CMS/EIP Fiscal Report Center: 07
Services beginning 10/01/2018 ending 12/31/2018 Date of Report:02/06/2019 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 1321 1280.250000 47369.2500 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 738 847.250000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1633 4233.500000 156510.0000 36.9694
Subtotal (Total Children Is Unduplicated) 1848 6361.000000 203879.2500 32.0514
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 34 51.000000 2550.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 7 13.500000 1012.5000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 4 8.000000 600.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 6 11.500000 638.2500 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 130 255.500000 19162.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 149 290.000000 16095.0000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 149 314.000000 23550.0000 75.0000
SCREEN-T1023-SCREENING 6 6.000000 300.0000 50.0000
Subtotal (Total Children Is Unduplicated) 307 949.500000 63908.2500 67.3073
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 146 194.250000 0.0000 0.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 2 11.000000 550.0000 50.0000
Subtotal (Total Children Is Unduplicated) 146 205.250000 550.0000 2.6797
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Total 7515.750000 268337.5000 35.7034
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Number of Children (Unduplicated) With at Least One Service 1856
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Center 07
Flag Claims Units Chgs Paid
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R 13 9.500000 351.5000 0.0000
U 0 0.000000 0.0000 0.0000
B 40 36.000000 1421.0000 0.0000
P 3564 3055.750000 129006.7500 128942.0000
D 179 143.250000 5982.2500 0.0000
S 9 68.000000 2620.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
6538 4202.250000 128919.0000 0.0000
Other 2 1.000000 37.0000 0.0000
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Total 10345 7515.750000 268337.5000 128942.0000