CMS/EIP Fiscal Report Center: 07
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 1582 1439.750000 53484.0000 37.1481
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 69 68.250000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1519 2848.000000 105818.2500 37.1553
Subtotal (Total Children Is Unduplicated) 1820 4356.000000 159302.2500 36.5708
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 1 1.500000 75.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 3 6.000000 450.0000 75.0000
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 1 2.000000 150.0000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 2 4.000000 300.0000 75.0000
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 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 4 8.000000 444.0000 55.5000
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 4 8.000000 444.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 54 108.000000 8100.0000 75.0000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 20 40.000000 3000.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 56 112.000000 8400.0000 75.0000
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 20 40.000000 3000.0000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 81 161.500000 8963.2500 55.5000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 60 117.500000 6521.2500 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 49 100.000000 7500.0000 75.0000
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 24 54.000000 4050.0000 75.0000
SCREEN-T1023-SCREENING 5 5.000000 250.0000 50.0000
Subtotal (Total Children Is Unduplicated) 251 771.500000 51947.5000 67.3331
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 60 115.750000 0.0000 0.0000
Subtotal (Total Children Is Unduplicated) 60 115.750000 0.0000 0.0000
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Total 5243.250000 211249.7500 40.2898
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Number of Children (Unduplicated) With at Least One Service 1866
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Center 07
Flag Claims Units Chgs Paid
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R 15 12.250000 455.7000 0.0000
U 0 0.000000 0.0000 0.0000
B 980 769.250000 33310.3000 0.0000
P 1516 1308.750000 58666.9500 65920.2500
D 10 10.250000 608.1000 0.0000
S 13 13.250000 492.9000 0.0000
H 8 16.000000 1200.0000 0.0000
T 0 0.000000 0.0000 0.0000
5424 2940.250000 110074.9000 0.0000
Other 353 173.250000 6440.9000 0.0000
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Total 8319 5243.250000 211249.7500 65920.2500