"$f":"'Staffing Input'!C37","v":0},{"$f":"'Staffing Input'!D37","v":0},{"$f":"'Staffing Input'!E37","v":0}]
[]
["Program Costs",null,{"$f":"'Other Costs Input'!B13","v":0},{"$f":"'Other Costs Input'!C13","v":0},{"$f":"'Other Costs Input'!D13","v":0},{"$f":"'Other Costs Input'!E13","v":0}]
[]
["Administrative Costs",null,{"$f":"'Other Costs Input'!B26+'Other Costs Input'!B25","v":0},{"$f":"'Other Costs Input'!C26+'Other Costs Input'!C25","v":0},{"$f":"'Other Costs Input'!D26+'Other Costs Input'!D25","v":0},{"$f":"'Other Costs Input'!E26+'Other Costs Input'!E25","v":0}]
[]
["In-Kind Costs",null,{"$f":"'In-Kind Input'!B35","v":0},{"$f":"'In-Kind Input'!C35","v":0},{"$f":"'In-Kind Input'!D35","v":0},{"$f":"'In-Kind Input'!E35","v":0}]
[]
["Total Expenses",null,{"$f":"SUM(C94,C92,C90,C88)","v":0},{"$f":"SUM(D94,D92,D90,D88)","v":0},{"$f":"SUM(E94,E92,E90,E88)","v":0},{"$f":"SUM(F94,F92,F90,F88)","v":0}]
[]
["Net Revenue/(Expense)",null,{"$f":"C85-C96","v":0},{"$f":"D85-D96","v":0},{"$f":"E85-E96","v":0},{"$f":"F85-F96","v":0}]
[]
[]
["Cost per User",null,{"$f":"C96/'Data Input'!B10","v":{"$error":"#DIV/0!"}},{"$f":"D96/'Data Input'!C10","v":{"$error":"#DIV/0!"}},{"$f":"E96/'Data Input'!D10","v":{"$error":"#DIV/0!"}},{"$f":"F96/'Data Input'!E10","v":{"$error":"#DIV/0!"}}]
["Cost per Visit",null,{"$f":"C96/'Data Input'!B11","v":{"$error":"#DIV/0!"}},{"$f":"D96/'Data Input'!C11","v":{"$error":"#DIV/0!"}},{"$f":"E96/'Data Input'!D11","v":{"$error":"#DIV/0!"}},{"$f":"F96/'Data Input'!E11","v":{"$error":"#DIV/0!"}}]