CMS/EIP Fiscal Report Center: 01
Services beginning 01/01/2020 ending 03/31/2020 Date of Report:05/15/2020 Page: 1
List order: No List
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 598 261.750000 9684.7500 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 783 734.250000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 2654 8948.500000 331076.0000 36.9979
Subtotal (Total Children Is Unduplicated) 2668 9944.500000 340760.7500 34.2663
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Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 9 9.000000 436.5000 48.5000
EXIT-EXIT-EXIT ASSESSMENT 198 374.500000 18725.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 20 33.000000 2392.9000 72.5121
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 1 0.500000 37.5000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 29 66.000000 4950.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 19 47.000000 2608.5000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 110 187.000000 13974.0000 74.7273
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 23 32.500000 2437.5000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 7 11.500000 862.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 280 449.500000 24947.2500 55.5000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 1 2.000000 111.0000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 231 386.000000 28950.0000 75.0000
PSTF-97164-PT RE-EVAL EST PLAN CARE 1 1.000000 51.0500 51.0500
PSTH-97163-PT EVAL HIGH COMPLEXITY 1 1.000000 51.0500 51.0500
SPCH-92521-EVAL OF SPEECH FLUENCY 2 2.000000 102.1000 51.0500
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 11 11.000000 561.5500 51.0500
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.0500 51.0500
SPCH-92610-EVAL OF ORAL,PHARYNGEAL SWALLOWING FUNC 2 2.000000 97.8800 48.9400
Subtotal (Total Children Is Unduplicated) 610 1616.500000 101347.3300 62.6955
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 1 1.000000 195.0000 195.0000
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 287 381.750000 19047.5000 49.8952
COIFF-COIFFGT-IFSP CONSULT,PROF,FACE TO FACE 1 0.500000 25.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 45 49.250000 1231.2500 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 79 145.500000 7275.0000 50.0000
CONIF-CONIFGT-CONSULT,ITDS,FACE TO FACE 2 2.000000 100.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 35 42.000000 1050.0000 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 39 60.500000 3025.0000 50.0000
CONOF-CONOFGT-CONSULT,OT,FACE TO FACE 5 4.000000 200.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 9 8.500000 212.5000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 49 68.500000 3425.0000 50.0000
CONPF-CONPFGT-CONSULT,PT,FACE TO FACE 5 4.500000 225.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 1 1.750000 43.7500 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 82 138.750000 6787.5000 48.9189
CONSF-CONSFGT-CONSULT,SLP,FACE TO FACE 9 9.000000 450.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 24 23.000000 575.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 569 3347.000000 167270.0000 49.9761
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 115 138.750000 6937.5000 50.0000
INTR-T1013-INTERPRETER 263 668.750000 33437.5000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 1526 11568.00000 115364.3000 9.9727
OCCT-97530-OT SESSION BY LICENSED OT 64 403.750000 28754.2900 71.2181
OCCT-97530GT-OT SESSION BY LICENSED OT 22 24.000000 1703.8800 70.9950
PHY-97110-PT SESSION BY LICENSED PT 86 485.750000 34598.5900 71.2272
PHY-97110GT-PT SESSION BY LICENSED PT 21 26.000000 1856.3100 71.3965
PHY-97110HM-PT SESSION BY PT ASST 2 2.000000 114.3200 57.1600
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 155 814.750000 58203.9800 71.4378
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 30 34.750000 2482.5400 71.4400
SPL-92508-GROUP SPL SESSION PER CHILD 2 2.000000 27.7600 13.8800
TELEC-TELEC-TELECONFERENCE,PROVIDER TO FAMILY,PHONE 57 42.000000 1554.0000 37.0000
TRAV-TRAVS-Travel by mile 981 76616.00000 31908.9000 0.4165
Subtotal (Total Children Is Unduplicated) 1833 95114.00000 528081.3700 5.5521
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Total 106675.000000 970189.4500 9.0948
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Number of Children (Unduplicated) With at Least One Service 2756
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Center 01
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 21414 89062.500000 395230.9000 395230.9000
D 652 1455.750000 21240.0100 0.0000
S 6 5.000000 279.8800 0.0000
H 11032 7632.250000 332663.3700 297861.9900
T 862 3051.500000 21712.2200 21374.5800
8050 5151.000000 178534.8200 0.0000
Other 194 317.000000 20528.2500 0.0000
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Total 42210 106675.000000 970189.4500 714467.4700