CMS/EIP Fiscal Report Center: 03
Services beginning 01/01/2025 ending 03/31/2025 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 191 117.000000 4352.4000 37.2000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 4 23.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 727 1306.000000 48583.2000 37.2000
Subtotal (Total Children Is Unduplicated) 825 1446.000000 52935.6000 36.6083
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 1 2.000000 119.8400 59.9200
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 30 63.500000 3804.9200 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 5 9.000000 539.2800 59.9200
SCREEN-T1023-SCREENING 4 4.000000 215.9200 53.9800
Subtotal (Total Children Is Unduplicated) 40 78.500000 4679.9600 59.6173
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EI Services,Class #03
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 2 2.000000 108.0000 54.0000
Subtotal (Total Children Is Unduplicated) 2 2.000000 108.0000 54.0000
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Total 1526.500000 57723.5600 37.8143
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Number of Children (Unduplicated) With at Least One Service 835
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Center 03
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 0 0.000000 0.0000 0.0000
2199 1526.500000 57723.5600 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 2199 1526.500000 57723.5600 0.0000