CMS/EIP Fiscal Report Center: 02
Services beginning 10/01/2013 ending 12/31/2013 Date of Report:02/18/2014 Page: 1
List order: No List
Agency Filter:EIP DEI DEIP
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Service Coordination,Class #01
CASE-CASE-NON-TCM CASE MANAGEMENT 587 519.250000 19184.5000 36.9466
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 229 243.500000 9009.5000 37.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 563 763.000000 28129.2500 36.8666
Subtotal (Total Children Is Unduplicated) 649 1525.750000 56323.2500 36.9151
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 2 4.000000 200.0000 50.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 1 1.000000 55.5000 55.5000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 17 32.500000 1803.7500 55.5000
Subtotal (Total Children Is Unduplicated) 20 37.500000 2059.2500 54.9133
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 1 1.000000 50.0000 50.0000
CONIF-CONIF-CONSULT ITDS, FACE TO FACE 1 1.000000 50.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 10 39.000000 1950.0000 50.0000
Subtotal (Total Children Is Unduplicated) 10 41.000000 2050.0000 50.0000
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Total 1604.250000 60432.5000 37.6703
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Number of Children (Unduplicated) With at Least One Service 654
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Center 02
Flag Claims Units Chgs Paid
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R 48 28.250000 1082.2500 0.0000
U 0 0.000000 0.0000 0.0000
B 787 522.750000 20070.5000 0.0000
P 0 0.000000 0.0000 0.0000
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
2038 1053.250000 39279.7500 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 2873 1604.250000 60432.5000 0.0000