CMS/EIP Fiscal Report Center: 07
Services beginning 01/01/2022 ending 03/31/2022 Date of Report:04/16/2022 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 81 123.500000 4569.5000 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 11 11.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 92 271.250000 10036.2500 37.0000
Subtotal (Total Children Is Unduplicated) 93 405.750000 14605.7500 35.9969
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 1 2.000000 150.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 1 4.000000 222.0000 55.5000
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 1 2.000000 111.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 5 10.000000 750.0000 75.0000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 3 6.000000 450.0000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 28 56.000000 3108.0000 55.5000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 34 67.500000 3746.2500 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 17 36.000000 2700.0000 75.0000
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 7 14.000000 1050.0000 75.0000
Subtotal (Total Children Is Unduplicated) 72 197.500000 12287.2500 62.2139
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 11 18.750000 0.0000 0.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 10 13.000000 130.0000 10.0000
Subtotal (Total Children Is Unduplicated) 21 31.750000 130.0000 4.0945
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Total 635.000000 27023.0000 42.5559
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Number of Children (Unduplicated) With at Least One Service 97
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Center 07
Flag Claims Units Chgs Paid
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R 3 6.250000 231.2500 0.0000
U 0 0.000000 0.0000 0.0000
B 87 126.500000 6219.5000 0.0000
P 105 145.750000 6615.7500 6588.0000
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 3 6.000000 450.0000 0.0000
T 0 0.000000 0.0000 0.0000
454 342.500000 13173.5000 0.0000
Other 10 8.000000 333.0000 0.0000
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Total 662 635.000000 27023.0000 6588.0000