CMS/EIP Fiscal Report Center: 02
Services beginning 10/01/2015 ending 12/31/2015 Date of Report:02/13/2016 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 529 560.000000 20720.0000 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 272 342.750000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 533 975.250000 36075.0000 36.9905
Subtotal (Total Children Is Unduplicated) 642 1878.000000 56795.0000 30.2423
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 14 22.250000 1112.5000 50.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 33 64.500000 3579.7500 55.5000
SCREEN-T1023-SCREENING 6 6.000000 300.0000 50.0000
Subtotal (Total Children Is Unduplicated) 53 92.750000 4992.2500 53.8248
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 8 14.500000 725.0000 50.0000
CONIF-CONIF-CONSULT, FACE TO FACE 23 18.000000 900.0000 50.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 4 12.000000 300.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 63 325.250000 16262.5000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 2 3.000000 30.0000 10.0000
TRAV-TRAVS-Travel by mile 90 5444.000000 2423.0450 0.4451
Subtotal (Total Children Is Unduplicated) 95 5816.750000 20640.5450 3.5485
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Total 7787.500000 82427.7950 10.5846
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Number of Children (Unduplicated) With at Least One Service 659
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Center 02
Flag Claims Units Chgs Paid
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R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 0 0.000000 0.0000 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 2 10.000000 4.4600 0.0000
10 11.250000 369.7500 0.0000
Other 3772 7766.250000 82053.5850 0.0000
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Total 3784 7787.500000 82427.7950 0.0000