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
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 1321 1280.250000 47369.2500 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 738 847.250000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 596 1629.500000 60245.2500 36.9716
Subtotal (Total Children Is Unduplicated) 1642 3757.000000 107614.5000 28.6437
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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 2 4.000000 300.0000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 1 2.000000 150.0000 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 56 110.000000 8250.0000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 66 128.000000 7104.0000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 63 134.000000 10050.0000 75.0000
Subtotal (Total Children Is Unduplicated) 149 433.000000 28626.0000 66.1109
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 146 194.250000 0.0000 0.0000
Subtotal (Total Children Is Unduplicated) 146 194.250000 0.0000 0.0000
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Total 4384.250000 136240.5000 31.0750
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Number of Children (Unduplicated) With at Least One Service 1661
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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 179 143.250000 5982.2500 0.0000
S 1 60.000000 2220.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
6507 4181.000000 128038.2500 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 6687 4384.250000 136240.5000 0.0000