CMS/EIP Fiscal Report Center: 53
Services beginning 07/01/2012 ending 09/30/2012 Date of Report:11/15/2012 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 484 432.750000 15873.0000 36.6794
IFSP-IFSP-INDIVIDUALIZED FAMILY SUPPORT PLAN 246 274.000000 0.0000 0.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 358 495.750000 18305.7500 36.9254
TCM-T1017TL-TARGETED CASE MANAGEMENT 668 2615.750000 96111.5000 36.7434
TCON-TCON-TRANSITION CONFERENCE 45 45.000000 0.0000 0.0000
Subtotal (Total Children Is Unduplicated) 702 3863.250000 130290.2500 33.7256
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Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 1 1.000000 48.5000 48.5000
EXIT-EXIT-TRANSITION ASSESSMENT 63 119.500000 5975.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 26 52.000000 3900.0000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 3 3.000000 225.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 35 68.000000 3774.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 7 13.500000 1012.5000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 4 7.500000 562.5000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 6 11.500000 862.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 70 137.500000 7631.2500 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 21 44.000000 3300.0000 75.0000
Subtotal (Total Children Is Unduplicated) 169 457.500000 27291.2500 59.6530
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 70 89.750000 4487.5000 50.0000
COIFP-COIFP-IFSP CONSULT, PRO, BY PHONE 16 12.500000 312.5000 25.0000
CONIF-CONIF-CONSULT ITDS, FACE TO FACE 93 52.500000 2625.0000 50.0000
CONIP-CONIP-CONSULT, ITDS, PHONE 1 0.500000 12.5000 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 8 80.000000 4000.0000 50.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 38 62.000000 3100.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 7 3.250000 81.2500 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 39 72.250000 3612.5000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 11 8.250000 206.2500 25.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 10 13.000000 325.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 177 1050.000000 52475.0000 49.9762
HERN-T1027SC-EI HEARING SERVICES AFTER SHINE 6 11.750000 587.5000 50.0000
SHIN-T1027SC-INITIAL SHINE SERVICES, INDIVIDUAL 12 40.000000 2000.0000 50.0000
TRAV-TRAV-PROVIDER TRAVEL TO NATURAL ENVIRONMENT 348 61439.00000 30640.5000 0.4987
Subtotal (Total Children Is Unduplicated) 368 62934.75000 104465.5000 1.6599
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Total 67255.500000 262047.0000 3.8963
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Number of Children (Unduplicated) With at Least One Service 713
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Center 53
Flag Claims Units Chgs Paid
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R 1 1.500000 55.5000 0.0000
U 0 0.000000 0.0000 0.0000
B 280 242.500000 10327.7500 9.2500
P 2671 2452.660000 101939.7500 101871.2500
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 1605 20533.750000 37151.0000 37057.5000
3651 43985.590000 110589.7500 110.5000
Other 39 39.500000 1983.2500 0.0000
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Total 8247 67255.500000 262047.0000 139048.5000