CMS/EIP Fiscal Report Center: 07
Services beginning 07/01/2019 ending 09/30/2019 Date of Report:11/04/2019 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 1416 1444.250000 53418.7500 36.9872
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 712 706.500000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 494 1228.250000 45380.5000 36.9473
Subtotal (Total Children Is Unduplicated) 1670 3379.000000 98799.2500 29.2392
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 89 136.750000 6825.0000 49.9086
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 3 6.000000 450.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 3 6.000000 333.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 36 71.500000 5362.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 52 104.000000 5772.0000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 45 86.286700 6471.5000 75.0000
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 2.000000 102.1000 51.0500
Subtotal (Total Children Is Unduplicated) 180 414.536700 25466.1000 61.4327
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 187 211.500000 0.0000 0.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 1 1.000000 50.0000 50.0000
Subtotal (Total Children Is Unduplicated) 187 212.500000 50.0000 0.2353
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Total 4006.036700 124315.3500 31.0320
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Number of Children (Unduplicated) With at Least One Service 1692
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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 1 0.250000 9.2500 37.0000
D 11 7.750000 299.7500 0.0000
S 49 24.000000 804.7500 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
6616 3974.036700 123201.6000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 6677 4006.036700 124315.3500 37.0000