CMS/EIP Fiscal Report Center: 53
Services beginning 07/01/2017 ending 06/30/2018 Date of Report:08/10/2018 Page: 1
List order: No List
Eligibility Filter:Not Part C
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Service Coordination,Class #01
CASE-CASE-NON-TCM CASE MANAGEMENT 230 367.000000 13579.0000 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 276 533.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 290 1431.750000 52974.7500 37.0000
Subtotal (Total Children Is Unduplicated) 294 2331.750000 66553.7500 28.5424
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 1 1.000000 50.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 1 1.500000 112.5000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 2 3.500000 262.5000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 8 13.500000 1050.0000 77.7778
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 8 14.500000 804.7500 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 36 52.500000 3937.5000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 22 34.000000 2550.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 8 11.500000 862.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 214 337.500000 18731.2500 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 201 339.500000 25462.5000 75.0000
Subtotal (Total Children Is Unduplicated) 261 809.000000 53823.5000 66.5309
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 1 0.500000 25.0000 50.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 5 18.250000 912.5000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 1 0.500000 12.5000 25.0000
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 189 245.500000 0.0000 0.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 8 60.000000 3000.0000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 265 612.000000 6120.0000 10.0000
TRAV-TRAVS-Travel by mile 105 2901.000000 1291.2700 0.4451
Subtotal (Total Children Is Unduplicated) 266 3837.750000 11361.2700 2.9604
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Total 6978.500000 131738.5200 18.8778
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Number of Children (Unduplicated) With at Least One Service 295
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Center 53
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 39 31.250000 1213.2500 9.2500
P 1298 1401.268920 65866.2501 65216.7500
D 0 0.000000 0.0000 0.0000
S 2 2.250000 83.2500 0.0000
H 187 1760.250000 2300.4900 2300.4900
T 134 1184.750000 2695.8100 2695.8100
2758 2567.731080 57460.7199 0.0000
Other 19 31.000000 2118.7500 0.0000
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Total 4437 6978.500000 131738.5200 70222.3000