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Summary Federal Award Financial Information <br />19. Budget Period Start Date - End Date <br />20.Total Amount of Federal Funds Obligated by this Action20a. Direct Cost Amount20b. Indirect Cost Amount <br />21.Authorized Carryover <br />22.Offset <br />23. Total Amount of Federal Funds Obligated this budget period <br />24. Total Approved Cost Sharing or Matching, where applicable <br />25. Total Federal and Non-Federal Approved this Budget Period <br />26.Project Period Start Date - End Date <br />27.Total Amount of the Federal Award including Approved Cost Sharing or Matching this Project Period <br />28. Authorized Treatment of Program Income <br />29. Grants Management Officer – Signature <br />Recipient Information <br />Fe deral Agency Information <br />10.Program Official Contact Information <br /> Federal Award Information <br />30.Remarks <br />1. Recipient Name <br />9. Awarding Agency Contact Information <br />Notice of Award <br />Award# <br />FAIN# <br />Federal Award Date: <br />Page 1 <br />2. Congressional District of Recipient <br />3.Payment System Identifier (ID) <br />4.Employer Identification Number (EIN) <br />5.Data Universal Numbering System (DUNS) <br />6.Recipient’s Unique Entity Identifier <br />7.Project Director or Principal Investigator <br />8.Authorized Official <br />11. Award Number <br />12. Unique Federal Award Identification Number (FAIN) <br />13. Statutory Authority <br />14. Federal Award Project Title <br />15. Assistance Listing Number <br />16. Assistance Listing Program Title <br />17. Award Action Type <br />18. Is the Award R&D? <br />01/01/2022 12/31/2022 <br />01/01/2020 <br />ADDITIONAL COSTS <br />01 <br />1560532129A1 <br />North Carolina Integrated Care for Kids Model <br />93.378 <br />Integrated Care for Kids Model <br />Non-Competing Continuation <br />No <br />Not Available <br />560532129 <br /> Meeka Jackson <br />Ms. <br />meeka.jackson@cms.hhs.gov <br />4107865792 <br />Centers for Medicare & Medicaid Services <br />Department of Health and Human Services <br />2B2CMS331758-03-00 <br />2B2CMS331758-03-00 <br />2B2CMS331758 <br />2B2CMS331758 <br />12/15/2021 <br />Office of Acquisitions and Grants Management <br /> See Remarks (continuation) <br />Mr. Gabriel Nah <br />Grants Management Officer <br />Ms. Jennifer McCallister <br />Authorized Representative <br />gcmail@mc.duke.edu <br />919 684-5175 <br />Duke University <br />2200 W Main St Ste 820 <br />Duke Univ. School of Medicine <br />Durham, NC 27705-4673 <br />[NoPhoneRecord] <br />Dr. Charlene Wong <br />Assistant Professor of Pediatrics <br />charlene.wong@duke.edu <br />919-668-5972 <br />$2,244,230.00 <br />$287,351.00 <br />12/31/2026 <br />$2,000,000.00 <br />$0.00 <br />$0.00 <br />$0.00 <br />$531,581.00 <br />Section 1115A of the Social Security Act (added by section 3021 of the Patient Protection and Affordable <br />Care Act (P.L. 111-148)) <br />044387793 <br />Jamie Atwood <br />Sr. Grants Policy Specialist <br />Jamie.Atwood@cms.HHS.gov <br />301-492-4295 <br />$2,000,000.00 <br />DocuSign Envelope ID: 7832B0E4-F34E-430E-A3C2-1A6A14F29307