CMS/EIP Fiscal Report Center: 07
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
Service Coordination,Class #01
CASE-CASE-NON-TCM CASE MANAGEMENT 71 119.500000 4454.7000 37.2778
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 18 19.250000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 72 244.500000 9095.4000 37.2000
Subtotal (Total Children Is Unduplicated) 72 383.250000 13550.1000 35.3558
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 1 2.000000 161.9600 80.9800
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 1 2.000000 161.9600 80.9800
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 1 2.000000 161.9600 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 1 2.000000 119.8400 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 2 4.000000 239.6800 59.9200
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 11 22.000000 1681.5600 76.4345
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 8 16.000000 1295.6800 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 4 8.000000 647.8400 80.9800
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 3 6.000000 485.8800 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 7 14.000000 1133.7200 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 1 2.000000 161.9600 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 26 52.000000 3115.8400 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 18 36.000000 2157.1200 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 9 18.000000 1457.6400 80.9800
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 1 2.000000 161.9600 80.9800
SCREEN-T1023-SCREENING 1 1.000000 53.9800 53.9800
Subtotal (Total Children Is Unduplicated) 55 189.000000 13198.5800 69.8338
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 14 23.000000 0.0000 0.0000
EPIC-99601-Early Steps Professional Development Fee 3 3.000000 45.0000 15.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 9 10.000000 120.0000 12.0000
TRAV-TRAVS-Travel by mile 3 30.000000 13.3500 0.4450
Subtotal (Total Children Is Unduplicated) 24 66.000000 178.3500 2.7023
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Total 638.250000 26927.0300 42.1888
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Number of Children (Unduplicated) With at Least One Service 74
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Center 07
Flag Claims Units Chgs Paid
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R 2 0.500000 18.6000 0.0000
U 0 0.000000 0.0000 0.0000
B 56 70.000000 3619.2400 0.0000
P 171 217.000000 9490.6100 9503.0900
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
417 346.750000 13649.7800 0.0000
Other 6 4.000000 148.8000 0.0000
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Total 652 638.250000 26927.0300 9503.0900