CMS/EIP Fiscal Report Center: 05
Services beginning 04/01/2025 ending 06/30/2025 Date of Report:07/19/2025 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 592 273.250000 10164.9000 37.2000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 196 172.750000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1018 2668.250000 99258.9000 37.2000
Subtotal (Total Children Is Unduplicated) 1048 3114.250000 109423.8000 35.1365
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 1 1.000000 98.9100 98.9100
Subtotal (Total Children Is Unduplicated) 1 1.000000 98.9100 98.9100
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Total 3115.250000 109522.7100 35.1570
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Number of Children (Unduplicated) With at Least One Service 1048
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Center 05
Flag Claims Units Chgs Paid
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R 21 14.000000 520.8000 0.0000
U 0 0.000000 0.0000 0.0000
B 2495 1367.250000 50861.7000 39440.0400
P 0 0.000000 0.0000 0.0000
D 35 12.250000 455.7000 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
3577 1654.500000 55182.8100 98.9100
Other 113 67.250000 2501.7000 0.0000
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Total 6241 3115.250000 109522.7100 39538.9500