CMS/EIP Fiscal Report Center: 10
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
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 836 761.500000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 3435 10107.25000 373803.7500 36.9837
Subtotal (Total Children Is Unduplicated) 3436 10868.75000 373803.7500 34.3925
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 2 8.000000 400.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 12 24.000000 1800.0000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 2 4.000000 300.0000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 2 3.500000 262.5000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 2 4.000000 300.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 12 24.000000 1332.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 365 728.000000 54600.0000 75.0000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 1 2.000000 150.0000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 167 296.000000 22200.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 114 201.500000 15112.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 357 731.500000 40598.2500 55.5000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 1 2.000000 111.0000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 67 143.500000 10762.5000 75.0000
Subtotal (Total Children Is Unduplicated) 498 2172.000000 147928.7500 68.1072
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EI Services,Class #03
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 8 25.000000 1250.0000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 7 19.000000 190.0000 10.0000
Subtotal (Total Children Is Unduplicated) 8 44.000000 1440.0000 32.7273
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Total 13084.750000 523172.5000 39.9834
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Number of Children (Unduplicated) With at Least One Service 3436
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Center 10
Flag Claims Units Chgs Paid
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R 138 106.250000 4413.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 1049 776.500000 30820.2500 9.2500
P 8545 6697.000000 277273.5000 287617.1000
D 37 37.250000 1839.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
6487 5353.750000 201076.2500 0.0000
Other 59 114.000000 7750.5000 0.0000
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Total 16315 13084.750000 523172.5000 287626.3500