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
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 3905 9819.000000 364785.2000 37.1510
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 361 484.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 3664 13822.00000 513920.2500 37.1813
Subtotal (Total Children Is Unduplicated) 4124 24125.00000 878705.4500 36.4230
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 2 4.000000 323.9200 80.9800
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 6 12.000000 935.8800 77.9900
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 8 16.000000 1271.7600 79.4850
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 7 14.000000 1109.8043 79.2717
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 11 22.000000 1745.6800 79.3491
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 4 8.000000 635.8800 79.4850
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 16 32.000000 1882.0800 58.8150
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 12 24.000000 1402.7200 58.4467
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 2 4.000000 323.9200 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 154 308.000000 24463.4527 79.4268
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 110 220.000000 17432.8800 79.2404
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 201 402.000000 32027.7346 79.6710
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 96 192.000000 15225.2400 79.2981
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 195 390.000000 30840.6995 79.0787
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 70 140.000000 11157.8093 79.6986
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 316 632.000000 37241.8000 58.9269
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 247 494.000000 29008.2000 58.7211
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 124 250.000000 19922.0882 79.6884
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 66 132.000000 10351.1230 78.4176
OCTH-97166-OT EVAL MODERATE COMPLEXITY 1 1.000000 58.1100 58.1100
OCTH-97167-OT EVAL HIGH COMPLEXITY 1 1.000000 58.1100 58.1100
SCREEN-T1023-SCREENING 8 8.000000 423.8800 52.9850
Subtotal (Total Children Is Unduplicated) 969 3306.000000 237842.7716 71.9428
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EI Services,Class #03
CONOF-CONOF-CONSULT, OT, FACE TO FACE 1 1.000000 50.0000 50.0000
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 300 530.250000 150.0000 0.2829
OCCT-97530-OT SESSION BY LICENSED OT 4 8.000000 603.7600 75.4700
OCCT-97530GO-OT SESSION BY LICENSED OT 1 1.000000 71.9600 71.9600
OCCT-97530GOGT-OT SESSION BY LICENSED OT 1 1.000000 71.9600 71.9600
PHY-97110-PT SESSION BY LICENSED PT 2 12.000000 975.8400 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 1 1.000000 81.3200 81.3200
Subtotal (Total Children Is Unduplicated) 300 554.250000 2004.8400 3.6172
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Total 27985.250000 1118553.0616 39.9694
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Number of Children (Unduplicated) With at Least One Service 4149
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Center 07
Flag Claims Units Chgs Paid
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R 2 2.250000 171.2600 0.0000
U 0 0.000000 0.0000 0.0000
B 529 447.000000 20905.5200 0.0000
P 10687 8908.230300 393190.0943 389009.2500
D 404 404.500000 24287.7400 0.0000
S 0 0.000000 0.0000 0.0000
H 66 129.000000 10280.0000 323.9200
T 0 0.000000 0.0000 0.0000
31578 17856.769700 660883.4473 0.0000
Other 617 237.500000 8835.0000 0.0000
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Total 43883 27985.250000 1118553.0616 389333.1700