CMS/EIP Fiscal Report Center: 07
Services beginning 10/01/2019 ending 12/31/2019 Date of Report:02/01/2020 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 1593 1730.750000 63964.2500 36.9575
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 738 718.250000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 505 1330.000000 49200.7500 36.9930
Subtotal (Total Children Is Unduplicated) 1805 3779.000000 113165.0000 29.9458
-----------------------------------------------------------------------------------------------------------------------
Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 66 103.250000 5162.5000 50.0000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 39 76.500000 5737.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 53 105.500000 5855.2500 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 32 66.000000 4950.0000 75.0000
SCREEN-T1023-SCREENING 3 3.000000 150.0000 50.0000
Subtotal (Total Children Is Unduplicated) 149 354.250000 21855.2500 61.6944
-----------------------------------------------------------------------------------------------------------------------
EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 141 223.500000 0.0000 0.0000
Subtotal (Total Children Is Unduplicated) 141 223.500000 0.0000 0.0000
-----------------------------------------------------------------------------------------------------------------------
Total 4356.750000 135020.2500 30.9910
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 1821
-----------------------------------------------------------------------------------------------------------------------
Center 07
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 31 28.500000 1091.5000 0.0000
S 0 0.000000 0.0000 0.0000
H 47 94.000000 7050.0000 0.0000
T 0 0.000000 0.0000 0.0000
7189 4232.250000 126767.7500 0.0000
Other 1 2.000000 111.0000 0.0000
---------------------------------------------------------
Total 7268 4356.750000 135020.2500 0.0000