CMS/EIP Fiscal Report Statewide
Services beginning 01/01/2013 ending 03/31/2013 Date of Report:05/17/2013 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 3998 5867.000000 216829.7500 36.9575
IFSP-IFSP-INDIVIDUALIZED FAMILY SUPPORT PLAN 2180 2415.000000 0.0000 0.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 2178 1997.000000 73816.0000 36.9634
TCM-T1017TL-TARGETED CASE MANAGEMENT 7841 24743.00000 914779.7500 36.9713
TCON-TCON-TRANSITION CONFERENCE 362 365.000000 0.0000 0.0000
Subtotal (Total Children Is Unduplicated) 8679 35387.00000 1205425.5000 34.0641
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Screening, Eval, and Assessment,Class #02
AUDE-92555-SPEECH AUD THRESHOLD (DETECTION) 64 64.000000 583.0400 9.1100
AUDE-92567-TYPMANOMETRY (IMPEDANCE TESTING) 27 27.000000 252.1800 9.3400
AUDE-92579-VISUAL REINFORCEMENT AUDIOMETRY 61 61.000000 1325.5300 21.7300
AUDE-92585-AUD EVOKED RESPONSE (DIAG) 1 1.000000 56.9400 56.9400
AUDE-92587-OTOACOUSTIC EMISSIONS (LIMITED) 2 2.000000 48.9400 24.4700
BEHV-BEHV-BEHAVIORAL ASSESSMENT 4 4.000000 425.0000 106.2500
EVAL-EVAL-DEVELOPMENTAL EVALUATION 81 79.000000 3950.0000 50.0000
EXIT-EXIT-EXIT ASSESSMENT 339 418.000000 20900.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 75 125.000000 9375.0000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 23 36.000000 2700.0000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 31 36.000000 2700.0000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 69 106.000000 7950.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 110 166.500000 9240.7500 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 650 990.000000 74250.0000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 251 422.500000 31687.5000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 313 422.500000 31687.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 1242 1919.000000 106504.5000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 521 645.000000 48375.0000 75.0000
MED-99203-OUTPATIENT VISIT, NEW, 30 MINS 148 148.000000 14563.1900 98.3999
MED-99213-OUTPATIENT VISIT, EST, 15 MINS 21 21.000000 820.7800 39.0848
PSTH-97001-EVAL BY LICENSED PT, INITIAL 6 6.000000 291.0000 48.5000
SPCH-92506-SPEECH EVAL BY LICENSED SLP 6 6.000000 291.0000 48.5000
Subtotal (Total Children Is Unduplicated) 2163 5705.500000 367977.8500 64.4953
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 1 1.000000 325.0000 325.0000
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 120 165.750000 8287.5000 50.0000
COIFP-COIFP-IFSP CONSULT, PRO, BY PHONE 3 1.250000 31.2500 25.0000
CONIF-CONIF-CONSULT ITDS, FACE TO FACE 9 11.250000 562.5000 50.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 8 8.750000 437.5000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 1 1.000000 25.0000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 57 62.250000 3112.5000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 87 70.250000 3512.5000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 63 225.500000 11275.0000 50.0000
INTR-INTR-INTERPRETER 119 201.750000 10087.5000 50.0000
OCCT-97530-OT SESSION BY LICENSED OT 11 35.500000 2409.7400 67.8800
PHY-97110-PT SESSION BY LICENSED PT 47 214.250000 14543.2900 67.8800
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 105 616.500000 41848.0200 67.8800
TRAN-TRAN-FAMILY TRANSPORTATION 381 390.000000 3120.0000 8.0000
TRAV-TRAV-PROV TRAVEL TO NATURAL ENV PER MINUTE 436 36795.00000 18368.0000 0.4992
Subtotal (Total Children Is Unduplicated) 1030 38800.00000 117945.3000 3.0398
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Total 79892.500000 1691348.6500 21.1703
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Number of Children (Unduplicated) With at Least One Service 8821
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Center 02
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 2 0.500000 18.5000 0.0000
U 0 0.000000 0.0000 0.0000
B 982 614.500000 22422.0000 0.0000
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 1 1.000000 325.0000 325.0000
2053 1083.250000 40753.0000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 3038 1699.250000 63518.5000 325.0000
Center 03
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 3 2.750000 101.7500 0.0000
U 0 0.000000 0.0000 0.0000
B 411 329.750000 14328.5000 50.0000
P 1608 988.750000 40084.7500 40110.7500
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
8800 16979.750000 165483.7900 0.0000
Other 156 156.000000 2303.6300 0.0000
---------------------------------------------------------
Total 10978 18457.000000 222302.4200 40160.7500
Center 04
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 112 62.500000 2312.5000 0.0000
U 0 0.000000 0.0000 0.0000
B 1778 1865.500000 71706.5000 0.0000
P 1397 1716.000000 67909.4200 69773.5400
D 36 40.250000 1489.2500 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
4739 4160.500000 146512.8000 0.0000
Other 3 2.250000 83.2500 0.0000
---------------------------------------------------------
Total 8065 7847.000000 290013.7200 69773.5400
Center 09
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 5 4.750000 175.7500 0.0000
U 0 0.000000 0.0000 0.0000
B 5087 5015.500000 219463.5800 0.0000
P 10152 31622.000000 257198.7500 257198.7500
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
643 950.000000 53628.3800 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 15887 37592.250000 530466.4600 257198.7500
Center 10
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 323 176.250000 6521.2500 0.0000
U 0 0.000000 0.0000 0.0000
B 2501 1524.250000 56397.2500 0.0000
P 3618 2785.500000 128301.0000 128301.0000
D 16 11.500000 425.5000 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
4215 3212.750000 139752.0000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 10673 7710.250000 331397.0000 128301.0000
Center 55
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 4 2.500000 92.5000 0.0000
P 1879 1701.573333 65558.5000 65700.0900
D 34 35.500000 1909.5000 0.0000
S 2 2.000000 131.0000 0.0000
H 8 11.000000 850.0000 0.0000
T 0 0.000000 0.0000 0.0000
1906 1394.926667 36635.0100 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 3833 3147.500000 105176.5100 65700.0900
Center 57
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 178 153.000000 5661.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 1165 1070.000000 42309.7500 0.0000
P 404 471.000000 25606.7500 25493.3000
D 10 12.750000 669.5000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 4 4.000000 280.5000 280.5000
2190 1707.500000 73886.5400 0.0000
Other 2 21.000000 60.0000 60.0000
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Total 3953 3439.250000 148474.0400 25833.8000