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
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 1710 2352.750000 87513.0000 37.1960
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 92 106.500000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1585 3526.000000 131092.8000 37.1789
Subtotal (Total Children Is Unduplicated) 1936 5985.250000 218605.8000 36.5241
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 2 4.000000 323.9200 80.9800
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 1 2.000000 161.9600 80.9800
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 1 2.000000 161.9600 80.9800
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 1 2.000000 161.9600 80.9800
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 479.3600 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 4 8.000000 479.3600 59.9200
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 50 100.000000 8098.0000 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 23 46.000000 3725.0800 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 49 98.000000 7936.0400 80.9800
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 16 32.000000 2591.3600 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 51 102.000000 8259.9600 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 12 24.000000 1943.5200 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 113 226.000000 13541.9200 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 38 76.000000 4553.9200 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 43 88.000000 7126.2400 80.9800
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 12 24.000000 1943.5200 80.9800
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 2 2.000000 107.9600 53.9800
Subtotal (Total Children Is Unduplicated) 255 852.000000 62198.1400 73.0025
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 76 135.000000 0.0000 0.0000
OCCT-97530-OT SESSION BY LICENSED OT 2 3.000000 243.9600 81.3200
PHY-97110-PT SESSION BY LICENSED PT 1 6.000000 487.9200 81.3200
Subtotal (Total Children Is Unduplicated) 76 144.000000 731.8800 5.0825
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Total 6981.250000 281535.8200 40.3274
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Number of Children (Unduplicated) With at Least One Service 1953
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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 403 352.000000 17195.5600 0.0000
P 2476 2070.750000 90025.4000 89160.1100
D 51 29.000000 1429.0400 0.0000
S 0 0.000000 0.0000 0.0000
H 46 92.000000 7450.1600 323.9200
T 0 0.000000 0.0000 0.0000
7550 4358.000000 162478.2600 0.0000
Other 202 79.500000 2957.4000 0.0000
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Total 10728 6981.250000 281535.8200 89484.0300