CMS/EIP Fiscal Report Center: 54
Services beginning 10/01/2025 ending 12/31/2025 Date of Report:01/07/2026 Page: 1
List order: No List
Eligibility Filter:Not Part C
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Service Coordination,Class #01
CASE-CASE-NON-TCM CASE MANAGEMENT 35 16.000000 669.4000 41.8375
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 18 16.500000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 115 712.500000 31967.7000 44.8669
Subtotal (Total Children Is Unduplicated) 115 745.000000 32637.1000 43.8082
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Screening, Eval, and Assessment,Class #02
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 1 2.000000 161.9600 80.9800
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 2 4.000000 323.9200 80.9800
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY EI PROF 1 2.000000 119.8400 59.9200
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 3 5.500000 329.5600 59.9200
IPDEF-T1024TSTLGT-F/U PHYC AND DEV EVAL BY EI PROF 2 3.500000 283.4300 80.9800
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 1 2.000000 161.9600 80.9800
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 3 6.000000 485.8800 80.9800
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 25 44.500000 3603.6100 80.9800
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 8 15.500000 1255.1900 80.9800
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 9 18.000000 1457.6400 80.9800
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 10 20.000000 1619.6000 80.9800
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 23 40.000000 2396.8000 59.9200
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 30 61.500000 3685.0800 59.9200
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 10 20.000000 1511.6400 75.5820
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 20 37.500000 3036.7500 80.9800
Subtotal (Total Children Is Unduplicated) 91 282.000000 20432.8600 72.4570
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EI Services,Class #03
DSTT-DSTT-DIRECT SERVICE PERSONNEL TRAVEL 28 26.750000 0.0000 0.0000
EPIC-99601-Early Steps Professional Development Fee 32 39.000000 624.0000 16.0000
INTR-T1013-INTERPRETER 1 1.000000 36.6000 36.6000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 9 12.000000 144.0000 12.0000
TRAV-TRAVS-Travel by mile 24 357.000000 158.7900 0.4448
Subtotal (Total Children Is Unduplicated) 46 435.750000 963.3900 2.2109
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Total 1462.750000 54033.3500 36.9396
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Number of Children (Unduplicated) With at Least One Service 115
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Center 54
Flag Claims Units Chgs Paid
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R 5 8.250000 251.2400 0.0000
U 0 0.000000 0.0000 0.0000
B 213 274.750000 13905.3600 0.0000
P 128 158.750000 8245.6400 8082.8000
D 14 12.250000 559.5800 325.5000
S 32 29.750000 1296.3400 0.0000
H 0 0.000000 0.0000 0.0000
T 36 174.000000 1576.4700 1576.4700
441 791.500000 27511.4400 0.0000
Other 9 13.500000 687.2800 561.8600
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Total 878 1462.750000 54033.3500 10546.6300