CMS/EIP Fiscal Report Center: 05
Services beginning 10/01/2025 ending 12/31/2025 Date of Report:01/07/2026 Page: 1
List order: No List
Payclass Filters:MED
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 545 1276.500000 58308.4000 45.6783
Subtotal (Total Children Is Unduplicated) 545 1276.500000 58308.4000 45.6783
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Total 1276.500000 58308.4000 45.6783
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Number of Children (Unduplicated) With at Least One Service 545
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Center 05
Flag Claims Units Chgs Paid
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R 1 0.250000 11.4200 0.0000
U 0 0.000000 0.0000 0.0000
B 2450 1226.000000 56001.5600 28053.9300
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
16 8.250000 376.8600 0.0000
Other 57 42.000000 1918.5600 0.0000
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Total 2524 1276.500000 58308.4000 28053.9300