Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period                                             Center: 04

This report estimates subtotals of units and fees for the number of days of overlap between each included
FSPSA record and the user-selected report period.  For example, if the FSPSA record authorizes services from
01/01/01 to 08/01/01, and the Report Period is selected as 01/01/01 to 03/01/01, this summary calculates
authorized units/fees for the 28 days of overlap (02/01/01 to 03/01/01).  Note that service authorization periods
may range from 1 to 12 months and may vary in intensity from child to child.
 
FSPSAs overlapping: 04-01-20 and 06-30-20                  Date of Report: 07-20-20                  Page: 1

Eligibility Filter: Program Patients
   
With the filters selected there were 2182 FSPSA's found 


Services  Cpt Code                                       Number of   Number of       Total Units      Total Fees          Avg Fee   
                                                         Children    Records         Overlapping      Overlapping       Per Unit Auth
                                                                                   Report Period     Report Period                



Service Coordination, Class # 01
 SCONLY-SCONLY      *SERVICE COORDINATION ONLY                  86         97           63.155553           $0.0000            $0.0000
                                                         ----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated)                       86         97           63.155553           $0.0000            $0.0000


Screening, Eval, and Assessment, Class # 02
 ASTE  -ASTE        ASSISTIVE TECHNOLOGY EVAL                    9         12            3.727781         $180.8100           $48.5000
 OCTH  -97167       OT EVAL HIGH COMPLEXITY                     13         14            4.783336         $244.2000           $51.0500
 PSTH  -97163       PT EVAL HIGH COMPLEXITY                     12         13            4.683337         $239.1000           $51.0500
 SPCH  -92521       EVAL OF SPEECH FLUENCY                       1          1            0.355556          $18.1500           $51.0600
 SPCH  -92522       EVAL OF SPCH SOUND PROD                      1          1            0.172222           $8.7900           $51.0400
 SPCH  -92523       EVAL OF SPCH SOUND PROD; EVAL LANG           9          9            3.405558         $173.8700           $51.0500
                                                         ----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated)                       35         50           17.127790         $864.9300           $50.5000


EI Services, Class # 03
 COIFF -COIFF       IFSP CONSULT, PROF, FACE TO FACE            31         93           26.486114        $1324.3200           $50.0000
 CONIF -CONIF       CONSULT, ITDS FACE TO FACE                   5          8            4.333334         $216.6700           $50.0000
 CONIF -CONIFGT     CONSULT,ITDS,FACE TO FACE                    1          1            1.011111          $50.5600           $50.0000
 CONIP -CONIP       CONSULT, ITDS PHONE                          1          1            1.011111          $25.2800           $25.0000
 CONOF -CONOF       CONSULT, OT, FACE TO FACE                    5          8            4.422223         $221.1200           $50.0000
 CONOP -CONOP       CONSULT, OT, PHONE                           2          2            1.111111          $27.7800           $25.0000
 CONPF -CONPFGT     CONSULT,PT,FACE TO FACE                      1          1            1.011111          $50.5600           $50.0000
 CONSF -CONSF       CONSULT, SLP, FACE TO FACE                   2          2            1.944444          $97.2200           $50.0000
 CONSP -CONSP       CONSULT, SLP, PHONE                          3          3            1.200000          $30.0000           $25.0000
 EIGF  -T1027TTSC   EI GROUP SESSION BY EI PROF                  1          2           13.000000         $325.0000           $25.0000
 EIIF  -T1027SC     EI INDIVIDUAL SESSION BY EI PROF           215        272         2215.571428      $110778.5700           $50.0000
 EIIF  -T1027SCGT   EI INDIVIDUAL SESSION BY EI PROF            10         10          130.714286        $6535.7200           $50.0000
 NESF  -99600       NATURAL ENVIRONMENT SUPPORT FEE           1192       1580        13383.603183      $133836.0500           $10.0000
 OCCT  -97530       OT SESSION BY LICENSED OT                    9         11           88.000000        $6286.7200           $71.4400
 OCCT  -97530HM     OT SESSION BY OT ASST                        3          3           33.000000        $1887.6000           $57.2000
 PHY   -97110       PT SESSION BY LICENSED PT                    7          9           73.142857        $5225.3200           $71.4400
 PHY   -97110HM     PT SESSION BY PT ASST                        5          5           50.142857        $2866.1700           $57.1600
 SPL   -92507       SPL THERAPY SESSION BY LICENSED SLP          2          2           26.000000        $1857.4400           $71.4400
 SPL   -92507HM     SPL THERAPY SESSION BY SLP ASST              5          6           49.142859        $2810.9700           $57.2000
 SPL   -92508       GROUP SPL SESSION PER CHILD                  2          2           14.714285         $204.2300           $13.8800
 TELEC -TELEC       TELECONFERENCE,PROVIDER TO FAMILY,P         10         14           50.178571        $1856.6200           $37.0000
                                                         ----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated)                     1243       2035        16169.740885      $276513.8800           $17.1000


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Total                                                                    2182        16250.024228      $277378.8100           $17.0700
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Number of Children (Unduplicated) With at Least One Authorization      1303