CMS/EIP Fiscal Report Center: 05
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 445 183.500000 6826.2000 37.2000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 131 117.250000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 976 2292.000000 85262.4000 37.2000
Subtotal (Total Children Is Unduplicated) 983 2592.750000 92088.6000 35.5177
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 1 1.000000 1133.9000 1133.9000
Subtotal (Total Children Is Unduplicated) 1 1.000000 1133.9000 1133.9000
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Total 2593.750000 93222.5000 35.9412
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Number of Children (Unduplicated) With at Least One Service 983
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Center 05
Flag Claims Units Chgs Paid
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R 27 18.500000 688.2000 0.0000
U 0 0.000000 0.0000 0.0000
B 2062 1247.750000 46416.3000 23724.3800
P 0 0.000000 0.0000 0.0000
D 7 3.250000 120.9000 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
2476 1272.500000 44072.0000 1133.9000
Other 66 51.750000 1925.1000 0.0000
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Total 4638 2593.750000 93222.5000 24858.2800