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
Payclass Filters:GR
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 748 3201.500000 118455.5000 37.0000
Subtotal (Total Children Is Unduplicated) 1896 9188.750000 339835.7500 36.9839
-----------------------------------------------------------------------------------------------------------------------
Screening, Eval, and Assessment,Class #02
EXIT-EXIT-EXIT ASSESSMENT 99 160.250000 8012.5000 50.0000
IPDEF-T1024TSGT-F/U PHYC AND DEV EVAL BY ITDS 1 2.000000 111.0000 55.5000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 11 19.000000 1425.0000 75.0000
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 12 22.500000 1687.5000 75.0000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 40 77.000000 4273.5000 55.5000
SPCH-92523GT-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 1.000000 51.0500 51.0500
Subtotal (Total Children Is Unduplicated) 148 281.750000 15560.5500 55.2282
-----------------------------------------------------------------------------------------------------------------------
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-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 11 51.000000 2550.0000 50.0000
INTR-T1013-INTERPRETER 77 288.750000 14387.5000 49.8268
OCCT-97530GT-OT SESSION BY LICENSED OT 1 4.000000 285.7600 71.4400
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 2 18.000000 1285.9200 71.4400
Subtotal (Total Children Is Unduplicated) 120 413.250000 20859.1800 50.4759
-----------------------------------------------------------------------------------------------------------------------
Total 9883.750000 376255.4800 38.0681
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 1906
-----------------------------------------------------------------------------------------------------------------------
Center 09
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 6788 6275.750000 238927.5800 238927.5800
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
3757 3603.000000 137068.9000 0.0000
Other 3 5.000000 259.0000 0.0000
---------------------------------------------------------
Total 10548 9883.750000 376255.4800 238927.5800