CMS/EIP Fiscal Report Center: 10
Services beginning 10/01/2017 ending 12/31/2017 Date of Report:02/03/2018 Page: 1
List order: No List
Agency Filter:EXT
Payclass Filters:MED
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Screening, Eval, and Assessment,Class #02
SPCH-92524-BEHAV & QUAL ANALYSIS OF
VOICE AND RES 1 1.000000 51.0500 51.0500
Subtotal (Total Children Is Unduplicated) 1 1.000000 51.0500 51.0500
-----------------------------------------------------------------------------------------------------------------------
EI Services,Class #03
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 1100 11148.50000 557275.0000 49.9865
OCCT-97530-OT SESSION BY LICENSED OT 19 143.000000 10215.9200 71.4400
PHY-97110-PT SESSION BY LICENSED PT 52 370.500000 26468.5200 71.4400
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 22 129.500000 9251.4800 71.4400
SPL-92508-GROUP SPL SESSION PER CHILD 1 0.500000 6.9400 13.8800
Subtotal (Total Children Is Unduplicated) 1152 11792.00000 603217.8600 51.1548
-----------------------------------------------------------------------------------------------------------------------
Total 11793.000000 603268.9100 51.1548
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 1152
-----------------------------------------------------------------------------------------------------------------------
Center 10
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 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
3296 11793.000000 603268.9100 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 3296 11793.000000 603268.9100 0.0000