CMS/EIP Fiscal Report Center: 07
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 938 730.000000 26973.0000 36.9493
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 483 1202.500000 92.5000 0.0769
TCM-T1017TL-TARGETED CASE MANAGEMENT 1359 4253.250000 156538.2500 36.8044
Subtotal (Total Children Is Unduplicated) 1435 6185.750000 183603.7500 29.6817
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 34 54.250000 2712.5000 50.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 6 16.000000 1200.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 1 2.000000 111.0000 55.5000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 150 377.000000 20923.5000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 124 276.500000 20737.5000 75.0000
SCREEN-T1023-SCREENING 10 10.000000 500.0000 50.0000
Subtotal (Total Children Is Unduplicated) 237 735.750000 46184.5000 62.7720
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EI Services,Class #03
CONIF-CONIF-CONSULT, FACE TO FACE 6 7.000000 350.0000 50.0000
CONIP-CONIP-CONSULT, PHONE 1 0.500000 12.5000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 12 31.750000 1587.5000 50.0000
TRAV-TRAVS-Travel by mile 1 21.000000 9.3450 0.4450
Subtotal (Total Children Is Unduplicated) 20 60.250000 1959.3450 32.5202
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Total 6981.750000 231747.5950 33.1933
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Number of Children (Unduplicated) With at Least One Service 1436
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Center 07
Flag Claims Units Chgs Paid
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R 28 18.000000 666.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 70 45.750000 1772.5000 0.0000
P 4189 3087.500000 125200.5000 125069.5000
D 0 0.000000 0.0000 0.0000
S 2 4.000000 300.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
4898 3826.500000 103808.5950 543.0000
Other 0 0.000000 0.0000 0.0000
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Total 9187 6981.750000 231747.5950 125612.5000