CMS/EIP Fiscal Report Center: 54
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 839 697.000000 25770.5000 36.9735
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 692 658.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1499 4962.250000 183288.7500 36.9366
Subtotal (Total Children Is Unduplicated) 1534 6317.250000 209059.2500 33.0934
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Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 11 14.000000 679.0000 48.5000
EXIT-EXIT-EXIT ASSESSMENT 24 44.750000 2237.5000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 9 16.000000 1200.0000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 8 10.500000 750.0000 71.4286
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 1 1.500000 112.5000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 3 5.500000 412.5000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 3 5.500000 412.5000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 5 11.000000 610.5000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 83 141.000000 10575.0000 75.0000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 5 8.000000 600.0000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 45 66.500000 4950.0000 74.4361
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 12 17.000000 1275.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 34 52.000000 3900.0000 75.0000
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 1 1.500000 112.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 38 60.000000 3330.0000 55.5000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 1 1.500000 83.2500 55.5000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 44 81.000000 6075.0000 75.0000
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 4 9.500000 712.5000 75.0000
SCREEN-T1023-SCREENING 10 10.000000 500.0000 50.0000
Subtotal (Total Children Is Unduplicated) 265 556.750000 38527.7500 69.2012
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 69 75.500000 3750.0000 49.6689
COIFF-COIFFGT-IFSP CONSULT,PROF,FACE TO FACE 1 1.000000 50.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 2 1.500000 37.5000 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 339 157.000000 7850.0000 50.0000
CONIF-CONIFGT-CONSULT,ITDS,FACE TO FACE 9 4.500000 225.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 23 6.250000 156.2500 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 326 134.250000 6712.5000 50.0000
CONOF-CONOFGT-CONSULT,OT,FACE TO FACE 4 2.000000 100.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 19 6.500000 156.2500 24.0385
CONPF-CONPF-CONSULT, PT, FACE TO FACE 186 98.500000 4925.0000 50.0000
CONPF-CONPFGT-CONSULT,PT,FACE TO FACE 16 7.000000 350.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 29 7.500000 187.5000 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 141 91.500000 4537.5000 49.5902
CONSP-CONSP-CONSULT, SLP, PHONE 14 4.750000 118.7500 25.0000
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 660 1764.750000 0.0000 0.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 95 423.500000 21175.0000 50.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 23 33.000000 1650.0000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 614 2171.000000 21710.0000 10.0000
OCCT-97530-OT SESSION BY LICENSED OT 93 485.500000 34630.6800 71.3299
OCCT-97530GT-OT SESSION BY LICENSED OT 35 54.750000 3911.3400 71.4400
OCCT-97530HMGT-OT SESSION BY OT ASST 3 4.000000 228.8000 57.2000
OCCT-97530TL-OT SESSION BY LICENSED OT 3 3.000000 214.3200 71.4400
OCCT-97530TLGT-OT SESSION BY LICENSED OT 1 1.000000 71.4400 71.4400
PHY-97110-PT SESSION BY LICENSED PT 77 315.500000 22539.3200 71.4400
PHY-97110GT-PT SESSION BY LICENSED PT 21 27.000000 1928.8800 71.4400
PHY-97110TLGT-PT SESSION BY LICENSED PT 1 1.000000 71.4400 71.4400
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 87 386.000000 27575.8400 71.4400
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 32 46.250000 3304.1000 71.4400
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 1 1.000000 57.2000 57.2000
SPL-92507TL-SPL THERAPY SESSION BY LICENSED SLP 2 2.000000 142.8800 71.4400
SPL-92508-GROUP SPL SESSION PER CHILD 2 2.000000 27.7600 13.8800
TELEC-TELEC-TELECONFERENCE,PROVIDER TO FAMILY,PHONE 36 22.750000 841.7500 37.0000
Subtotal (Total Children Is Unduplicated) 804 6341.750000 169237.0000 26.6862
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Total 13215.750000 416824.0000 31.5399
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Number of Children (Unduplicated) With at Least One Service 1541
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Center 54
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 1252 1032.750000 48565.8000 157.2500
P 4811 3684.355924 161055.9400 167135.3200
D 346 315.144076 20655.3200 3.3000
S 0 0.000000 0.0000 0.0000
H 4 3.250000 126.7500 34.2500
T 9 8.500000 405.9400 0.0000
11689 8068.750000 179243.5200 0.0000
Other 105 103.000000 6770.7300 0.0000
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Total 18216 13215.750000 416824.0000 167330.1200