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
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 191 117.000000 4352.4000 37.2000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 4 23.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 393 605.000000 22506.0000 37.2000
Subtotal (Total Children Is Unduplicated) 536 745.000000 26858.4000 36.0515
-----------------------------------------------------------------------------------------------------------------------
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 27 56.500000 3385.4800 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 3 6.000000 359.5200 59.9200
SCREEN-T1023-SCREENING 1 1.000000 53.9800 53.9800
Subtotal (Total Children Is Unduplicated) 32 65.500000 3918.8200 59.8293
-----------------------------------------------------------------------------------------------------------------------
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
-----------------------------------------------------------------------------------------------------------------------
Total 812.500000 30885.2200 38.0126
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 547
-----------------------------------------------------------------------------------------------------------------------
Center 03
Flag Claims Units Chgs Paid
---------------------------------------------------------
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
1170 812.500000 30885.2200 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 1170 812.500000 30885.2200 0.0000