CMS/EIP Fiscal Report Center: 51
Services beginning 04/01/2025 ending 06/30/2025 Date of Report:07/19/2025 Page: 1
List order: No List
Eligibility Filter:Not Part C
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 2 2.000000 161.9600 80.9800
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 1 1.000000 80.9800 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 2 3.500000 209.7200 59.9200
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 7 10.500000 809.8000 77.1238
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 2 2.000000 161.9600 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 1 2.000000 140.9000 70.4500
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 1 3.000000 89.8800 29.9600
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 11 13.500000 1065.2400 78.9067
SPCH-92521-EVAL OF SPEECH FLUENCY 1 1.000000 80.9800 80.9800
Subtotal (Total Children Is Unduplicated) 20 38.500000 2801.4200 72.7642
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EI Services,Class #03
EPIC-99601-Early Steps Professional Development Fee 1 1.000000 15.0000 15.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 9 19.000000 228.0000 12.0000
OCCT-97530HM-OT SESSION BY OT ASST 1 7.000000 455.8400 65.1200
Subtotal (Total Children Is Unduplicated) 10 27.000000 698.8400 25.8830
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Total 65.500000 3500.2600 53.4391
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Number of Children (Unduplicated) With at Least One Service 22
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Center 51
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 44 53.500000 2528.5000 2528.5000
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
10 12.000000 971.7600 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 54 65.500000 3500.2600 2528.5000