CMS/EIP Fiscal Report Center: 51
Services beginning 10/01/2022 ending 12/31/2022 Date of Report:01/23/2023 Page: 1
List order: No List
Payclass Filters:GR
Eligibility Filter:Not Part C
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Screening, Eval, and Assessment,Class #02
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 7 7.000000 388.5000 55.5000
Subtotal (Total Children Is Unduplicated) 7 7.000000 388.5000 55.5000
-----------------------------------------------------------------------------------------------------------------------
EI Services,Class #03
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 8 8.000000 80.0000 10.0000
Subtotal (Total Children Is Unduplicated) 8 8.000000 80.0000 10.0000
-----------------------------------------------------------------------------------------------------------------------
Total 15.000000 468.5000 31.2333
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 9
-----------------------------------------------------------------------------------------------------------------------
Center 51
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 15 15.000000 468.5000 468.5000
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 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 15 15.000000 468.5000 468.5000