CMS/EIP Fiscal Report Center: 07
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 1717 2343.250000 86966.3000 37.1135
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 99 197.750000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1658 3540.250000 131578.6500 37.1665
Subtotal (Total Children Is Unduplicated) 1981 6081.250000 218544.9500 35.9375
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 3 6.000000 450.0000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 2 4.000000 300.0000 75.0000
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 2 4.000000 300.0043 75.0011
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 3 6.000000 450.0000 75.0000
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 1 2.000000 150.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 4 8.000000 444.0000 55.5000
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 4 8.000000 444.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 39 78.000000 5850.0086 75.0001
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 29 58.000000 4350.0000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 42 84.000000 6300.0105 75.0001
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 23 46.000000 3337.5000 72.5543
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 58 116.000000 8700.0107 75.0001
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 15 30.000000 2250.0093 75.0003
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 67 134.000000 7437.0000 55.5000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 60 120.000000 6660.0000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 27 54.000000 4050.0082 75.0002
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 16 32.000000 2289.0030 71.5313
SCREEN-T1023-SCREENING 2 2.000000 100.0000 50.0000
Subtotal (Total Children Is Unduplicated) 245 792.000000 53861.5546 68.0070
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EI Services,Class #03
CONOF-CONOF-CONSULT, OT, FACE TO FACE 1 1.000000 50.0000 50.0000
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 76 147.500000 150.0000 1.0169
Subtotal (Total Children Is Unduplicated) 76 148.500000 200.0000 1.3468
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Total 7021.750000 272606.5046 38.8232
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Number of Children (Unduplicated) With at Least One Service 1988
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Center 07
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 24 20.000000 983.6000 0.0000
P 2802 2337.312700 100795.1371 100378.0800
D 115 121.750000 6948.3000 0.0000
S 0 0.000000 0.0000 0.0000
H 13 26.000000 1950.0000 0.0000
T 0 0.000000 0.0000 0.0000
7995 4466.937300 160078.7675 0.0000
Other 123 49.750000 1850.7000 0.0000
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Total 11072 7021.750000 272606.5046 100378.0800