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CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
1221 OAK ST
ALAMEDA COUNTY TREASURER
OAKLAND, CA 94612
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
21,257.59
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$21,257.59Gross Claim
$21,257.59Net Claim / Payment Amount
YTD Amount: $228,349.23
Page 1 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 217
ALPINE COUNTY TREASURER
MARKLEEVILLE, CA 96120
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
874.39
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$874.39Gross Claim
$874.39Net Claim / Payment Amount
YTD Amount: $9,392.72
Page 2 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
810 COURT ST
AMADOR COUNTY TREASURER
JACKSON, CA 95642
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
7,736.88
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$7,736.88Gross Claim
$7,736.88Net Claim / Payment Amount
YTD Amount: $83,109.65
Page 3 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
25 COUNTY CENTER DR
BUTTE COUNTY TREASURER
OROVILLE, CA 95965
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
18,154.00
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$18,154.00Gross Claim
$18,154.00Net Claim / Payment Amount
YTD Amount: $195,010.51
Page 4 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
GOVERNMENT CENTER
CALAVERAS COUNTY TREASURER
SAN ANDREAS, CA 95249
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
11,405.08
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$11,405.08Gross Claim
$11,405.08Net Claim / Payment Amount
YTD Amount: $122,513.50
Page 5 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
546 JAY ST
COLUSA COUNTY TREASURER
COLUSA, CA 95932
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
7,652.22
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$7,652.22Gross Claim
$7,652.22Net Claim / Payment Amount
YTD Amount: $82,200.19
Page 6 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
625 COURT ST RM 102
CONTRA COSTA COUNTY TREASURER
MARTINEZ, CA 94553
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
30,877.42
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$30,877.42Gross Claim
$30,877.42Net Claim / Payment Amount
YTD Amount: $331,685.59
Page 7 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
981 H ST STE 150
DEL NORTE COUNTY TREASURER
CRESCENT CITY, CA 95531
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
7,704.36
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$7,704.36Gross Claim
$7,704.36Net Claim / Payment Amount
YTD Amount: $82,760.28
Page 8 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
360 FAIR LN
EL DORADO COUNTY TREASURER
PLACERVILLE, CA 95667
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
6,653.46
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$6,653.46Gross Claim
$6,653.46Net Claim / Payment Amount
YTD Amount: $71,471.56
Page 9 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1406
FRESNO COUNTY TREASURER
SACRAMENTO, CA 95812
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
7,654.71
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$7,654.71Gross Claim
$7,654.71Net Claim / Payment Amount
YTD Amount: $82,226.98
Page 10 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
516 WEST SYCAMORE STREET
GLENN COUNTY TREASURER
WILLOWS, CA 95988
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
7,698.10
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$7,698.10Gross Claim
$7,698.10Net Claim / Payment Amount
YTD Amount: $82,693.02
Page 11 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
825 FIFTH ST RM 125
HUMBOLDT COUNTY TREASURER
EUREKA, CA 95501
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
16,637.78
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$16,637.78Gross Claim
$16,637.78Net Claim / Payment Amount
YTD Amount: $178,723.24
Page 12 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
940 WEST MAIN ST
IMPERIAL COUNTY TREASURER
EL CENTRO, CA 92243 2863
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
10,231.62
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$10,231.62Gross Claim
$10,231.62Net Claim / Payment Amount
YTD Amount: $109,908.17
Page 13 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX O
INYO COUNTY TREASURER
INDEPENDENCE, CA 93526
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
7,650.64
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$7,650.64Gross Claim
$7,650.64Net Claim / Payment Amount
YTD Amount: $82,183.21
Page 14 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 981240
KERN COUNTY TREASURER
SACRAMENTO, CA 95798 1240
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
33,294.44
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$33,294.44Gross Claim
$33,294.44Net Claim / Payment Amount
YTD Amount: $357,649.22
Page 15 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1406
KINGS COUNTY TREASURER
SACRAMENTO, CA 95812 1406
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
11,312.71
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$11,312.71Gross Claim
$11,312.71Net Claim / Payment Amount
YTD Amount: $121,521.29
Page 16 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
255 NORTH FORBES ST RM 215
LAKE COUNTY TREASURER
LAKEPORT, CA 95453
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
15,508.62
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$15,508.62Gross Claim
$15,508.62Net Claim / Payment Amount
YTD Amount: $166,593.80
Page 17 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
COUNTY COURTHOUSE RM 103
LASSEN COUNTY TREASURER
SUSANVILLE, CA 96130
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
7,736.88
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$7,736.88Gross Claim
$7,736.88Net Claim / Payment Amount
YTD Amount: $83,109.65
Page 18 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1859
LOS ANGELES COUNTY TREASURER
SACRAMENTO, CA 95812
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
375,955.55
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$375,955.55Gross Claim
$375,955.55Net Claim / Payment Amount
YTD Amount: $4,038,518.77
Page 19 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1859
C/O BANK OF AMERICA
MADERA COUNTY TREASURER
SACRAMENTO, CA 95812 1859
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
11,915.51
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$11,915.51Gross Claim
$11,915.51Net Claim / Payment Amount
YTD Amount: $127,996.57
Page 20 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
CIVIC CENTER
PO BOX 4220
MARIN COUNTY TREASURER
SAN RAFAEL, CA 94913
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
19,982.77
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$19,982.77Gross Claim
$19,982.77Net Claim / Payment Amount
YTD Amount: $214,655.17
Page 21 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 36
MARIPOSA COUNTY TREASURER
MARIPOSA, CA 95338
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
7,638.86
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$7,638.86Gross Claim
$7,638.86Net Claim / Payment Amount
YTD Amount: $82,056.71
Page 22 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
501 LOW GAP RD 1060
MENDOCINO COUNTY TREASURER
UKIAH, CA 95482
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
16,252.18
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$16,252.18Gross Claim
$16,252.18Net Claim / Payment Amount
YTD Amount: $174,581.05
Page 23 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 981311
MERCED COUNTY TREASURER
WEST SACRAMENTO, CA 95798 1311
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
17,788.00
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$17,788.00Gross Claim
$17,788.00Net Claim / Payment Amount
YTD Amount: $191,078.90
Page 24 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
204 COURT ST RM 101
MODOC COUNTY TREASURER
ALTURAS, CA 96101
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
7,605.13
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$7,605.13Gross Claim
$7,605.13Net Claim / Payment Amount
YTD Amount: $81,694.36
Page 25 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 495
MONO COUNTY TREASURER
BRIDGEPORT, CA 93517
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
7,609.95
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$7,609.95Gross Claim
$7,609.95Net Claim / Payment Amount
YTD Amount: $81,746.11
Page 26 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1406
MONTEREY COUNTY TREASURER
SACRAMENTO, CA 95812 1406
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
18,098.22
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$18,098.22Gross Claim
$18,098.22Net Claim / Payment Amount
YTD Amount: $194,411.31
Page 27 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
1195 THIRD ST RM 108
NAPA COUNTY TREASURER
NAPA, CA 94559 3035
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
10,789.53
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$10,789.53Gross Claim
$10,789.53Net Claim / Payment Amount
YTD Amount: $115,901.24
Page 28 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 128
NEVADA COUNTY TREASURER
NEVADA CITY, CA 95959
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
13,912.96
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$13,912.96Gross Claim
$13,912.96Net Claim / Payment Amount
YTD Amount: $149,453.16
Page 29 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 981024
ORANGE COUNTY TREASURER
WEST SACRAMENTO, CA 95798 1024
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
105,014.68
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$105,014.68Gross Claim
$105,014.68Net Claim / Payment Amount
YTD Amount: $1,128,068.86
Page 30 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
2976 Richardson Dr.
PLACER COUNTY TREASURER
Auburn, CA 95603
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
14,306.05
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$14,306.05Gross Claim
$14,306.05Net Claim / Payment Amount
YTD Amount: $153,675.73
Page 31 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 176
PLUMAS COUNTY TREASURER
QUINCY, CA 95971
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
7,662.63
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$7,662.63Gross Claim
$7,662.63Net Claim / Payment Amount
YTD Amount: $82,312.06
Page 32 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 4035
C/O UNION BANK OF CA ST GOV
RIVERSIDE COUNTY TREASURER
SACRAMENTO, CA 95812 4035
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
54,774.03
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$54,774.03Gross Claim
$54,774.03Net Claim / Payment Amount
YTD Amount: $588,383.28
Page 33 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 980264
SACRAMENTO COUNTY TREASURER
WEST SACRAMENTO, CA 95798 0264
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
31,542.34
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$31,542.34Gross Claim
$31,542.34Net Claim / Payment Amount
YTD Amount: $338,828.13
Page 34 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
440 FIFTH ST RM 107
COURTHOUSE
SAN BENITO COUNTY TREASURER
HOLLISTER, CA 95023
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
7,812.28
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$7,812.28Gross Claim
$7,812.28Net Claim / Payment Amount
YTD Amount: $83,919.58
Page 35 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1859
SAN BERNARDINO CO TREASURER
SACRAMENTO, CA 95812
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
67,362.91
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$67,362.91Gross Claim
$67,362.91Net Claim / Payment Amount
YTD Amount: $723,613.10
Page 36 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 980304
SAN DIEGO COUNTY TREASURER
WEST SACRAMENTO, CA 95798 0304
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
110,645.46
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$110,645.46Gross Claim
$110,645.46Net Claim / Payment Amount
YTD Amount: $1,188,554.80
Page 37 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 2920
SAN FRANCISCO COUNTY TREASURER
SACRAMENTO, CA 95814 2920
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
19,342.54
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$19,342.54Gross Claim
$19,342.54Net Claim / Payment Amount
YTD Amount: $207,777.78
Page 38 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 981355
SAN JOAQUIN COUNTY TREASURER
WEST SACRAMENTO, CA 95798 1355
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
16,585.19
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$16,585.19Gross Claim
$16,585.19Net Claim / Payment Amount
YTD Amount: $178,158.31
Page 39 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1149
SAN LUIS OBISPO COUNTY TREASURER
SAN LUIS OBISPO, CA 93406
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
20,078.39
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$20,078.39Gross Claim
$20,078.39Net Claim / Payment Amount
YTD Amount: $215,682.32
Page 40 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 4035
C/O UNION BANK ST GOVT DEPT
SAN MATEO COUNTY TREASURER
Sacramento, CA 95812
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
35,519.33
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$35,519.33Gross Claim
$35,519.33Net Claim / Payment Amount
YTD Amount: $381,549.07
Page 41 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 579
SANTA BARBARA COUNTY TREASURER
SANTA BARBARA, CA 93102
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
16,103.13
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$16,103.13Gross Claim
$16,103.13Net Claim / Payment Amount
YTD Amount: $172,980.03
Page 42 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1406
SANTA CLARA CO TREASURER
SACRAMENTO, CA 95812
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
75,742.73
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$75,742.73Gross Claim
$75,742.73Net Claim / Payment Amount
YTD Amount: $813,629.26
Page 43 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1817
SANTA CRUZ COUNTY TREASURER
SANTA CRUZ, CA 95061
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
18,151.88
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$18,151.88Gross Claim
$18,151.88Net Claim / Payment Amount
YTD Amount: $194,987.72
Page 44 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1859
SHASTA COUNTY TREASURER
SACRAMENTO, CA 95812 1859
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
13,354.83
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$13,354.83Gross Claim
$13,354.83Net Claim / Payment Amount
YTD Amount: $143,457.76
Page 45 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 376
SIERRA COUNTY TREASURER
DOWNIEVILLE, CA 95936 0376
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
7,568.53
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$7,568.53Gross Claim
$7,568.53Net Claim / Payment Amount
YTD Amount: $81,301.20
Page 46 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
311 FOURTH ST RM 104
SISKIYOU COUNTY TREASURER
YREKA, CA 96097
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
12,157.68
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$12,157.68Gross Claim
$12,157.68Net Claim / Payment Amount
YTD Amount: $130,597.94
Page 47 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
675 TEXAS ST STE 1900
SOLANO COUNTY T TC
FAIRFIELD, CA 94533 6337
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
23,060.70
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$23,060.70Gross Claim
$23,060.70Net Claim / Payment Amount
YTD Amount: $247,718.25
Page 48 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1204
SONOMA COUNTY TREASURER
SACRAMENTO, CA 95812 1204
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
13,112.59
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$13,112.59Gross Claim
$13,112.59Net Claim / Payment Amount
YTD Amount: $140,855.55
Page 49 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 3052
STANISLAUS COUNTY TREASURER
MODESTO, CA 95353 3052
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
17,106.88
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$17,106.88Gross Claim
$17,106.88Net Claim / Payment Amount
YTD Amount: $183,762.25
Page 50 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 546
SUTTER COUNTY TREASURER
YUBA CITY, CA 95992
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
13,487.11
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$13,487.11Gross Claim
$13,487.11Net Claim / Payment Amount
YTD Amount: $144,878.71
Page 51 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1150
TEHAMA COUNTY TREASURER
RED BLUFF, CA 96080
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
12,431.38
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$12,431.38Gross Claim
$12,431.38Net Claim / Payment Amount
YTD Amount: $133,538.06
Page 52 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1297
TRINITY CO TREASURER
WEAVERVILLE, CA 96093 1297
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
8,625.84
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$8,625.84Gross Claim
$8,625.84Net Claim / Payment Amount
YTD Amount: $92,658.83
Page 53 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
221 SOUTH MOONEY BL
COUNTY CIVIC CENTER RM 103E
TULARE COUNTY TREASURER
VISALIA, CA 93291
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
15,371.90
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$15,371.90Gross Claim
$15,371.90Net Claim / Payment Amount
YTD Amount: $165,125.09
Page 54 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
2 SOUTH GREEN ST
TUOLUMNE COUNTY TREASURER
SONORA, CA 95370
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
13,635.40
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$13,635.40Gross Claim
$13,635.40Net Claim / Payment Amount
YTD Amount: $146,471.61
Page 55 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 980307
C/O WELLS FARGO BANK
VENTURA COUNTY TREASURER
WEST SACRAMENTO, CA 95798 0307
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
33,871.44
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$33,871.44Gross Claim
$33,871.44Net Claim / Payment Amount
YTD Amount: $363,847.35
Page 56 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
PO BOX 1995
YOLO COUNTY TREASURER
WOODLAND, CA 95695
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
16,844.78
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$16,844.78Gross Claim
$16,844.78Net Claim / Payment Amount
YTD Amount: $180,946.80
Page 57 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
CONTROLLER OF CALIFORNIA, STATE OF CALIFORNIA
P O BOX 942850, SACRAMENTO, CA 94250-0001
REMITTANCE ADVICE
06/26/2012
CLAIM SCHEDULE NUMBER:
PAYMENT ISSUE DATE:
915 8TH ST STE 103
YUBA COUNTY TREASURER
MARYSVILLE, CA 95901 5273
Financial_Activity
1100404A
Fiscal Year: 2011
Payment Calculations:
NonDrug MediCal Subs Abuse Subacct apportionment amount for current
period.
10,627.28
NonDrug MediCal Subs Abuse Subaccount apportionment per ABX1 16
05/16/2012 06/15/2012Collection Period: To
NonDrug MediCal Substance Abuse Treatment Services Subaccount per Government Code Section 30028.5(j).
Per schedule from the Department of Finance.
To be deposited in the County Local Revenue Fund 2011, Health and Human Services Account
Additional Description:
$10,627.28Gross Claim
$10,627.28Net Claim / Payment Amount
YTD Amount: $114,158.38
Page 58 of 58
For assistance, please call: Lisa Frediani at (916) 323-7979
Remittance Advice - EFT
