CMS/EIP Fiscal Report Center: 05
Services beginning 10/01/2022 ending 12/31/2022 Date of Report:01/23/2023 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 494 216.500000 8053.8000 37.2000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 94 81.500000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1038 2885.500000 107268.3500 37.1750
Subtotal (Total Children Is Unduplicated) 1041 3183.500000 115322.1500 36.2250
-----------------------------------------------------------------------------------------------------------------------
Total 3183.500000 115322.1500 36.2250
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 1041
-----------------------------------------------------------------------------------------------------------------------
Center 05
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 6 3.000000 111.6000 0.0000
U 0 0.000000 0.0000 0.0000
B 2733 1628.750000 60549.6000 28183.9800
P 0 0.000000 0.0000 0.0000
D 1 0.250000 9.2500 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
2945 1524.250000 53639.1000 0.0000
Other 40 27.250000 1012.6000 0.0000
---------------------------------------------------------
Total 5725 3183.500000 115322.1500 28183.9800