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
Agency Filter:EIP DEI DEIP
Payclass Filters:TPIN
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 2 0.500000 18.5000 37.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 6 7.750000 277.5000 35.8065
Subtotal (Total Children Is Unduplicated) 6 8.250000 296.0000 35.8788
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Screening, Eval, and Assessment,Class #02
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 22 42.667000 3200.0250 75.0000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 22 38.420400 2881.5300 75.0000
SCREEN-T1023-SCREENING 2 2.000000 100.0000 50.0000
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 2 2.000000 102.1000 51.0500
Subtotal (Total Children Is Unduplicated) 35 85.087400 6283.6550 73.8494
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 1 1.250000 0.0000 0.0000
Subtotal (Total Children Is Unduplicated) 1 1.250000 0.0000 0.0000
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Total 94.587400 6579.6550 69.5616
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Number of Children (Unduplicated) With at Least One Service 39
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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 2 0.500000 18.5000 0.0000
P 6 5.087400 381.5550 381.5300
D 16 31.000000 2301.0500 0.0000
S 3 2.250000 96.2500 0.0000
H 18 35.000000 2601.0500 0.0000
T 0 0.000000 0.0000 0.0000
19 20.750000 1181.2500 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 64 94.587400 6579.6550 381.5300