CMS/EIP Fiscal Report Center: 53
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 705 931.250000 34447.0000 36.9901
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 579 656.250000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 949 2647.750000 97929.7500 36.9860
Subtotal (Total Children Is Unduplicated) 1038 4235.250000 132376.7500 31.2559
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 4 4.250000 212.5000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 16 39.500000 2962.5000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 13 29.000000 2175.0000 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 7 13.500000 1012.5000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 6 12.000000 666.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 22 41.500000 3112.5000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 14 24.000000 1800.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 9 15.500000 1162.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 64 112.500000 6243.7500 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 95 184.500000 13837.5000 75.0000
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.0500 51.0500
Subtotal (Total Children Is Unduplicated) 188 479.250000 33385.8000 69.6626
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 28 24.750000 1237.5000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 2 1.000000 25.0000 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 285 563.500000 28131.2500 49.9224
CONIP-CONIP-CONSULT, ITDS PHONE 43 22.250000 556.2500 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 2 0.500000 25.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 2 0.500000 12.5000 25.0000
CONSP-CONSP-CONSULT, SLP, PHONE 1 0.750000 18.7500 25.0000
COUN-H2019HR-INDIVIDUAL/FAMILY THERAPY 1 2.000000 146.6400 73.3200
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 508 1655.500000 0.0000 0.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 5 6.000000 150.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 319 1635.250000 81775.0000 50.0076
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 559 3030.000000 30290.0000 9.9967
Subtotal (Total Children Is Unduplicated) 569 6942.000000 142367.8900 20.5082
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Total 11656.500000 308130.4400 26.4342
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Number of Children (Unduplicated) With at Least One Service 1085
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Center 53
Flag Claims Units Chgs Paid
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R 2 2.000000 74.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 304 201.250000 7446.2500 0.0000
P 3138 2994.228600 135510.1800 133235.7800
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
10908 8388.271400 161300.7600 0.0000
Other 65 70.750000 3799.2500 0.0000
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Total 14417 11656.500000 308130.4400 133235.7800