CMS/EIP Fiscal Report Center: 07
Services beginning 10/01/2016 ending 12/31/2016 Date of Report:02/04/2017 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 1128 870.750000 32180.7500 36.9575
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 642 869.750000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1515 4911.000000 181438.7500 36.9454
Subtotal (Total Children Is Unduplicated) 1610 6651.500000 213619.5000 32.1160
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 44 64.500000 3225.0000 50.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 9 17.500000 1312.5000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 13 25.500000 1415.2500 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 6 11.000000 825.0000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 120 218.000000 12099.0000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 140 335.500000 25162.5000 75.0000
SCREEN-T1023-SCREENING 26 26.000000 1300.0000 50.0000
Subtotal (Total Children Is Unduplicated) 265 698.000000 45339.2500 64.9559
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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 5 6.500000 325.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 1 0.750000 18.7500 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 14 43.500000 2175.0000 50.0000
Subtotal (Total Children Is Unduplicated) 20 51.750000 2568.7500 49.6377
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Total 7401.250000 261527.5000 35.3356
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Number of Children (Unduplicated) With at Least One Service 1610
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Center 07
Flag Claims Units Chgs Paid
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R 6 4.750000 175.7500 0.0000
U 0 0.000000 0.0000 0.0000
B 213 141.500000 5387.2500 0.0000
P 4892 3594.750000 144988.5000 144951.5000
D 76 55.250000 2309.2500 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
6015 3605.000000 108666.7500 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 11202 7401.250000 261527.5000 144951.5000