CMS/EIP Fiscal Report Center: 07
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 286 592.750000 22078.2000 37.2471
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 68 75.500000 74.4000 0.9854
TCM-T1017TL-TARGETED CASE MANAGEMENT 294 1142.500000 42501.0000 37.2000
Subtotal (Total Children Is Unduplicated) 295 1810.750000 64653.6000 35.7054
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 3 6.000000 473.9200 78.9867
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 1 2.000000 150.0000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 3 6.000000 473.9200 78.9867
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 1 2.000000 161.9600 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 4 8.000000 378.4300 47.3038
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 1 2.000000 119.8400 59.9200
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 46 92.000000 6767.1900 73.5564
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 36 72.000000 5684.8800 78.9567
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 33 66.000000 5180.8943 78.4984
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 26 52.000000 4103.3200 78.9100
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 36 72.000000 5758.8000 79.9833
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 18 36.000000 2855.4800 79.3189
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 110 220.000000 12996.7600 59.0762
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 60 120.000000 7075.4800 58.9623
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 38 78.000000 5983.1200 76.7067
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 22 44.000000 3417.4400 77.6691
SCREEN-T1023-SCREENING 2 2.000000 107.9600 53.9800
Subtotal (Total Children Is Unduplicated) 240 880.000000 61689.3943 70.1016
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 51 78.750000 0.0000 0.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 1 2.000000 100.0000 50.0000
EPIC-99601-Early Steps Professional Development Fee 18 20.000000 300.0000 15.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 84 104.000000 1248.0000 12.0000
TRAV-TRAVS-Travel by mile 12 124.000000 55.1600 0.4448
Subtotal (Total Children Is Unduplicated) 132 328.750000 1703.1600 5.1807
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Total 3019.500000 128046.1543 42.4064
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Number of Children (Unduplicated) With at Least One Service 299
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Center 07
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 46 54.500000 2955.0800 0.0000
P 1144 1395.829100 62594.7943 62023.0200
D 28 41.750000 3069.3800 0.0000
S 0 0.000000 0.0000 0.0000
H 9 18.000000 1433.7200 0.0000
T 0 0.000000 0.0000 0.0000
2135 1500.170900 57649.0800 0.0000
Other 17 9.250000 344.1000 0.0000
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Total 3379 3019.500000 128046.1543 62023.0200