CMS/EIP Fiscal Report Center: 09
Services beginning 01/01/2020 ending 03/31/2020 Date of Report:05/15/2020 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 1881 5004.500000 185166.5000 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 591 604.750000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1951 7349.750000 271894.5000 36.9937
Subtotal (Total Children Is Unduplicated) 2153 12959.00000 457061.0000 35.2698
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 110 221.000000 11050.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 14 23.500000 1762.5000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 4 6.500000 487.5000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 2 4.000000 300.0000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 2 3.500000 262.5000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 15 25.500000 1415.2500 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 136 226.000000 16800.0000 74.3363
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 2 3.500000 262.5000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 111 190.000000 14150.0000 74.4737
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 2 4.000000 300.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 22 35.500000 2662.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 225 398.500000 21961.2500 55.1098
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 4 7.500000 416.2500 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 55 95.500000 7112.5000 74.4764
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.0500 51.0500
Subtotal (Total Children Is Unduplicated) 504 1245.500000 78993.8000 63.4234
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 12 16.000000 800.0000 50.0000
COIFF-COIFFGT-IFSP CONSULT,PROF,FACE TO FACE 1 2.000000 100.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 8 8.250000 206.2500 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 2 3.000000 150.0000 50.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 4 4.000000 200.0000 50.0000
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 191 247.250000 0.0000 0.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 49 183.000000 9150.0000 50.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 10 10.000000 500.0000 50.0000
INTR-T1013-INTERPRETER 103 212.750000 10637.5000 50.0000
OCCT-97530-OT SESSION BY LICENSED OT 13 70.500000 5036.5200 71.4400
OCCT-97530GT-OT SESSION BY LICENSED OT 4 4.000000 285.7600 71.4400
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 22 136.000000 9490.8400 69.7856
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 11 13.000000 928.7200 71.4400
Subtotal (Total Children Is Unduplicated) 299 909.750000 37485.5900 41.2043
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Total 15114.250000 573540.3900 37.9470
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Number of Children (Unduplicated) With at Least One Service 2202
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Center 09
Flag Claims Units Chgs Paid
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R 1 2.000000 150.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 176 171.250000 6781.2500 0.0000
P 15765 14357.000000 537682.2800 537731.5400
D 58 53.500000 2186.1400 0.0000
S 0 0.000000 0.0000 0.0000
H 343 512.500000 25462.0000 0.0000
T 0 0.000000 0.0000 0.0000
15 15.500000 1116.2200 0.0000
Other 2 2.500000 162.5000 0.0000
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Total 16360 15114.250000 573540.3900 537731.5400