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
Payclass Filters:GR
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 927 3437.250000 127865.7000 37.2000
Subtotal (Total Children Is Unduplicated) 1858 8245.750000 306518.7000 37.1729
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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 2 3.500000 233.2500 66.6429
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 1 1.500000 112.5000 75.0000
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 4 7.000000 388.5000 55.5000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 15 27.500000 2062.5000 75.0000
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 9 17.500000 1312.5000 75.0000
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 1 4.000000 300.0000 75.0000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 42 81.500000 4523.2500 55.5000
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.4100 51.4100
Subtotal (Total Children Is Unduplicated) 230 448.000000 24208.9100 54.0377
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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 51 131.500000 0.5000 0.0038
EIIF-EIIF_NM-EI INDIVIDUAL SESSION BY NONMED PROF 1 1.000000 50.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 12 52.000000 2600.0000 50.0000
INTR-T1013-INTERPRETER 114 467.500000 23350.0000 49.9465
OCCT-97530-OT SESSION BY LICENSED OT 2 1.750000 125.9300 71.9600
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 4 6.000000 431.7600 71.9600
TRAV-TRAVS-Travel by mile 19 958.000000 355.6200 0.3712
Subtotal (Total Children Is Unduplicated) 206 1698.000000 30476.3100 17.9484
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Total 10391.750000 361203.9200 34.7587
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Number of Children (Unduplicated) With at Least One Service 1911
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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 9603 10387.500000 361045.8200 361045.8200
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 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 9610 10391.750000 361203.9200 361185.3200