CMS/EIP Fiscal Report Center: 09
Services beginning 01/01/2018 ending 03/31/2018 Date of Report:05/05/2018 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 1597 4054.000000 149998.0000 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 689 624.500000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1699 6246.250000 231092.7500 36.9970
Subtotal (Total Children Is Unduplicated) 1859 10924.75000 381090.7500 34.8832
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 130 263.000000 13150.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 6 10.500000 787.5000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 3 5.000000 375.0000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 2 3.000000 225.0000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 4 7.000000 525.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 6 11.500000 638.2500 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 150 224.000000 15964.8500 71.2717
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 59 95.500000 7080.0200 74.1363
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 56 83.500000 5951.2900 71.2729
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 195 334.500000 17760.9800 53.0971
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 74 119.000000 8463.8300 71.1246
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.0500 51.0500
SPCH-92610-EVAL OF ORAL,PHARYNGEAL SWALLOWING FUNC 1 1.000000 44.5500 44.5500
Subtotal (Total Children Is Unduplicated) 515 1158.500000 71017.3200 61.3011
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 29 34.250000 1712.5000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 1 0.500000 12.5000 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 8 10.000000 500.0000 50.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 1 1.000000 50.0000 50.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 2 2.000000 100.0000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 5 8.000000 400.0000 50.0000
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 238 324.500000 0.0000 0.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 65 344.500000 17225.0000 50.0000
INTR-T1013-INTERPRETER 112 231.750000 11587.5000 50.0000
OCCT-97530-OT SESSION BY LICENSED OT 7 15.000000 991.6000 66.1067
PHY-97110-PT SESSION BY LICENSED PT 3 9.000000 642.9600 71.4400
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 21 149.000000 10083.1600 67.6722
Subtotal (Total Children Is Unduplicated) 350 1129.500000 43305.2200 38.3402
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Total 13212.750000 495413.2900 37.4951
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Number of Children (Unduplicated) With at Least One Service 1892
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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 27 27.750000 1000.9500 50.0000
P 13877 12541.750000 465366.7500 466347.8500
D 12 17.000000 1214.6400 0.0000
S 0 0.000000 0.0000 0.0000
H 47 88.500000 6044.1300 0.0000
T 0 0.000000 0.0000 0.0000
539 537.750000 21786.8200 74.4000
Other 0 0.000000 0.0000 0.0000
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Total 14502 13212.750000 495413.2900 466472.2500