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
Payclass Filters:GR
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 67 131.000000 4873.2000 37.2000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 20 21.750000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 33 119.250000 4436.1000 37.2000
Subtotal (Total Children Is Unduplicated) 69 272.000000 9309.3000 34.2254
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 2 4.000000 230.8400 57.7100
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 4 8.000000 378.3800 47.2975
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 2 3.152800 198.4200 62.9345
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 2 2.518100 64.0500 25.4358
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 2 4.000000 311.9600 77.9900
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 2 4.000000 311.9600 77.9900
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 21 42.000000 2428.2400 57.8152
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 6 12.000000 692.5200 57.7100
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 4 8.000000 523.9200 65.4900
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 2 4.000000 311.9600 77.9900
SCREEN-T1023-SCREENING 1 1.000000 53.9800 53.9800
Subtotal (Total Children Is Unduplicated) 34 92.670900 5506.2300 59.4170
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 11 12.750000 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 6 7.000000 105.0000 15.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 29 36.000000 432.0000 12.0000
TRAV-TRAVS-Travel by mile 3 30.000000 13.3500 0.4450
Subtotal (Total Children Is Unduplicated) 40 87.750000 650.3500 7.4114
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Total 452.420900 15465.8800 34.1847
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Number of Children (Unduplicated) With at Least One Service 73
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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 0 0.000000 0.0000 0.0000
P 66 111.000000 2549.7400 2549.7400
D 3 1.750000 65.1000 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
498 339.670900 12851.0400 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 567 452.420900 15465.8800 2549.7400