CMS/EIP Fiscal Report Center: 10
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
TCM-T1017TL-TARGETED CASE MANAGEMENT 6044 34374.75000 1271126.0000 36.9785
Subtotal (Total Children Is Unduplicated) 6044 34374.75000 1271126.0000 36.9785
-----------------------------------------------------------------------------------------------------------------------
Screening, Eval, and Assessment,Class #02
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 92 185.500000 14655.1400 79.0035
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 2 4.000000 311.9600 77.9900
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 11 27.000000 2122.0500 78.5944
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 14 32.000000 2555.4800 79.8588
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 72 142.500000 8423.6800 59.1135
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 2 4.000000 230.8400 57.7100
IPDEF-T1024TSTL-F/U PSYCH AND DEV EVAL BY EI PROF 6 11.500000 931.2700 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 1655 3255.500000 258422.9300 79.3804
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 68 130.000000 10213.4500 78.5650
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 285 536.500000 42790.9500 79.7595
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 13 25.500000 2026.1200 79.4557
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 292 548.000000 43466.4600 79.3184
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 8 15.000000 1193.7700 79.5847
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 1369 2676.500000 157602.7300 58.8839
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 27 52.500000 3064.0300 58.3625
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 362 668.000000 53061.8400 79.4339
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 4 9.000000 728.8200 80.9800
Subtotal (Total Children Is Unduplicated) 1983 8323.000000 601801.5200 72.3058
-----------------------------------------------------------------------------------------------------------------------
Total 42697.750000 1872927.5200 43.8648
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 6051
-----------------------------------------------------------------------------------------------------------------------
Center 10
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 778 768.250000 28606.8000 0.0000
U 0 0.000000 0.0000 0.0000
B 25132 23595.500000 1041257.5700 0.0000
P 62 109.000000 7214.8400 0.0000
D 5 3.000000 111.6000 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
19697 17938.000000 785162.6100 0.0000
Other 374 284.000000 10574.1000 0.0000
---------------------------------------------------------
Total 46048 42697.750000 1872927.5200 0.0000