CMS/EIP Fiscal Report Center: 53
Services beginning 07/01/2019 ending 06/30/2020 Date of Report:07/21/2020 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 2264 6312.000000 233396.0000 36.9766
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 1402 2094.750000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 2468 11099.00000 410153.7500 36.9541
Subtotal (Total Children Is Unduplicated) 2622 19505.75000 643549.7500 32.9928
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Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 1 1.000000 48.5000 48.5000
EVAL-96111GT-DEVELOPMENTAL EVALUATION 4 5.000000 250.0000 50.0000
EXIT-EXIT-EXIT ASSESSMENT 17 20.750000 1037.5000 50.0000
IPDEF-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 12 19.500000 1462.5000 75.0000
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 4 5.000000 375.0000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 8 13.000000 975.0000 75.0000
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 2 4.000000 300.0000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 6 9.500000 712.5000 75.0000
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 1 2.000000 150.0000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 21 37.500000 2812.5000 75.0000
IPDEF-T1024TLTSGT-F/U PHYC AND DEV EVAL BY EI PROF 5 9.500000 712.5000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 34 54.500000 3024.7500 55.5000
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 7 13.500000 749.2500 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 102 184.500000 13762.5000 74.5935
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 42 78.500000 5887.5000 75.0000
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 86 145.000000 10875.0000 75.0000
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 31 57.000000 4275.0000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 74 121.000000 9075.0000 75.0000
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 22 38.500000 2887.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 297 499.500000 27638.0000 55.3313
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 104 185.000000 10156.5000 54.9000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 297 534.500000 40050.0000 74.9298
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 65 122.500000 9187.5000 75.0000
SCREEN-T1023-SCREENING 7 13.000000 650.0000 50.0000
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.0500 51.0500
SPCH-92523TL-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.0500 51.0500
SPCH-92523TLGT-EVAL OF SPCH SOUND PROD; EVAL LANG COM 1 1.000000 51.0500 51.0500
Subtotal (Total Children Is Unduplicated) 797 2176.750000 147207.6500 67.6273
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 62 52.500000 2625.0000 50.0000
COIFF-COIFFGT-IFSP CONSULT,PROF,FACE TO FACE 10 9.000000 450.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 18 13.500000 337.5000 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 493 602.500000 30100.0000 49.9585
CONIF-CONIFGT-CONSULT,ITDS,FACE TO FACE 256 226.000000 11300.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 36 20.000000 500.0000 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 367 323.250000 16162.5000 50.0000
CONOF-CONOFGT-CONSULT,OT,FACE TO FACE 191 136.500000 6825.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 74 39.000000 975.0000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 329 267.750000 13387.5000 50.0000
CONPF-CONPFGT-CONSULT,PT,FACE TO FACE 125 53.750000 2687.5000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 7 4.500000 112.5000 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 385 358.250000 17887.5000 49.9302
CONSF-CONSFGT-CONSULT,SLP,FACE TO FACE 234 224.750000 11225.0000 49.9444
CONSP-CONSP-CONSULT, SLP, PHONE 34 18.750000 468.7500 25.0000
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 1014 5418.250000 0.0000 0.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 41 121.000000 3025.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 376 3295.750000 164732.5000 49.9833
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 171 1001.500000 50075.0000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 1062 8402.000000 84000.0000 9.9976
OCCT-97530-OT SESSION BY LICENSED OT 74 591.750000 42263.1800 71.4207
OCCT-97530GT-OT SESSION BY LICENSED OT 43 148.500000 10608.8400 71.4400
OCCT-97530HM-OT SESSION BY OT ASST 2 2.000000 114.4000 57.2000
OCCT-97530TL-OT SESSION BY LICENSED OT 2 2.000000 142.8800 71.4400
OCCT-97530TLGT-OT SESSION BY LICENSED OT 29 102.250000 7304.7400 71.4400
PHY-97110-PT SESSION BY LICENSED PT 76 904.710000 64478.1800 71.2694
PHY-97110GT-PT SESSION BY LICENSED PT 32 158.840000 11384.0800 71.6701
PHY-97110TL-PT SESSION BY LICENSED PT 9 16.250000 1160.9000 71.4400
PHY-97110TLGT-PT SESSION BY LICENSED PT 31 155.500000 11048.0800 71.0487
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 101 945.800000 66040.9660 69.8255
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 58 232.250000 16591.9400 71.4400
SPL-92507TL-SPL THERAPY SESSION BY LICENSED SLP 7 18.000000 1285.9200 71.4400
SPL-92507TLGT-SPL THERAPY SESSION BY LICENSED SLP 35 128.000000 9144.3200 71.4400
SPL-92508-GROUP SPL SESSION PER CHILD 5 4.000000 55.5200 13.8800
SPL-92508TLGT-SPL THERAPY SESSION BY LICENSED SLP 3 2.500000 34.7000 13.8800
TELEC-TELEC-TELECONFERENCE,PROVIDER TO FAMILY,PHONE 88 183.500000 6789.5000 37.0000
TRAV-TRAVS-Travel by mile 16 503.000000 223.7400 0.4448
Subtotal (Total Children Is Unduplicated) 1198 24687.35000 665548.1360 26.9591
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Total 46369.850000 1456305.5360 31.4063
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Number of Children (Unduplicated) With at Least One Service 2636
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Center 53
Flag Claims Units Chgs Paid
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R 31 21.500000 1187.3400 0.0000
U 0 0.000000 0.0000 0.0000
B 3477 2972.000000 142644.1500 149.1900
P 11759 10686.400000 496698.1700 499505.2800
D 1541 1497.940000 86085.4860 0.0000
S 13 12.250000 689.2100 0.0000
H 43 42.500000 2827.1600 50.0000
T 9 17.500000 451.9500 4.4500
41349 30562.010000 688149.0600 37.0000
Other 550 557.750000 37573.0100 0.0000
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Total 58772 46369.850000 1456305.5360 499745.9200