CMS/EIP Fiscal Report Center: 54
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 617 506.500000 18740.5000 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 893 2927.750000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1254 3551.000000 131257.5000 36.9635
Subtotal (Total Children Is Unduplicated) 1326 6985.250000 149998.0000 21.4735
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Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 5 6.000000 291.0000 48.5000
EXIT-EXIT-EXIT ASSESSMENT 15 30.500000 1525.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 17 29.500000 2212.5000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 10 15.000000 1125.0000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 4 6.500000 487.5000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 10 17.000000 1275.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 9 12.500000 693.7500 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 114 192.500000 14400.0000 74.8052
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 58 90.000000 6750.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 10 15.500000 1162.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 68 104.500000 5744.2500 54.9689
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 46 76.500000 5737.5000 75.0000
SCREEN-T1023-SCREENING 5 5.000000 250.0000 50.0000
Subtotal (Total Children Is Unduplicated) 269 601.000000 41654.0000 69.3078
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 44 21.250000 1062.5000 50.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 513 500.000000 25000.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 5 1.250000 31.2500 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 11 11.000000 550.0000 50.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 2 2.000000 50.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 415 2098.500000 104925.0000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 788 3750.000000 37490.0000 9.9973
TRAV-TRAVS-Travel by mile 1 10.000000 4.4600 0.4460
Subtotal (Total Children Is Unduplicated) 803 6394.000000 169113.2100 26.4487
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Total 13980.250000 360765.2100 25.8053
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Number of Children (Unduplicated) With at Least One Service 1326
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Center 54
Flag Claims Units Chgs Paid
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R 3 2.000000 74.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 4712 3815.000000 163983.5000 50.0000
P 672 682.750000 35758.7500 35774.5000
D 0 0.000000 0.0000 0.0000
S 1 0.250000 9.2500 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
12429 9477.500000 160837.9600 0.0000
Other 4 2.750000 101.7500 0.0000
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Total 17821 13980.250000 360765.2100 35824.5000