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
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 1470 1746.500000 64620.5000 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 43 47.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 500 1069.750000 39506.7500 36.9308
Subtotal (Total Children Is Unduplicated) 1550 2863.250000 104127.2500 36.3668
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 6 8.000000 400.0000 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 2 4.000000 300.0000 75.0000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 4 5.827160 437.0370 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 27 54.000000 2997.0000 55.5000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 21 42.000000 2331.0000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 16 34.000000 2550.0000 75.0000
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 9 15.230900 1142.3175 75.0000
Subtotal (Total Children Is Unduplicated) 72 165.058060 10268.3545 62.2106
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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 3180.808060 114395.6045 35.9643
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Number of Children (Unduplicated) With at Least One Service 1570
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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 14 11.750000 623.7500 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
6030 3169.058060 113771.8545 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 6044 3180.808060 114395.6045 0.0000