CMS/EIP Fiscal Report Center: 55
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 776 906.250000 33531.2500 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 174 163.500000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 795 2184.000000 80808.0000 37.0000
Subtotal (Total Children Is Unduplicated) 935 3253.750000 114339.2500 35.1408
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 2 2.000000 100.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 1 2.000000 150.0000 75.0000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 55 110.000000 8250.0000 75.0000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 26 52.000000 3900.0000 75.0000
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 2 2.000000 102.1000 51.0500
Subtotal (Total Children Is Unduplicated) 60 168.000000 12502.1000 74.4173
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EI Services,Class #03
CONIP-CONIP-CONSULT, PHONE 7 1.750000 43.7500 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 15 82.000000 4100.0000 50.0000
Subtotal (Total Children Is Unduplicated) 22 83.750000 4143.7500 49.4776
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Total 3505.500000 130985.1000 37.3656
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Number of Children (Unduplicated) With at Least One Service 939
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Center 55
Flag Claims Units Chgs Paid
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R 1 1.000000 37.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 149 134.750000 4985.7500 18.5000
P 1710 1557.000000 62502.7500 80411.0000
D 42 42.000000 1554.0000 0.0000
S 31 19.000000 703.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
2843 1751.750000 61202.6000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 4776 3505.500000 130985.1000 80429.5000