CMS/EIP Fiscal Report Center: 07
Services beginning 01/01/2020 ending 03/31/2020 Date of Report:05/15/2020 Page: 1
List order: No List
Eligibility Filter:Not Part C
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Service Coordination,Class #01
CASE-CASE-NON-TCM CASE MANAGEMENT 33 31.000000 1147.0000 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 21 22.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 44 169.250000 6262.2500 37.0000
Subtotal (Total Children Is Unduplicated) 44 222.250000 7409.2500 33.3375
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Screening, Eval, and Assessment,Class #02
EVAL-96111-DEVELOPMENTAL EVALUATION 1 1.000000 50.0000 50.0000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 16 31.000000 2325.0000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 25 48.500000 2691.7500 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 17 32.000000 2400.0000 75.0000
SCREEN-T1023-SCREENING 1 1.000000 50.0000 50.0000
Subtotal (Total Children Is Unduplicated) 36 113.500000 7516.7500 66.2269
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 7 12.250000 0.0000 0.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 17 21.000000 210.0000 10.0000
Subtotal (Total Children Is Unduplicated) 22 33.250000 210.0000 6.3158
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Total 369.000000 15136.0000 41.0190
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Number of Children (Unduplicated) With at Least One Service 44
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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 20 22.750000 993.7500 0.0000
P 113 169.750000 7906.0000 7956.0000
D 1 2.000000 150.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 2 4.000000 300.0000 0.0000
T 0 0.000000 0.0000 0.0000
180 170.500000 5786.2500 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 316 369.000000 15136.0000 7956.0000