CMS/EIP Fiscal Report Center: 02
Services beginning 01/01/2023 ending 03/31/2023 Date of Report:04/20/2023 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 798 682.750000 25398.3000 37.2000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 169 200.500000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 639 1197.000000 44528.4000 37.2000
Subtotal (Total Children Is Unduplicated) 898 2080.250000 69926.7000 33.6146
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 1 0.750000 37.5000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 1 2.000000 150.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 2 3.000000 166.5000 55.5000
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 3 6.000000 333.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 33 58.500000 4387.5000 75.0000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 3 5.500000 412.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 60 110.000000 6105.0000 55.5000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 7 13.500000 749.2500 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 30 55.000000 4125.0000 75.0000
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 17 33.500000 2512.5000 75.0000
Subtotal (Total Children Is Unduplicated) 111 287.750000 18978.7500 65.9557
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 1 1.500000 75.0000 50.0000
COIFF-COIFFGT-IFSP CONSULT,PROF,FACE TO FACE 6 8.250000 412.5000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 1 1.000000 25.0000 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 14 12.750000 637.5000 50.0000
CONIF-CONIFGT-CONSULT,ITDS,FACE TO FACE 6 3.250000 162.5000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 1 0.500000 12.5000 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 6 7.000000 350.0000 50.0000
CONOF-CONOFGT-CONSULT,OT,FACE TO FACE 1 0.750000 37.5000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 17 18.500000 925.0000 50.0000
CONSF-CONSFGT-CONSULT,SLP,FACE TO FACE 21 11.500000 575.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 37 135.500000 6775.0000 50.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 18 68.750000 3437.5000 50.0000
TRAV-TRAVS-Travel by mile 109 9606.000000 4274.2200 0.4450
Subtotal (Total Children Is Unduplicated) 141 9875.250000 17699.2200 1.7923
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Total 12243.250000 106604.6700 8.7072
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Number of Children (Unduplicated) With at Least One Service 919
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Center 02
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 0 0.000000 0.0000 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
0 0.000000 0.0000 0.0000
Other 4607 12243.250000 106604.6700 0.0000
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Total 4607 12243.250000 106604.6700 0.0000