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
    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                     1612            2351.000000        87401.4000           37.1763
  SCTT-SCTT-SERVICE COORDINATOR TRAVEL                    84              86.500000            0.0000            0.0000
  TCM-T1017TL-TARGETED CASE MANAGEMENT                   656            1288.750000        47941.5000           37.2000
Subtotal (Total Children Is Unduplicated)               1703            3726.250000       135342.9000           36.3215
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Screening, Eval, and Assessment,Class #02
  IPDEF-T1024GNTS-F/U PSYCH 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-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF          1               2.000000          119.8400           59.9200
  IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT       3               6.000000          485.8800           80.9800
  IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT     3               6.000000          485.8800           80.9800
  IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT        10              18.986500         1537.5268           80.9800
  IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT       5              10.000000          809.8000           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       4               8.000000          647.8400           80.9800
  IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS      33              66.000000         3954.7200           59.9200
  IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS    35              70.000000         4194.4000           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    5               9.214100          746.1578           80.9800
Subtotal (Total Children Is Unduplicated)                 90             232.200600        15897.3246           68.4638
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EI Services,Class #03
  DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL               85             128.500000            0.0000            0.0000
Subtotal (Total Children Is Unduplicated)                 85             128.500000            0.0000            0.0000
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Total                                                                   4086.950600       151240.2246           37.0056
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Number of Children (Unduplicated) With at Least One Service       1712
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Center 07
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             26      15.000000     558.0000       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 
            7139    4070.700600  150635.7246       0.0000 
Other          3       1.250000      46.5000       0.0000 
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Total       7168    4086.950600  151240.2246       0.0000