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
Payclass Filters:GR
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 574 1724.750000 63815.7500 37.0000
Subtotal (Total Children Is Unduplicated) 1530 3361.250000 97800.2500 29.0964
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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 2 4.000000 300.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 2 4.000000 222.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 15 29.500000 2212.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 71 138.000000 7659.0000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 69 151.500000 11362.5000 75.0000
SCREEN-T1023-SCREENING 1 1.000000 50.0000 50.0000
Subtotal (Total Children Is Unduplicated) 130 375.500000 24231.0000 64.5300
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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 2 3.000000 150.0000 50.0000
Subtotal (Total Children Is Unduplicated) 142 200.250000 443.7500 2.2160
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Total 3937.000000 122475.0000 31.1087
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Number of Children (Unduplicated) With at Least One Service 1542
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Center 07
Flag Claims Units Chgs Paid
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R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 0 0.000000 0.0000 0.0000
P 0 0.000000 0.0000 0.0000
D 189 144.250000 5898.0000 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
5876 3792.750000 116577.0000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 6065 3937.000000 122475.0000 0.0000