CMS/EIP Fiscal Report Center: 05
Services beginning 07/01/2024 ending 09/30/2024 Date of Report:04/06/2025 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 484 225.000000 8370.0000 37.2000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 152 121.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 942 2555.750000 95073.9000 37.2000
Subtotal (Total Children Is Unduplicated) 964 2901.750000 103443.9000 35.6488
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Total 2901.750000 103443.9000 35.6488
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Number of Children (Unduplicated) With at Least One Service 964
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Center 05
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 2037 1137.000000 42296.4000 40559.6900
P 0 0.000000 0.0000 0.0000
D 56 37.000000 1376.4000 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
3089 1532.750000 52517.1000 0.0000
Other 315 195.000000 7254.0000 6956.4000
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Total 5497 2901.750000 103443.9000 47516.0900