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
Payclass Filters:TPIN
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Screening, Eval, and Assessment,Class #02
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 23 50.500000 3996.8000 79.1446
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 3 10.000000 769.3100 76.9310
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 5 14.500000 1174.2100 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 16 35.500000 2065.2800 58.1769
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 86 178.000000 13592.1900 76.3606
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 1 3.000000 225.0000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 8 14.000000 1070.9300 76.4950
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 1 1.500000 112.5000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 14 27.500000 2101.3700 76.4135
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 65 136.500000 7723.8200 56.5848
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 15 34.500000 2614.4100 75.7800
Subtotal (Total Children Is Unduplicated) 114 509.500000 35769.7400 70.2056
-----------------------------------------------------------------------------------------------------------------------
Total 509.500000 35769.7400 70.2056
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 114
-----------------------------------------------------------------------------------------------------------------------
Center 10
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 0 0.000000 0.0000 0.0000
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
246 509.500000 35769.7400 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 246 509.500000 35769.7400 0.0000