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
Agency Filter:EXT
Payclass Filters:GR
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
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 9 9.000000 436.5000 48.5000
EXIT-EXIT-EXIT ASSESSMENT 177 342.000000 17100.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 2 4.000000 217.9000 54.4750
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 12 21.500000 1612.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 28 50.000000 2775.0000 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 5 7.500000 562.5000 75.0000
SPCH-92521-EVAL OF SPEECH FLUENCY 1 1.000000 51.0500 51.0500
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.0500 51.0500
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.0500 51.0500
Subtotal (Total Children Is Unduplicated) 224 437.000000 22857.5500 52.3056
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 232 298.250000 14872.5000 49.8659
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 33 36.750000 918.7500 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 59 117.000000 5850.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 19 14.750000 368.7500 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 21 31.000000 1550.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 1 1.000000 25.0000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 19 25.000000 1250.0000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 49 92.000000 4450.0000 48.3696
CONSP-CONSP-CONSULT, SLP, PHONE 4 4.000000 100.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 127 627.750000 31387.5000 50.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 19 25.750000 1287.5000 50.0000
INTR-T1013-INTERPRETER 96 424.250000 21212.5000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 1526 11568.00000 115364.3000 9.9727
OCCT-97530-OT SESSION BY LICENSED OT 4 8.000000 511.7800 63.9725
PHY-97110-PT SESSION BY LICENSED PT 11 65.000000 4643.6000 71.4400
PHY-97110GT-PT SESSION BY LICENSED PT 1 1.000000 71.4400 71.4400
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 11 32.000000 2286.0800 71.4400
TELEC-TELEC-TELECONFERENCE,PROVIDER TO FAMILY,PHONE 19 12.750000 471.7500 37.0000
TRAV-TRAVS-Travel by mile 981 76599.00000 31901.5600 0.4165
Subtotal (Total Children Is Unduplicated) 1568 89983.25000 238523.0100 2.6507
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Total 90420.250000 261380.5600 2.8907
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Number of Children (Unduplicated) With at Least One Service 1575
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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 18714 86331.500000 244872.0000 244872.0000
D 388 1188.500000 5831.6700 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 681 2865.250000 10219.0400 10219.0400
2 30.000000 112.1000 0.0000
Other 3 5.000000 345.7500 0.0000
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Total 19788 90420.250000 261380.5600 255091.0400