CMS/EIP Fiscal Report Center: 55
Services beginning 10/01/2024 ending 12/31/2024 Date of Report:03/31/2025 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 905 731.000000 27193.2000 37.2000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 105 70.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1197 4852.750000 180457.2000 37.1866
Subtotal (Total Children Is Unduplicated) 1247 5653.750000 207650.4000 36.7279
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 19 37.000000 2984.3000 80.6568
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 3 6.000000 485.8800 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 8 16.000000 958.7200 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 1 2.000000 119.8400 59.9200
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 161 321.000000 25863.0200 80.5702
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 14 30.000000 2429.4000 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 54 107.000000 6393.7600 59.7548
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 7 14.000000 838.8800 59.9200
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 58.1100 58.1100
Subtotal (Total Children Is Unduplicated) 206 534.000000 40131.9100 75.1534
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EI Services,Class #03
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 1 0.500000 12.5000 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 24 24.500000 1225.0000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 25 25.000000 1250.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 64 403.250000 21775.5000 54.0000
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 12 46.000000 3740.7200 81.3200
SPL-92507TL-SPL THERAPY SESSION BY LICENSED SLP 16 72.000000 5855.0400 81.3200
Subtotal (Total Children Is Unduplicated) 94 571.250000 33858.7600 59.2714
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Total 6759.000000 281641.0700 41.6690
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Number of Children (Unduplicated) With at Least One Service 1253
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Center 55
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 1431 1441.750000 66343.2600 0.0000
P 1794 1683.750000 69395.3000 68960.0400
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 44 80.000000 6426.7000 0.0000
T 0 0.000000 0.0000 0.0000
4810 3553.500000 139475.8100 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 8079 6759.000000 281641.0700 68960.0400