CMS/EIP Fiscal Report Center: 09
Services beginning 01/01/2024 ending 03/31/2024 Date of Report:04/04/2025 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 1682 4802.500000 178653.0000 37.2000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 1 6.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1799 6815.750000 253536.6000 37.1986
Subtotal (Total Children Is Unduplicated) 1990 11624.25000 432189.6000 37.1800
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-COS Exit 170 304.500000 15225.0000 50.0000
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 5 9.500000 683.2500 71.9211
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 2 3.500000 262.5000 75.0000
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 9 17.000000 943.5000 55.5000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 91 165.000000 12375.0000 75.0000
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 51 97.000000 7245.7500 74.6985
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 20 40.500000 3037.5000 75.0000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 199 385.500000 21434.2500 55.6012
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 4 4.000000 205.6400 51.4100
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 2 2.000000 102.8200 51.4100
Subtotal (Total Children Is Unduplicated) 488 1028.500000 61515.2100 59.8106
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 12 15.500000 775.0000 50.0000
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 21 35.750000 1762.5000 49.3007
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 16 17.000000 425.0000 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 6 6.000000 300.0000 50.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 1 1.000000 50.0000 50.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 2 2.000000 100.0000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 3 3.000000 150.0000 50.0000
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 53 139.250000 0.5000 0.0036
EIIF-EIIF_NM-EI INDIVIDUAL SESSION BY NONMED PROF 1 1.000000 50.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 37 177.000000 8850.0000 50.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 2 3.000000 150.0000 50.0000
INTR-T1013-INTERPRETER 114 467.500000 23350.0000 49.9465
OCCT-97530-OT SESSION BY LICENSED OT 7 24.500000 1763.0200 71.9600
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 13 52.500000 3777.9000 71.9600
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 2 2.000000 143.9200 71.9600
SPL-92507TLGT-SPL THERAPY SESSION BY LICENSED SLP 1 3.000000 215.8800 71.9600
TRAV-TRAVS-Travel by mile 19 958.000000 355.6200 0.3712
Subtotal (Total Children Is Unduplicated) 210 1908.000000 42219.3400 22.1275
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Total 14560.750000 535924.1500 36.8061
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Number of Children (Unduplicated) With at Least One Service 2018
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Center 09
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 9740 10517.250000 367525.0600 367525.0600
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 3681 4039.250000 168240.9900 168110.7900
T 5 3.750000 139.5000 139.5000
2 0.500000 18.6000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 13428 14560.750000 535924.1500 535775.3500