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
Payclass Filters:GR
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 541 400.500000 14790.7500 36.9307
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 828 2692.000000 194.2500 0.0722
TCM-T1017TL-TARGETED CASE MANAGEMENT 263 612.250000 22283.2500 36.3957
Subtotal (Total Children Is Unduplicated) 1025 3704.750000 37268.2500 10.0596
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Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 13 15.000000 727.5000 48.5000
EXIT-EXIT-EXIT ASSESSMENT 24 48.250000 2362.5000 48.9637
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 3 4.500000 337.5000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 1 1.000000 75.0000 75.0000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 5 9.000000 675.0000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 1 1.500000 112.5000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 2 2.500000 187.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 16 27.000000 1461.5000 54.1296
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 8 12.500000 937.5000 75.0000
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.0500 51.0500
Subtotal (Total Children Is Unduplicated) 62 122.250000 6927.5500 56.6671
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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 382 385.250000 19175.0000 49.7729
CONIP-CONIP-CONSULT, PHONE 5 26.000000 650.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 41 181.000000 9037.5000 49.9309
INTR-T1013-INTERPRETER 1 1.000000 50.0000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 619 2473.000000 24700.0000 9.9879
Subtotal (Total Children Is Unduplicated) 639 3111.250000 55850.0000 17.9510
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Total 6938.250000 100045.8000 14.4195
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Number of Children (Unduplicated) With at Least One Service 1041
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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 0 0.000000 0.0000 0.0000
P 0 0.000000 0.0000 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 2409 1769.500000 25528.3000 25528.3000
3724 3015.750000 42943.0000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 8962 6938.250000 100045.8000 56981.8000