CMS/EIP Fiscal Report Center: 54
Services beginning 10/01/2015 ending 12/31/2015 Date of Report:02/13/2016 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 545 406.000000 14994.2500 36.9317
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 829 2694.500000 194.2500 0.0721
TCM-T1017TL-TARGETED CASE MANAGEMENT 1120 3094.250000 112415.2500 36.3304
Subtotal (Total Children Is Unduplicated) 1221 6194.750000 127603.7500 20.5987
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Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 13 15.000000 727.5000 48.5000
EVAL-96111-DEVELOPMENTAL EVALUATION 1 1.000000 50.0000 50.0000
EXIT-EXIT-EXIT ASSESSMENT 25 50.250000 2462.5000 49.0050
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 7 11.000000 825.0000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 3 2.500000 187.5000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 1 2.000000 150.0000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 1 2.000000 150.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 4 6.000000 333.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 93 155.500000 11662.5000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 30 42.000000 3150.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 15 20.000000 1500.0000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 110 175.500000 9666.2500 55.0783
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 33 52.000000 3862.5000 74.2788
SCREEN-T1023-SCREENING 2 2.000000 100.0000 50.0000
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.0500 51.0500
Subtotal (Total Children Is Unduplicated) 245 537.750000 34877.8000 64.8588
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 103 45.000000 2237.5000 49.7222
CONIF-CONIF-CONSULT, FACE TO FACE 382 386.750000 19250.0000 49.7738
CONIP-CONIP-CONSULT, PHONE 5 26.000000 650.0000 25.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 1 1.000000 25.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 355 1713.000000 85537.5000 49.9343
INTR-T1013-INTERPRETER 1 1.000000 50.0000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 619 2478.000000 24750.0000 9.9879
Subtotal (Total Children Is Unduplicated) 653 4650.750000 132500.0000 28.4900
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Total 11383.250000 294981.5500 25.9136
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Number of Children (Unduplicated) With at Least One Service 1226
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Center 54
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 4400 3788.750000 165578.7500 0.0000
P 1 2.000000 74.0000 0.0000
D 2 3.000000 111.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 2827 2150.000000 31463.5000 31453.5000
T 2411 1771.500000 25615.3000 25528.3000
4458 3667.250000 72111.2500 0.0000
Other 1 0.750000 27.7500 0.0000
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Total 14100 11383.250000 294981.5500 56981.8000