CMS/EIP Fiscal Report Center: 07
Services beginning 10/01/2023 ending 12/31/2023 Date of Report:01/14/2024 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 1547 1549.500000 57669.3000 37.2180
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 102 113.500000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1509 2798.250000 104085.1500 37.1965
Subtotal (Total Children Is Unduplicated) 1818 4461.250000 161754.4500 36.2577
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 4 8.000000 600.0000 75.0000
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 1 2.000000 150.0000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 2 4.000000 300.0000 75.0000
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 1 2.000000 150.0000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 4 8.000000 600.0000 75.0000
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 1 2.000000 150.0000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 4 8.000000 600.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 3 6.000000 333.0000 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 63 126.000000 9450.0000 75.0000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 29 58.000000 4350.0000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 55 110.000000 8250.0000 75.0000
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 18 36.000000 2700.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 53 106.000000 7950.0000 75.0000
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 16 32.000000 2400.0000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 67 134.000000 7348.2000 54.8373
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 44 88.000000 4884.0000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 51 102.000000 7563.3000 74.1500
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 6 12.000000 900.0000 75.0000
SCREEN-T1023-SCREENING 2 2.000000 200.0000 100.0000
Subtotal (Total Children Is Unduplicated) 262 854.000000 59322.5000 69.4643
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 83 109.250000 0.0000 0.0000
Subtotal (Total Children Is Unduplicated) 83 109.250000 0.0000 0.0000
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Total 5424.500000 221076.9500 40.7553
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Number of Children (Unduplicated) With at Least One Service 1846
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Center 07
Flag Claims Units Chgs Paid
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R 58 36.750000 1367.1000 0.0000
U 0 0.000000 0.0000 0.0000
B 706 597.500000 27861.5000 0.0000
P 1700 1372.697800 61642.3350 61605.1300
D 36 32.000000 1453.8000 0.0000
S 2 0.500000 18.6000 0.0000
H 10 20.000000 1500.0000 0.0000
T 0 0.000000 0.0000 0.0000
5822 3261.302200 123374.1150 0.0000
Other 224 103.750000 3859.5000 0.0000
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Total 8558 5424.500000 221076.9500 61605.1300