CMS/EIP Fiscal Report Center: 07
Services beginning 04/01/2025 ending 06/30/2025 Date of Report:07/19/2025 Page: 1
List order: No List
Payclass Filters:OTHER
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Service Coordination,Class #01
TCM-T1017TL-TARGETED CASE MANAGEMENT 6 3.000000 111.6000 37.2000
Subtotal (Total Children Is Unduplicated) 6 3.000000 111.6000 37.2000
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EI Services,Class #03
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 6 32.000000 491.0000 15.3438
Subtotal (Total Children Is Unduplicated) 6 32.000000 491.0000 15.3438
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Total 35.000000 602.6000 17.2171
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Number of Children (Unduplicated) With at Least One Service 12
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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 32 32.000000 491.0000 491.0000
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
0 0.000000 0.0000 0.0000
Other 9 3.000000 111.6000 0.0000
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Total 41 35.000000 602.6000 491.0000