CMS/EIP Fiscal Report Statewide
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
Payclass Filters:GR
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 13046 15164.00000 560910.7500 36.9896
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 6451 6100.250000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 8421 26557.00000 981954.2500 36.9753
Subtotal (Total Children Is Unduplicated) 18990 47821.25000 1542865.0000 32.2632
-----------------------------------------------------------------------------------------------------------------------
Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 12 15.000000 727.5000 48.5000
EVAL-96111-DEVELOPMENTAL EVALUATION 45 48.750000 2437.5000 50.0000
EXIT-EXIT-EXIT ASSESSMENT 604 845.500000 42275.0000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 13 22.500000 1687.5000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 11 16.500000 1200.0000 72.7273
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 1 1.500000 112.5000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 19 21.000000 1575.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 35 40.500000 2247.7500 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 294 494.646867 37098.5149 75.0000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 3 4.836800 362.7600 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 128 195.000000 14625.0000 75.0000
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 3 4.000000 300.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 57 91.000000 6825.0000 75.0000
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 1 2.000000 150.0000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 455 619.000000 34354.5000 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 130 200.200800 15015.0600 75.0000
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 2 4.000000 300.0000 75.0000
OCTH-97165-OT EVAL LOW COMPLEXITY 1 1.000000 51.0500 51.0500
OCTH-97167-OT EVAL HIGH COMPLEXITY 2 2.000000 102.1000 51.0500
PSTH-97163-PT EVAL HIGH COMPLEXITY 1 1.000000 51.0500 51.0500
SCREEN-T1023-SCREENING 55 56.000000 2800.0000 50.0000
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 17 17.000000 867.8500 51.0500
Subtotal (Total Children Is Unduplicated) 1458 2704.934467 165276.6349 61.1019
-----------------------------------------------------------------------------------------------------------------------
EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 278 308.500000 15400.0000 49.9190
COIFF-COIFFGT-IFSP CONSULT,PROF,FACE TO FACE 19 33.500000 1675.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 39 35.250000 881.2500 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 809 726.750000 36337.5000 50.0000
CONIF-CONIFGT-CONSULT,ITDS,FACE TO FACE 90 71.000000 3550.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 63 50.750000 1268.7500 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 564 329.750000 16487.5000 50.0000
CONOF-CONOFGT-CONSULT,OT,FACE TO FACE 21 12.500000 625.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 33 19.000000 468.7500 24.6711
CONPF-CONPF-CONSULT, PT, FACE TO FACE 351 225.750000 11287.5000 50.0000
CONPF-CONPFGT-CONSULT,PT,FACE TO FACE 21 11.500000 575.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 32 10.250000 256.2500 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 435 368.000000 18362.5000 49.8981
CONSF-CONSFGT-CONSULT,SLP,FACE TO FACE 32 22.000000 1100.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 55 36.250000 906.2500 25.0000
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 1794 4175.250000 0.0000 0.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 7 20.000000 500.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 156 657.000000 32850.0000 50.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 32 41.750000 2087.5000 50.0000
INTR-T1013-INTERPRETER 311 540.750000 27037.5000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 1335 5263.000000 52630.0000 10.0000
OCCT-97530-OT SESSION BY LICENSED OT 30 139.750000 9969.5000 71.3381
OCCT-97530GT-OT SESSION BY LICENSED OT 10 15.000000 1071.6000 71.4400
OCCT-97530HMGT-OT SESSION BY OT ASST 1 1.000000 57.2000 57.2000
PHY-97110-PT SESSION BY LICENSED PT 20 115.500000 8251.3200 71.4400
PHY-97110GT-PT SESSION BY LICENSED PT 10 11.500000 821.5600 71.4400
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 60 251.250000 17834.1800 70.9818
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 15 18.000000 1285.9200 71.4400
SPL-92508-GROUP SPL SESSION PER CHILD 2 2.000000 27.7600 13.8800
TELEC-TELEC-TELECONFERENCE,PROVIDER TO FAMILY,PHONE 151 112.250000 4153.2500 37.0000
TRAV-TRAVS-Travel by mile 469 32377.00000 14405.0800 0.4449
Subtotal (Total Children Is Unduplicated) 3059 46001.75000 282163.6200 6.1338
-----------------------------------------------------------------------------------------------------------------------
Total 96527.934467 1990305.2549 20.6190
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 19831
-----------------------------------------------------------------------------------------------------------------------
Center 01
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 0 0.000000 0.0000 0.0000
D 6 6.000000 428.6400 0.0000
S 1 0.500000 18.5000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
7770 4822.500000 160057.2100 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 7777 4829.000000 160504.3500 0.0000
Center 02
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 0 0.000000 0.0000 0.0000
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
0 0.000000 0.0000 0.0000
Other 3647 13560.250000 60352.3300 0.0000
---------------------------------------------------------
Total 3647 13560.250000 60352.3300 0.0000
Center 03
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 0 0.000000 0.0000 0.0000
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 1 1.000000 50.0000 50.0000
T 0 0.000000 0.0000 0.0000
5256 5383.750000 117501.1800 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 5257 5384.750000 117551.1800 50.0000
Center 04
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 0 0.000000 0.0000 0.0000
D 1 1.000000 55.5000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
3515 3134.000000 123446.0500 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 3516 3135.000000 123501.5500 0.0000
Center 05
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 40 168.000000 3500.2200 3500.2200
D 39 22.250000 861.2500 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
3247 1878.000000 56090.5000 812.5000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 3326 2068.250000 60451.9700 4312.7200
Center 06
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 0 0.000000 0.0000 0.0000
D 1 0.750000 27.7500 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
7006 3785.000000 129992.0000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 7007 3785.750000 130019.7500 0.0000
Center 07
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 5 3.250000 120.2500 0.0000
U 0 0.000000 0.0000 0.0000
B 0 0.000000 0.0000 0.0000
P 0 0.000000 0.0000 0.0000
D 45 28.000000 1036.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 7 14.000000 1050.0000 0.0000
T 0 0.000000 0.0000 0.0000
7756 4325.912600 129125.9950 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 7813 4371.162600 131332.2450 0.0000
Center 09
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 11487 9878.000000 350221.1400 350202.6400
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
0 0.000000 0.0000 0.0000
Other 2 2.500000 162.5000 0.0000
---------------------------------------------------------
Total 11489 9880.500000 350383.6400 350202.6400
Center 10
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 11 32.000000 840.0000 840.0000
D 19 19.000000 988.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
6168 4623.750000 151862.0000 0.0000
Other 59 114.000000 7750.5000 0.0000
---------------------------------------------------------
Total 6257 4788.750000 161440.5000 840.0000
Center 51
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 0 0.000000 0.0000 0.0000
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
2750 1982.250000 69190.3400 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 2750 1982.250000 69190.3400 0.0000
Center 52
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 2 18.250000 17.2600 17.2600
D 0 0.000000 0.0000 0.0000
S 50 42.500000 1572.5000 0.0000
H 0 0.000000 0.0000 0.0000
T 1752 19642.500000 37859.0200 33381.1800
1750 1191.000000 37520.5000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 3554 20894.250000 76969.2800 33398.4400
Center 53
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 2 1.000000 37.0000 37.0000
D 19 19.500000 803.3800 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 3 2.500000 149.5000 0.0000
10169 7268.750000 145768.6000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 10193 7291.750000 146758.4800 37.0000
Center 54
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 1 0.250000 9.2500 0.0000
P 1 0.500000 18.5000 18.5000
D 26 23.000000 1504.1900 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 9 8.500000 405.9400 0.0000
11390 7759.000000 158765.4200 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 11427 7791.250000 160703.3000 18.5000
Center 55
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 0 0.000000 0.0000 0.0000
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
5336 2982.021867 107414.5899 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 5336 2982.021867 107414.5899 0.0000
Center 57
Flag Claims Units Chgs Paid
---------------------------------------------------------
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 3 1.000000 37.0000 37.0000
D 1 0.500000 18.5000 0.0000
S 0 0.000000 0.0000 0.0000
H 1 0.250000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
4332 3781.250000 133676.2500 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 4337 3783.000000 133731.7500 37.0000