CMS/EIP Fiscal Report Center: 51
Services beginning 04/01/2020 ending 06/30/2020 Date of Report:07/21/2020 Page: 1
List order: No List
Agency Filter:EXT
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Screening, Eval, and Assessment,Class #02
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 1 1.000000 75.0000 75.0000
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 1 1.000000 75.0000 75.0000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 42 42.000000 3150.0000 75.0000
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 10 10.000000 750.0000 75.0000
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 3 3.000000 225.0000 75.0000
SPCH-92521GT-EVAL OF SPEECH FLUENCY 1 1.000000 51.0500 51.0500
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.0500 51.0500
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.0500 51.0500
SPCH-92524GT-BEHAV & QUAL ANALYSIS OF VOICE AND RES 2 2.000000 102.1000 51.0500
Subtotal (Total Children Is Unduplicated) 62 62.000000 4530.2500 73.0685
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 1 1.000000 62.0400 62.0400
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 1 1.000000 6.2500 6.2500
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 1 1.000000 50.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 1 0.750000 18.7500 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 2 2.000000 12.5000 6.2500
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 25 203.500000 2825.0000 13.8821
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 46 138.750000 6787.5000 48.9189
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 71 227.000000 2270.0000 10.0000
OCCT-97530-OT SESSION BY LICENSED OT 20 64.000000 4572.1600 71.4400
OCCT-97530GT-OT SESSION BY LICENSED OT 3 4.000000 285.7600 71.4400
OCCT-97530HM-OT SESSION BY OT ASST 5 9.000000 514.8000 57.2000
OCCT-97530HMGT-OT SESSION BY OT ASST 7 34.000000 1944.8000 57.2000
OCCT-97530TLGT-OT SESSION BY LICENSED OT 1 1.000000 71.4400 71.4400
PHY-97110-PT SESSION BY LICENSED PT 5 14.250000 1018.0200 71.4400
PHY-97110GT-PT SESSION BY LICENSED PT 17 47.250000 3047.3700 64.4946
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 49 166.000000 11793.8500 71.0473
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 123 388.500000 27609.0300 71.0657
SPL-92507TL-SPL THERAPY SESSION BY LICENSED SLP 1 4.000000 285.7600 71.4400
SPL-92507TLGT-SPL THERAPY SESSION BY LICENSED SLP 3 10.000000 714.4000 71.4400
SPL-92508TLGT-SPL THERAPY SESSION BY LICENSED SLP 1 1.000000 13.8800 13.8800
TELEC-TELEC-TELECONFERENCE,PROVIDER TO FAMILY,PHONE 1 0.750000 27.7500 37.0000
Subtotal (Total Children Is Unduplicated) 256 1318.750000 63931.0600 48.4785
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Total 1380.750000 68461.3100 49.5827
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Number of Children (Unduplicated) With at Least One Service 312
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Center 51
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 0 0.000000 0.0000 0.0000
P 298 959.000000 41050.2900 41050.2900
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
177 421.750000 27411.0200 10.0000
Other 0 0.000000 0.0000 0.0000
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Total 475 1380.750000 68461.3100 41060.2900