CMS/EIP Fiscal Report Center: 02
Services beginning 01/01/2025 ending 03/31/2025 Date of Report:04/06/2025 Page: 1
List order: No List
Eligibility Filter:Not Part C
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Screening, Eval, and Assessment,Class #02
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 3 6.000000 485.8800 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 5 9.500000 569.2400 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 9 21.500000 1741.0700 80.9800
Subtotal (Total Children Is Unduplicated) 14 37.000000 2796.1900 75.5727
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EI Services,Class #03
INTR-T1013-INTERPRETER 7 21.500000 1075.0000 50.0000
TRAV-TRAVS-Travel by mile 28 1143.000000 508.5900 0.4450
Subtotal (Total Children Is Unduplicated) 30 1164.500000 1583.5900 1.3599
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Total 1201.500000 4379.7800 3.6453
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Number of Children (Unduplicated) With at Least One Service 37
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Center 02
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 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 48 839.500000 2972.3300 2972.3300
23 362.000000 1407.4500 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 71 1201.500000 4379.7800 2972.3300