CMS/EIP Fiscal Report Center: 07
Services beginning 10/01/2017 ending 12/31/2017 Date of Report:02/03/2018 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 1183 918.500000 33984.5000 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 624 718.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1656 4929.750000 182400.7500 37.0000
Subtotal (Total Children Is Unduplicated) 1784 6566.250000 216385.2500 32.9542
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 26 45.500000 2275.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 1 2.000000 150.0000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 6 12.000000 900.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 7 14.000000 777.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 32 62.500000 4687.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 158 303.500000 16844.2500 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 177 400.500000 30037.5000 75.0000
SCREEN-T1023-SCREENING 6 6.000000 300.0000 50.0000
Subtotal (Total Children Is Unduplicated) 279 846.000000 55971.2500 66.1599
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 1 0.750000 37.5000 50.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 4 4.500000 225.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 1 1.250000 31.2500 25.0000
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 141 190.750000 0.0000 0.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 7 17.750000 887.5000 50.0000
Subtotal (Total Children Is Unduplicated) 142 215.000000 1181.2500 5.4942
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Total 7627.250000 273537.7500 35.8632
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Number of Children (Unduplicated) With at Least One Service 1786
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Center 07
Flag Claims Units Chgs Paid
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R 19 12.500000 538.5000 0.0000
U 0 0.000000 0.0000 0.0000
B 8 7.250000 496.2500 0.0000
P 4687 3652.500000 149323.0000 149323.0000
D 189 144.250000 5898.0000 0.0000
S 5 9.500000 364.5000 0.0000
H 0 0.000000 0.0000 0.0000
T 1 0.500000 18.5000 0.0000
5892 3800.250000 116880.5000 0.0000
Other 2 0.500000 18.5000 0.0000
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Total 10803 7627.250000 273537.7500 149323.0000