CMS/EIP Fiscal Report Center: 02
Services beginning 10/01/2008 ending 12/31/2008 Date of Report:02/17/2009 Page: 1
Agency Filter:EIP DEI DEIP
Eligibility Filter:Part C (excluding not eligible)
List order: No List
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Service Coordination,Class #01
CASE-CASE-NON-TCM CASE MANAGEMENT 150 59.00 2183.00 37.00
IFSP-IFSP-INDIVIDUALIZED FAMILY SUPPORT PLAN 101 102.00 0.00 0.00
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 137 208.25 7705.25 37.00
TCM-T1017TL-TARGETED CASE MANAGEMENT 443 920.50 33929.00 36.86
TCON-TCON-TRANSITION CONFERENCE 15 15.00 0.00 0.00
Subtotal (Total Children Is Unduplicated) 469 1304.75 43817.25 33.58
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Screening, Eval, and Assessment,Class #02
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 1 1.50 112.50 75.00
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 2 2.50 187.50 75.00
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 9 14.00 721.50 51.54
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 1 1.00 75.00 75.00
Subtotal (Total Children Is Unduplicated) 11 19.00 1096.50 57.71
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 2 2.00 347.09 173.55
Subtotal (Total Children Is Unduplicated) 2 2.00 347.09 173.55
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Total 1325.75 45260.84 34.14
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Number of Children (Unduplicated) With at Least One Service 469
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Center 02
Flag Claims Units Chgs Paid
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R 10 6.50 240.50 0.00
U 0 0.00 0.00 0.00
B 727 523.75 19314.00 0.00
P 0 0.00 0.00 0.00
D 0 0.00 0.00 0.00
S 0 0.00 0.00 0.00
H 0 0.00 0.00 0.00
T 0 0.00 0.00 0.00
1002 795.50 25706.34 0.00
Other 0 0.00 0.00 0.00
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Total 1739 1325.75 45260.84 0.00