CMS/EIP Fiscal Report Statewide
Services beginning 07/01/2019 ending 06/30/2020 Date of Report:07/21/2020 Page: 1
List order: No List
Payclass Filters:LEA
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-T1024GNTS-F/U PSYCH AND DEV EVAL BY SPAT 6 11.500000 862.5000 75.0000
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 1 2.000000 150.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 1 1.500000 83.2500 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 74 142.000000 10650.0000 75.0000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 8 16.000000 1200.0000 75.0000
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 2 4.000000 300.0000 75.0000
OCTH-97166-OT EVAL MODERATE COMPLEXITY 1 1.000000 51.0500 51.0500
OCTH-97167-OT EVAL HIGH COMPLEXITY 6 6.000000 306.3000 51.0500
PSTH-97163-PT EVAL HIGH COMPLEXITY 4 4.000000 204.2000 51.0500
SPCH-92523-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 13 13.000000 663.6500 51.0500
SPCH-92524-BEHAV & QUAL ANALYSIS OF VOICE AND RES 1 1.000000 51.0500 51.0500
Subtotal (Total Children Is Unduplicated) 113 202.000000 14522.0000 71.8911
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EI Services,Class #03
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 96 4538.000000 113450.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 18 252.000000 12600.0000 50.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 21 317.500000 15875.0000 50.0000
OCCT-97530-OT SESSION BY LICENSED OT 58 453.500000 32398.0400 71.4400
OCCT-97530HM-OT SESSION BY OT ASST 106 515.250000 29472.3000 57.2000
PHY-97110-PT SESSION BY LICENSED PT 44 229.500000 16395.4800 71.4400
PHY-97110GT-PT SESSION BY LICENSED PT 9 22.000000 1571.6800 71.4400
PHY-97110HM-PT SESSION BY PT ASST 84 378.750000 21649.3500 57.1600
PHY-97110HMGT-PT SESSION BY LICENSED PT ASST 6 5.500000 314.3800 57.1600
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 78 449.750000 32130.1400 71.4400
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 6 13.000000 928.7200 71.4400
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 124 578.000000 33061.6000 57.2000
SPL-92507HMGT-SPL THERAPY SESSION BY SLP ASST 1 2.000000 114.4000 57.2000
SPL-92508-GROUP SPL SESSION PER CHILD 5 2.250000 31.2300 13.8800
Subtotal (Total Children Is Unduplicated) 253 7757.000000 309992.3200 39.9629
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Total 7959.000000 324514.3200 40.7733
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Number of Children (Unduplicated) With at Least One Service 347
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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 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
158 2436.750000 64646.8400 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 158 2436.750000 64646.8400 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 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
92 177.000000 13245.7500 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 92 177.000000 13245.7500 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 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
1311 5345.250000 246621.7300 246766.2700
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 1311 5345.250000 246621.7300 246766.2700