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
    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                      581             259.500000        11726.7600           45.1898
  SCTT-SCTT-SERVICE COORDINATOR TRAVEL                   169             150.000000            0.0000            0.0000
  TCM-T1017TL-TARGETED CASE MANAGEMENT                   998            2393.000000       109310.1200           45.6791
Subtotal (Total Children Is Unduplicated)               1049            2802.500000       121036.8800           43.1889
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EI Services,Class #03
  CONIF-CONIF-CONSULT, ITDS FACE TO FACE                   1               0.250000           -0.1000            0.0000
  EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF               1               3.000000           81.0000           27.0000
  EPIC-99601-Early Steps Professional Development Fee      1               1.000000           15.0000           15.0000
Subtotal (Total Children Is Unduplicated)                  2               4.250000           95.9000           22.5647
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Total                                                                   2806.750000       121132.7800           43.1577
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Number of Children (Unduplicated) With at Least One Service       1051
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Center 05
Flag      Claims          Units         Chgs         Paid
---------------------------------------------------------
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              4       4.000000      96.0000      96.0000 
D             13       4.250000     194.1400       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 
            3276    1525.000000   62682.8000       0.0000 
Other         70      47.250000    2146.8600      -0.1000 
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Total       5814    2806.750000  121132.7800   28149.8300