AGENCY: Department of Health. Bureau of Health Promotion

SERIES: 81934
TITLE: Early and periodic screening, diagnosis, and treatment statistical summary report
DATES: 1986-
ARRANGEMENT: Chronological

DESCRIPTION: This is a summary report by district and county of the status of the claims and recipients in the program. This report includes the number of screening claims read during the month by total claims paid, denied, and the total; the reimbursement amounts by total, under six years of age, and between six and twenty-one years old; the number of recipients with specified conditions such as vision or respiratory by total, by number under six years old, and by ages six to twenty-one; the number of recipients screened but not referred for diagnosis or treatment during the month by total, by number under six years old, and by ages six to twenty-one; the number of recipients referred for diagnosis or treatment during the month by total, by number under six years old and by number between six and twenty-one years old; a summary of EPSDT status by total, ages six and under, and ages six to twenty-one; and the number of recipients not currently eligible but still being tracked by total, ages under six, and six to twenty-one. This is a report of automated data system, file key: EPSDT.

RETENTION

Retain for 4 year(s)

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

These records are in Archives' permanent custody.

APPROVED: 06/1987

FORMAT MANAGEMENT

Paper: Retain in Office for 4 years and then destroy.

APPRAISAL

Administrative

Retention based on the requirements of 42 CFR 431.17 and 45 CFR Part 74.

PRIMARY DESIGNATION

Private