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
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 1717 2343.250000 86966.3000 37.1135
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 99 197.750000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 739 1582.000000 58731.7500 37.1250
Subtotal (Total Children Is Unduplicated) 1841 4123.000000 145698.0500 35.3379
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 1 1.101700 77.2600 70.1280
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 2 4.000000 222.0000 55.5000
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 1 2.000000 111.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 12 21.365500 1591.6775 74.4976
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 4 8.000000 600.0000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 7 12.740300 948.0000 74.4096
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 4 8.000000 600.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 19 35.443900 2649.2800 74.7457
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 3 4.424900 328.7200 74.2887
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 31 62.000000 3441.0000 55.5000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 23 46.000000 2553.0000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 6 9.856900 726.4600 73.7007
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 4 6.254100 458.6200 73.3311
Subtotal (Total Children Is Unduplicated) 91 221.187300 14307.0175 64.6828
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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 75 145.000000 0.0000 0.0000
Subtotal (Total Children Is Unduplicated) 75 146.000000 50.0000 0.3425
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Total 4490.187300 160055.0675 35.6455
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Number of Children (Unduplicated) With at Least One Service 1848
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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 0 0.000000 0.0000 0.0000
P 0 0.000000 0.0000 0.0000
D 82 57.000000 2120.4000 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
7964 4432.437300 157906.7675 0.0000
Other 1 0.750000 27.9000 0.0000
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Total 8047 4490.187300 160055.0675 0.0000