CMS/EIP Fiscal Report Center: 52
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 319 145.500000 5383.5000 37.0000
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 187 129.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 734 2174.500000 80190.2500 36.8776
Subtotal (Total Children Is Unduplicated) 796 2449.000000 85573.7500 34.9423
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 2 2.000000 100.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 14 26.500000 1987.5000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 4 8.000000 600.0000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 1 2.000000 150.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 1 2.000000 111.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 118 243.500000 17792.3400 73.0692
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 30 64.000000 4644.6800 72.5731
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 19 40.000000 2935.0000 73.3750
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 51 102.000000 5633.2500 55.2279
OCTH-97166-OT EVAL MODERATE COMPLEXITY 2 2.000000 102.1000 51.0500
SCREEN-T1023-SCREENING 22 22.000000 1100.0000 50.0000
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 11 11.000000 561.5500 51.0500
Subtotal (Total Children Is Unduplicated) 175 525.000000 35717.4200 68.0332
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 43 40.500000 2025.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 3 2.750000 68.7500 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 38 61.250000 3062.5000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 1 0.250000 6.2500 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 17 18.500000 925.0000 50.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 10 10.500000 525.0000 50.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 45 72.750000 3637.5000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 1 0.250000 6.2500 25.0000
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 33 52.250000 0.0000 0.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 119 680.000000 33965.0000 49.9485
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 2 1.500000 75.0000 50.0000
INTR-T1013-INTERPRETER 11 83.500000 4175.0000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 214 1166.000000 11660.0000 10.0000
OCCT-97530-OT SESSION BY LICENSED OT 5 23.000000 1643.1200 71.4400
OCCT-97530GT-OT SESSION BY LICENSED OT 1 1.000000 71.4400 71.4400
PHY-97110-PT SESSION BY LICENSED PT 1 6.000000 428.6400 71.4400
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 61 302.250000 21592.7400 71.4400
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 4 4.000000 285.7600 71.4400
TELEC-TELEC-TELECONFERENCE,PROVIDER TO FAMILY,PHONE 3 2.750000 101.7500 37.0000
TRAV-TRAVS-Travel by mile 282 18402.00000 8187.4900 0.4449
Subtotal (Total Children Is Unduplicated) 311 20931.00000 92442.1900 4.4165
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Total 23905.000000 213733.3600 8.9409
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Number of Children (Unduplicated) With at Least One Service 827
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Center 52
Flag Claims Units Chgs Paid
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R 5 3.250000 120.2500 0.0000
U 0 0.000000 0.0000 0.0000
B 317 289.250000 14158.4100 0.0000
P 1347 1354.500000 63155.4200 62187.8800
D 4 4.000000 200.0000 200.0000
S 523 501.250000 19124.2500 355.7500
H 145 188.500000 12558.1600 447.7600
T 2078 19988.000000 58951.6200 48006.9500
1883 1576.250000 45465.2500 55.6800
Other 0 0.000000 0.0000 0.0000
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Total 6302 23905.000000 213733.3600 111254.0200