Summary Report for FSPSAs Ending During the Report PeriodCenter: 53

This report shows the total number of units/fees for FSPSAs ending during the report period.
(i.e., end date of service authorization occurs during the report period). This report does not
represent all FSPSAs that overlap the report period. Note that service authorization periods may
range from 1 to 12 months and may vary in intensity from child to child.

FSPSAs ending between: 10-01-14 and 12-31-14                  Date of Report: 01-12-15

Child has a MEDICAID # Filter: Y
Eligibility Filter: Program Patients


Services                                       Number of   Number of       Total Units  Total Cost of        Avg Fee
                                               Children    Records         Authorized   Auth Services     Per Unit Auth



NO DATA FOUND FOR LISTED FILTERS!