CMS/EIP Fiscal Report Center: 09
Services beginning 01/01/2022 ending 03/31/2022 Date of Report:04/16/2022 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 1837 5984.250000 221380.2500 36.9938
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 1 3.000000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 1808 7211.750000 266816.2500 36.9974
Subtotal (Total Children Is Unduplicated) 1973 13199.00000 488196.5000 36.9874
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Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 99 160.250000 8012.5000 50.0000
IPDEF-T1024GNTSGT-F/U PHYC AND DEV EVAL BY SPAT 5 9.000000 675.0000 75.0000
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 3 5.000000 375.0000 75.0000
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 1 2.000000 150.0000 75.0000
IPDEF-T1024TS-F/U PSYCH AND DEV EVAL BY ITDS 2 3.500000 194.2500 55.5000
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 17 32.500000 1753.7500 53.9615
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 93 165.000000 12225.0000 74.0909
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 82 146.500000 10947.5000 74.7270
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 7 13.000000 975.0000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 2 4.000000 222.0000 55.5000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 268 501.500000 27560.2000 54.9555
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 1 2.000000 150.0000 75.0000
OCTH-97166GT-OT EVAL MODERATE COMPLEXITY 1 1.000000 31.0500 31.0500
OCTH-97166TLGT-OT EVAL MODERATE COMPLEXITY 2 2.000000 102.1000 51.0500
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 4 4.000000 184.2000 46.0500
SPCH-92523TLGT-EVAL OF SPCH SOUND PROD; EVAL LANG COM 2 2.000000 102.1000 51.0500
Subtotal (Total Children Is Unduplicated) 450 1053.250000 63659.6500 60.4412
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 1 1.000000 50.0000 50.0000
COIFF-COIFFGT-IFSP CONSULT,PROF,FACE TO FACE 13 24.500000 1225.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 9 9.000000 225.0000 25.0000
CONIF-CONIFGT-CONSULT,ITDS,FACE TO FACE 7 8.000000 400.0000 50.0000
CONOF-CONOFGT-CONSULT,OT,FACE TO FACE 4 6.000000 300.0000 50.0000
CONSF-CONSFGT-CONSULT,SLP,FACE TO FACE 2 3.000000 150.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 1 1.000000 50.0000 50.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 34 169.000000 8450.0000 50.0000
INTR-T1013-INTERPRETER 77 288.750000 14387.5000 49.8268
OCCT-97530GT-OT SESSION BY LICENSED OT 2 10.000000 674.4000 67.4400
OCCT-97530TLGT-OT SESSION BY LICENSED OT 5 30.500000 2178.9200 71.4400
PHY-97110GT-PT SESSION BY LICENSED PT 1 9.000000 642.9600 71.4400
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 7 44.000000 2855.8000 64.9045
SPL-92507TLGT-SPL THERAPY SESSION BY LICENSED SLP 3 20.000000 1428.8000 71.4400
Subtotal (Total Children Is Unduplicated) 146 623.750000 33018.3800 52.9353
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Total 14876.000000 584874.5300 39.3167
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Number of Children (Unduplicated) With at Least One Service 1984
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Center 09
Flag Claims Units Chgs Paid
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R 10 8.500000 314.5000 0.0000
U 0 0.000000 0.0000 0.0000
B 1055 1109.250000 44273.7600 37.0000
P 10029 9579.000000 370817.7900 371080.8950
D 11 11.000000 550.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 168 274.500000 16089.0000 0.0000
T 12 13.750000 697.7500 729.5000
3904 3823.750000 149976.4800 225.0000
Other 44 56.250000 2155.2500 0.0000
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Total 15233 14876.000000 584874.5300 372072.3950