CMS/EIP Fiscal Report Center: 07
Services beginning 10/01/2021 ending 12/31/2021 Date of Report:02/04/2022 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 1653 1945.500000 71928.0000 36.9715
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 66 80.250000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 576 1344.500000 49718.7500 36.9794
Subtotal (Total Children Is Unduplicated) 1773 3370.250000 121646.7500 36.0943
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 12 17.000000 850.0000 50.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 1 2.000000 111.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 3 5.298600 397.3950 75.0000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 3 4.996500 374.7375 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 36 72.000000 3996.0000 55.5000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 25 50.000000 2775.0000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 17 34.500000 2587.5000 75.0000
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 8 16.000000 1200.0000 75.0000
Subtotal (Total Children Is Unduplicated) 91 201.795100 12291.6325 60.9115
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 39 77.250000 0.0000 0.0000
Subtotal (Total Children Is Unduplicated) 39 77.250000 0.0000 0.0000
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Total 3649.295100 133938.3825 36.7025
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Number of Children (Unduplicated) With at Least One Service 1783
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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 0 0.000000 0.0000 0.0000
P 0 0.000000 0.0000 0.0000
D 18 16.250000 677.2500 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
6645 3627.545100 133066.8825 0.0000
Other 8 5.500000 194.2500 0.0000
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Total 6671 3649.295100 133938.3825 0.0000