CMS/EIP Fiscal Report Statewide
Services beginning 10/01/2019 ending 12/31/2019 Date of Report:02/01/2020 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 12268 13619.25000 503718.5000 36.9858
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 6887 6433.500000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 22690 68476.25000 2532120.0000 36.9781
Subtotal (Total Children Is Unduplicated) 24226 88529.00000 3035838.5000 34.2920
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Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 9 12.000000 582.0000 48.5000
EVAL-96111-DEVELOPMENTAL EVALUATION 73 78.750000 3937.5000 50.0000
EXIT-EXIT-EXIT ASSESSMENT 629 880.000000 44000.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 124 188.500000 14047.5000 74.5225
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 62 86.000000 6342.5000 73.7500
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 72 99.000000 7425.0000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 103 175.000000 13125.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 150 215.000000 11932.5000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 1791 2998.859733 223124.4800 74.4031
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 825 1277.663200 94804.1500 74.2012
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 521 797.500000 59812.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 2384 3783.500000 209868.7500 55.4695
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 1025 1686.973600 127442.0100 75.5448
OCTH-97165-OT EVAL LOW COMPLEXITY 2 2.000000 102.1000 51.0500
OCTH-97166-OT EVAL MODERATE COMPLEXITY 5 5.000000 255.2500 51.0500
OCTH-97167-OT EVAL HIGH COMPLEXITY 6 6.000000 306.3000 51.0500
PSTH-97161-PT EVAL LOW COMPLEXITY 1 1.000000 51.0500 51.0500
PSTH-97162-PT EVAL MODERATE COMPLEXITY 1 1.000000 51.0500 51.0500
PSTH-97163-PT EVAL HIGH COMPLEXITY 3 3.000000 153.1500 51.0500
SCREEN-T1023-SCREENING 123 137.000000 6850.0000 50.0000
SPCH-92521-EVAL OF SPEECH FLUENCY 2 2.000000 102.1000 51.0500
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 31 31.000000 1582.5500 51.0500
Subtotal (Total Children Is Unduplicated) 4950 12466.74653 825897.4400 66.2480
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 275 322.000000 16100.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 27 17.500000 437.5000 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 764 694.750000 34650.0000 49.8741
CONIP-CONIP-CONSULT, ITDS PHONE 43 26.000000 650.0000 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 497 307.500000 15375.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 55 25.000000 625.0000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 400 268.500000 13425.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 15 7.250000 181.2500 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 422 401.500000 20075.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 35 21.250000 531.2500 25.0000
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 2024 4752.250000 0.0000 0.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 23 49.000000 1225.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 907 4135.250000 206732.5000 49.9927
INTR-T1013-INTERPRETER 340 532.250000 26563.7500 49.9084
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 1667 7893.000000 78900.0000 9.9962
OCCT-97530-OT SESSION BY LICENSED OT 196 1040.000000 74201.3000 71.3474
OCCT-97530HM-OT SESSION BY OT ASST 10 117.250000 6706.7000 57.2000
PHY-97110-PT SESSION BY LICENSED PT 213 1146.750000 81852.4200 71.3777
PHY-97110HM-PT SESSION BY PT ASST 7 22.000000 1257.5200 57.1600
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 364 1940.550000 134608.2400 69.3660
SPL-92508-GROUP SPL SESSION PER CHILD 13 35.000000 485.8000 13.8800
TRAV-TRAVS-Travel by mile 588 36094.00000 16058.6200 0.4449
Subtotal (Total Children Is Unduplicated) 3495 59848.55000 730641.8500 12.2082
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Total 160844.296533 4592377.7900 28.5517
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Number of Children (Unduplicated) With at Least One Service 24659
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Center 01
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 201 200.750000 14300.8000 0.0000
P 0 0.000000 0.0000 0.0000
D 0 0.000000 0.0000 0.0000
S 2443 1794.250000 77780.2300 0.0000
H 6872 5072.000000 221389.2300 198557.6000
T 0 0.000000 0.0000 0.0000
6645 4512.750000 162878.2600 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 16161 11579.750000 476348.5200 198557.6000
Center 02
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
0 0.000000 0.0000 0.0000
Other 5311 16684.250000 113908.3200 0.0000
---------------------------------------------------------
Total 5311 16684.250000 113908.3200 0.0000
Center 03
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 41 31.500000 1202.5000 0.0000
U 0 0.000000 0.0000 0.0000
B 2945 2153.250000 90460.8400 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
5249 4048.500000 125026.6400 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 8235 6233.250000 216689.9800 0.0000
Center 04
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 498 753.000000 27861.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 1004 1503.750000 59258.5000 46.2500
P 2713 4145.750000 164534.9400 162310.1300
D 1 1.500000 55.5000 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
3897 3462.250000 144090.2500 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 8113 9866.250000 395800.1900 162356.3800
Center 05
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 2473 1642.000000 64700.9200 39715.5000
P 93 407.000000 6689.1100 6689.1100
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
2867 1706.250000 49739.8200 214.3200
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 5433 3755.250000 121129.8500 46618.9300
Center 06
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
10762 6967.500000 279860.2500 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 10762 6967.500000 279860.2500 0.0000
Center 07
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 112 128.500000 4767.5000 0.0000
U 0 0.000000 0.0000 0.0000
B 596 508.000000 20658.2500 0.0000
P 2900 2605.000000 112601.5000 112578.9500
D 31 28.500000 1091.5000 0.0000
S 0 0.000000 0.0000 0.0000
H 48 96.000000 7200.0000 0.0000
T 0 0.000000 0.0000 0.0000
7323 4328.750000 130451.2500 0.0000
Other 1 2.000000 111.0000 0.0000
---------------------------------------------------------
Total 11011 7696.750000 276881.0000 112578.9500
Center 09
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 2 0.500000 18.5000 0.0000
U 0 0.000000 0.0000 0.0000
B 171 174.000000 6973.5100 120.2500
P 14947 13924.500000 519274.8800 519850.9200
D 14 12.500000 772.4600 0.0000
S 0 0.000000 0.0000 0.0000
H 274 402.500000 20147.7500 0.0000
T 2 2.500000 129.5000 259.0000
68 77.250000 4503.7500 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 15478 14593.750000 551820.3500 520230.1700
Center 10
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 180 151.000000 5587.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 3446 2783.750000 114474.7500 18.5000
P 5902 4773.250000 202437.5000 201709.9580
D 8 7.500000 277.5000 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
6180 5389.750000 204479.7500 0.0000
Other 1 0.500000 18.5000 0.0000
---------------------------------------------------------
Total 15717 13105.750000 527275.0000 201728.4580
Center 51
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 3 3.000000 166.5000 0.0000
U 0 0.000000 0.0000 0.0000
B 593 387.750000 15292.5000 0.0000
P 38 38.000000 2062.5000 2193.0000
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
3741 2395.250000 84100.0900 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 4375 2824.000000 101621.5900 2193.0000
Center 52
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 13 12.500000 547.0000 18.5000
U 0 0.000000 0.0000 0.0000
B 299 289.000000 14333.2300 0.0000
P 1777 1728.000000 80851.0500 78243.5100
D 0 0.000000 0.0000 0.0000
S 293 248.000000 9039.2500 0.0000
H 106 134.750000 9395.5000 74.9000
T 2066 22824.500000 61769.0400 50289.1000
2112 1510.500000 50593.6800 36.6700
Other 1 0.250000 9.2500 9.2500
---------------------------------------------------------
Total 6667 26747.500000 226538.0000 128671.9300
Center 53
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 28 23.750000 930.7500 0.0000
U 0 0.000000 0.0000 0.0000
B 1684 1562.750000 73842.7500 50.0000
P 1583 1522.250000 72893.2200 73592.2100
D 195 212.550000 11243.9200 0.0000
S 1 1.000000 37.0000 0.0000
H 29 30.250000 2102.3700 0.0000
T 0 0.000000 0.0000 0.0000
11310 9373.500000 184810.2500 37.0000
Other 76 72.750000 4472.4400 0.0000
---------------------------------------------------------
Total 14906 12798.800000 350332.7000 73679.2100
Center 54
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 133 139.750000 5464.6400 0.0000
U 0 0.000000 0.0000 0.0000
B 2503 1957.250000 90261.1900 55.5000
P 3059 2402.460000 106435.5000 5036653.4700
D 173 167.750000 11149.9300 0.0000
S 0 0.000000 0.0000 0.0000
H 23 23.750000 1700.5500 0.0000
T 1 0.750000 0.0000 0.0000
12809 9589.040000 199711.0100 46.2500
Other 84 85.250000 5874.7300 64.7500
---------------------------------------------------------
Total 18785 14366.000000 420597.5500 5036819.9700
Center 55
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 931 729.500000 30554.5000 0.0000
P 2782 2345.500000 95911.2500 95681.0000
D 0 0.000000 0.0000 0.0000
S 1 1.303467 97.7600 0.0000
H 8 16.000000 1200.0000 0.0000
T 0 0.000000 0.0000 0.0000
4126 2480.443066 89329.4800 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 7848 5572.746533 217092.9900 95681.0000
Center 57
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 1 1.000000 37.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 362 430.000000 16690.7500 55.0000
P 3342 3867.250000 155281.2500 151937.2700
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 9 11.500000 862.5000 0.0000
T 0 0.000000 0.0000 0.0000
3599 3742.500000 143591.5000 0.0000
Other 1 0.500000 18.5000 18.5000
---------------------------------------------------------
Total 7314 8052.750000 316481.5000 152010.7700