CMS/EIP Fiscal Report Center: 06
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
Service Coordination,Class #01
CASE-CASE-NON-TCM CASE MANAGEMENT 218 112.250000 4166.4000 37.1171
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 6 3.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 386 1831.750000 68159.7000 37.2102
Subtotal (Total Children Is Unduplicated) 387 1947.000000 72326.1000 37.1475
-----------------------------------------------------------------------------------------------------------------------
Screening, Eval, and Assessment,Class #02
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 6 7.000000 566.8600 80.9800
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 4 5.500000 445.3900 80.9800
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 4 4.500000 358.4300 79.6511
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 2 3.000000 242.9400 80.9800
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 4 4.000000 323.9200 80.9800
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 1 1.500000 121.4700 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 6 6.500000 385.0600 59.2400
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 107 124.000000 9755.8500 78.6762
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 113 150.500000 11900.4500 79.0728
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 110 137.000000 10762.3700 78.5574
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 83 114.500000 8952.2800 78.1859
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 47 57.000000 4458.7600 78.2239
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 47 67.000000 5282.1400 78.8379
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 91 112.000000 6593.3900 58.8696
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 89 121.000000 7062.4700 58.3675
Subtotal (Total Children Is Unduplicated) 361 915.000000 67211.7800 73.4555
-----------------------------------------------------------------------------------------------------------------------
EI Services,Class #03
INTR-T1013-INTERPRETER 21 46.000000 3760.0000 81.7391
Subtotal (Total Children Is Unduplicated) 21 46.000000 3760.0000 81.7391
-----------------------------------------------------------------------------------------------------------------------
Total 2908.000000 143297.8800 49.2771
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 388
-----------------------------------------------------------------------------------------------------------------------
Center 06
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 20 40.000000 3340.0000 3340.0000
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 0 0.000000 0.0000 0.0000
3116 2847.000000 139001.5600 0.0000
Other 22 21.000000 956.3200 0.0000
---------------------------------------------------------
Total 3158 2908.000000 143297.8800 3340.0000