CMS/EIP Fiscal Report Center: 04
Services beginning 01/01/2020 ending 03/31/2020 Date of Report:05/15/2020 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 970 951.500000 35205.5000 37.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1655 7624.250000 282097.2500 37.0000
Subtotal (Total Children Is Unduplicated) 1689 8575.750000 317302.7500 37.0000
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Screening, Eval, and Assessment,Class #02
EVAL-96111-DEVELOPMENTAL EVALUATION 32 30.750000 1537.5000 50.0000
EXIT-EXIT-EXIT ASSESSMENT 90 90.250000 4512.5000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 16 11.000000 825.0000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 21 17.500000 1312.5000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 36 51.000000 4190.3600 82.1639
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 41 56.000000 3108.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 98 74.500000 5587.5000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 131 104.000000 7800.0000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 268 313.000000 17285.5000 55.2252
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 153 150.500000 14998.2300 99.6560
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 11 11.000000 561.5500 51.0500
Subtotal (Total Children Is Unduplicated) 446 909.500000 61718.6400 67.8600
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Total 9485.250000 379021.3900 39.9590
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Number of Children (Unduplicated) With at Least One Service 1696
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Center 04
Flag Claims Units Chgs Paid
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R 34 49.750000 1840.7500 0.0000
U 0 0.000000 0.0000 0.0000
B 1103 1594.000000 61738.7500 101.7500
P 2568 3931.250000 156988.8800 156521.9200
D 2 2.000000 130.5000 0.0000
S 2 4.000000 148.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
4115 3898.250000 157952.5100 81.4600
Other 4 6.000000 222.0000 0.0000
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Total 7828 9485.250000 379021.3900 156705.1300