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
    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
  CASE-CASE-NON-TCM CASE MANAGEMENT                     1470            1746.500000        64620.5000           37.0000
  SCTT-SCTT-SERVICE COORDINATOR TRAVEL                    43              47.000000            0.0000            0.0000
  TCM-T1017TL-TARGETED CASE MANAGEMENT                  1412            2899.750000       107189.0000           36.9649
Subtotal (Total Children Is Unduplicated)               1715            4693.250000       171809.5000           36.6078
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Screening, Eval, and Assessment,Class #02
  EXIT-EXIT-EXIT ASSESSMENT                                6               8.000000          400.0000           50.0000
  IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT           2               4.000000          300.0000           75.0000
  IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT          3               6.000000          450.0000           75.0000
  IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF        1               2.000000          150.0000           75.0000
  IPDEF-T1024TLTSGT-F/U PHYC AND DEV EVAL BY EI PROF       1               2.000000          150.0000           75.0000
  IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS             3               8.000000          444.0000           55.5000
  IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS            2               4.000000          222.0000           55.5000
  IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT      56             112.000000         8400.0000           75.0000
  IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT    24              48.000000         3600.0000           75.0000
  IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS      73             146.000000         8103.0000           55.5000
  IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS    72             143.500000         7964.2500           55.5000
  IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF     60             124.000000         9300.0000           75.0000
  IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF   71             148.000000        11100.0000           75.0000
Subtotal (Total Children Is Unduplicated)                257             755.500000        50583.2500           66.9533
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EI Services,Class #03
  DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL             43             152.500000            0.0000            0.0000
Subtotal (Total Children Is Unduplicated)                 43             152.500000            0.0000            0.0000
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Total                                                                   5601.250000       222392.7500           39.7041
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Number of Children (Unduplicated) With at Least One Service       1750
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Center 07
Flag      Claims          Units         Chgs         Paid
---------------------------------------------------------
R             90      78.500000    2904.5000       0.0000 
U              0       0.000000       0.0000       0.0000 
B            906     840.250000   39351.0000       0.0000 
P           1472    1268.441940   54071.3955   53967.5400 
D             17      17.750000    1073.7500       0.0000 
S              1       0.250000       9.2500       0.0000 
H              7      14.000000    1050.0000       0.0000 
T              1       0.250000       9.2500       0.0000 
            6068    3232.808060  118334.6045       0.0000 
Other        296     149.000000    5589.0000       0.0000 
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Total       8858    5601.250000  222392.7500   53967.5400