CMS/EIP Fiscal Report Center: 05
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 503 220.500000 8221.2000 37.2844
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 173 154.750000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 937 2412.750000 89726.4000 37.1884
Subtotal (Total Children Is Unduplicated) 962 2788.000000 97947.6000 35.1319
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 1 2.000000 119.8400 59.9200
Subtotal (Total Children Is Unduplicated) 1 2.000000 119.8400 59.9200
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Total 2790.000000 98067.4400 35.1496
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Number of Children (Unduplicated) With at Least One Service 962
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Center 05
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 2226 1182.000000 43970.4000 32375.6600
P 1 2.000000 119.8400 119.8400
D 14 5.250000 195.3000 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
3010 1475.750000 49131.9000 0.0000
Other 173 125.000000 4650.0000 0.0000
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Total 5424 2790.000000 98067.4400 32495.5000