CMS/EIP Fiscal Report Center: 09
Services beginning 10/01/2013 ending 12/31/2013 Date of Report:02/18/2014 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 1221 2474.250000 91519.5000 36.9888
IFSP-IFSP-INDIVIDUALIZED FAMILY SUPPORT PLAN 887 973.000000 0.0000 0.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 903 958.500000 35464.5000 37.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1625 7959.500000 294410.0000 36.9885
TCON-TCON-TRANSITION CONFERENCE 212 213.000000 0.0000 0.0000
Subtotal (Total Children Is Unduplicated) 1701 12578.25000 421394.0000 33.5018
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 94 152.750000 7637.5000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 36 68.000000 5100.0000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 7 7.500000 562.5000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 1 1.500000 112.5000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 33 63.000000 4725.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 12 22.000000 1221.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 127 201.500000 15112.5000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 106 151.000000 11325.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 73 121.000000 9075.0000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 179 326.500000 18120.7500 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 139 231.000000 17325.0000 75.0000
Subtotal (Total Children Is Unduplicated) 453 1345.750000 90316.7500 67.1126
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 41 55.250000 2762.5000 50.0000
COIFP-COIFP-IFSP CONSULT, PRO, BY PHONE 9 2.250000 56.2500 25.0000
CONIF-CONIF-CONSULT ITDS, FACE TO FACE 4 1.750000 87.5000 50.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 1 1.000000 50.0000 50.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 11 5.250000 262.5000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 45 49.500000 2475.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 30 150.000000 7500.0000 50.0000
INTR-INTR-INTERPRETER 161 376.750000 18687.5000 49.6019
OCCT-97530-OT SESSION BY LICENSED OT 8 36.000000 2443.6800 67.8800
PHY-97110-PT SESSION BY LICENSED PT 29 156.000000 10589.2800 67.8800
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 97 563.000000 38216.4400 67.8800
SPL-92508-GROUP SPL SESSION PER CHILD 2 2.000000 26.4000 13.2000
TRAV-TRAV-PROV TRAVEL TO NATURAL ENV PER MINUTE 273 25584.00000 12792.0000 0.5000
Subtotal (Total Children Is Unduplicated) 452 26982.75000 95949.0500 3.5559
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Total 40906.750000 607659.8000 14.8548
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Number of Children (Unduplicated) With at Least One Service 1724
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Center 09
Flag Claims Units Chgs Paid
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R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 6449 5930.500000 252256.4000 55.5000
P 12383 33999.500000 310870.0700 310923.3200
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
521 976.750000 44533.3300 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 19353 40906.750000 607659.8000 310978.8200