CMS/EIP Fiscal Report Center: 02
Services beginning 07/01/2024 ending 06/30/2025 Date of Report:07/19/2025 Page: 1
List order: No List
Eligibility Filter:Not Part C
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Screening, Eval, and Assessment,Class #02
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 1.500000 83.2500 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 16 32.000000 2507.6400 78.3638
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 1 2.000000 161.9600 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 16 30.500000 2451.9500 80.3918
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 38 72.000000 4283.3000 59.4903
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 2 4.000000 239.6800 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 51 111.500000 8882.7600 79.6660
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 1 2.000000 161.9600 80.9800
Subtotal (Total Children Is Unduplicated) 87 257.500000 18934.4600 73.5319
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EI Services,Class #03
EPIC-99601-Early Steps Professional Development Fee 4 4.000000 60.0000 15.0000
INTR-T1013-INTERPRETER 11 35.500000 1775.0000 50.0000
TRAV-TRAVS-Travel by mile 110 5964.000000 2653.7700 0.4450
Subtotal (Total Children Is Unduplicated) 116 6003.500000 4488.7700 0.7477
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Total 6261.000000 23423.2300 3.7411
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Number of Children (Unduplicated) With at Least One Service 154
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Center 02
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 265 5415.000000 18915.3000 17776.5000
59 846.000000 4507.9300 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 324 6261.000000 23423.2300 17776.5000