CMS/EIP Fiscal Report Center: 05
Services beginning 07/01/2024 ending 06/30/2025 Date of Report:07/19/2025 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 590 390.750000 14554.5000 37.2476
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 261 305.750000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 429 2251.750000 83765.1000 37.2000
Subtotal (Total Children Is Unduplicated) 772 2948.250000 98319.6000 33.3485
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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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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 2 2.000000 219.2700 109.6350
Subtotal (Total Children Is Unduplicated) 2 2.000000 219.2700 109.6350
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Total 2952.250000 98658.7100 33.4181
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Number of Children (Unduplicated) With at Least One Service 772
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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 0 0.000000 0.0000 0.0000
P 1 2.000000 119.8400 119.8400
D 127 66.750000 2483.1000 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
6129 2881.000000 95962.7700 219.2700
Other 5 2.500000 93.0000 0.0000
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Total 6262 2952.250000 98658.7100 339.1100