Page 69 - 2021 MHA Start-up Guide

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Sample Budget Template – Dental

MTD & YTD Budget vs. Actual ($) Report
July 31, 2018

Jul '18 Jul '18 Variance YTD YTD Variance Annual Remaining Remaining
Actual Budget Actual Budget Budget Budget Budget (%)
Direct Dental Operating Expenses
Contract Dental Clinical Staff
Contract Drivers
Dental Supplies
Screening Supplies
Dental Equipment less than $2500
School Based Outreach and Forms
Complex Care Subsidy Program
Oral Health Education Program
Miscellaneous Dental Expenses
Van Expenses
Repairs & Maintenance
Repairs & Maintenance - Trucks &
Generators
Dental Equipment Maintenance
Vans - Fuel
Vans - Other
Vans - IT Expense
Vans - Insurance
Vans - Malpractice Insurance
Vans - Software Maintenance
Total Van Expenses
Total Direct Dental Operating Expenses

Salary and Benefits
Gross Payroll
ER Payroll Tax Expense
ER 401(k) Matching Contribution
ER 401(k) Safe Harbor Contribution
Health Insurance
Salary and Benefits
Seminars, Training, and Travel
Training, Seminars & Conferences
Tuition Reimbursement
Travel
Patient Navigation
Mileage Reimbursement-Staff
Staff Meals & Catering
Seminars, Training, and Travel
Other Employee Related Expenses
Books & Subscriptions
Dues, Memberships & Licenses
Misc-Employee Related Expenses
Other Employee Related Expenses
Professional Fees
IT Support
Public Relations
Contract/Consulting
Professional Fees

MOBILE HEALTHCARE ASSOCIATION 6 7