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24 <br /> Docusign Envebpe ID: 50585F21-A7384303BD3F-60841076ED5E <br /> Contract Number 00048145 / Page 22 of 30 <br /> Budget Detail - Year 1 <br /> Category Item Narrative Amount <br /> Operational Other Not Otherwise Classified Drug screens reimbursement, up to $ 1 ,500. Average of 100 per $ 11500. 00 <br /> year / $ 15.00 each . Total ( 100 x $ 15 = $1 ,500) <br /> s <br /> Operational Other Not Otherwise Classified Substance Use Disorder Assessment reimbursement, up to $600. $600.00 <br /> Average 2 per year / $300 Total (2 x $300 = $600) <br /> Operational Other Not Otherwise Classified Treatment Services reimbursement, up to $ 14,000 includes $ 141000.00 <br /> uncovered/uninsured treatments, (For uncovered treatments , <br /> assume 10% Uninsured/Unable to access State funded (Medicaid) <br /> Services) Total $ 14 ,000 <br /> Subcontracts and Grants $0 .00 <br /> I <br /> Match $0.00 <br /> E <br /> E <br /> Cost Per Service $0.00 <br /> 4 <br /> i <br /> Sub Total $3201480.00 <br /> I <br /> Indirect Cost $0.00 <br /> Totes Budget $320T480 .00 <br /> Subcontracting and Grants Budget Detail = Year 1 <br /> Category Item Narrative Amount <br /> I <br /> t <br /> Line Item Budget Detail (08111 ) <br /> i <br /> i <br />