CMS/EIP Fiscal Report Center: 53
Services beginning 07/01/2021 ending 06/30/2022 Date of Report:08/08/2022 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 2454 6466.500000 239158.7500 36.9843
SCTT-SCTT-SERVICE COORDINATOR TRAVEL 93 100.250000 0.0000 0.0000
TCM-T1017TL-TARGETED CASE MANAGEMENT 2633 10934.75000 404539.5000 36.9958
Subtotal (Total Children Is Unduplicated) 2866 17501.50000 643698.2500 36.7796
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Screening, Eval, and Assessment,Class #02
ASTE-ASTE-ASSISTIVE TECHNOLOGY EVAL 2 2.000000 97.0000 48.5000
EVAL-96111-DEVELOPMENTAL EVALUATION 1 2.000000 100.0000 50.0000
EVAL-96111GT-DEVELOPMENTAL EVALUATION 4 8.000000 400.0000 50.0000
EXIT-EXIT-EXIT ASSESSMENT 1 1.000000 50.0000 50.0000
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 16 31.000000 2325.0000 75.0000
IPDEF-T1024GOTS-F/U PSYCH AND DEV EVAL BY OT 3 6.000000 450.0000 75.0000
IPDEF-T1024GOTSGT-F/U PHYC AND DEV EVAL BY OT 13 23.500000 1762.5000 75.0000
IPDEF-T1024GPTS-F/U PSYCH AND DEV EVAL BY PT 1 2.000000 150.0000 75.0000
IPDEF-T1024GPTSGT-F/U PHYC AND DEV EVAL BY PT 4 8.000000 600.0000 75.0000
IPDEF-T1024TLTS-F/U PSYCH AND DEV EVAL BY EI PROF 1 2.000000 150.0000 75.0000
IPDEF-T1024TLTSGT-F/U PHYC AND DEV EVAL BY EI PROF 9 18.000000 1350.0000 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 16 32.000000 1776.0000 55.5000
IPDEI-T1024GNUK-INITIAL PSYCH AND DEV EVAL BY SPAT 14 24.500000 1837.5000 75.0000
IPDEI-T1024GNUKGT-INITIAL PSYCH AND DEV EVAL BY SPAT 318 578.500000 43575.0000 75.3241
IPDEI-T1024GOUK-INITIAL PSYCH AND DEV EVAL BY OT 14 24.500000 1837.5000 75.0000
IPDEI-T1024GOUKGT-INITIAL PSYCH AND DEV EVAL BY OT 220 410.500000 30787.5000 75.0000
IPDEI-T1024GPUK-INITIAL PSYCH AND DEV EVAL BY PT 9 16.000000 1200.0000 75.0000
IPDEI-T1024GPUKGT-INITIAL PSYCH AND DEV EVAL BY PT 154 252.500000 18937.5000 75.0000
IPDEI-T1024HNUK-INITIAL PSYCH AND DEV EVAL BY ITDS 8 13.500000 749.2500 55.5000
IPDEI-T1024HNUKGT-INITIAL PSYCH AND DEV EVAL BY ITDS 375 695.000000 38564.2500 55.4881
IPDEI-T1024TL-INITIAL PSYCH AND DEV EVAL BY EI PROF 8 13.500000 1012.5000 75.0000
IPDEI-T1024TLGT-INITIAL PSYCH AND DEV EVAL BY EI PROF 105 196.000000 14700.0000 75.0000
SPCH-92522GT-EVAL OF SPCH SOUND PROD 1 1.000000 51.0500 51.0500
SPCH-92523TL-EVAL OF SPCH SOUND PROD; EVAL LANG COMP 1 2.000000 102.1000 51.0500
SPL-92526-TREATMENT OF SWALLOWING DYSFUNCTION 1 6.000000 315.4200 52.5700
Subtotal (Total Children Is Unduplicated) 876 2384.000000 163936.8200 68.7654
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EI Services,Class #03
ASST-ASST-ASSISTIVE TECHNOLOGY 1 3.000000 214.3200 71.4400
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 13 9.000000 450.0000 50.0000
COIFF-COIFFGT-IFSP CONSULT,PROF,FACE TO FACE 74 65.250000 3262.5000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 5 3.750000 93.7500 25.0000
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 22 10.000000 500.0000 50.0000
CONIF-CONIFGT-CONSULT,ITDS,FACE TO FACE 446 455.000000 22750.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 17 6.750000 168.7500 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 54 52.500000 2625.0000 50.0000
CONOF-CONOFGT-CONSULT,OT,FACE TO FACE 363 363.000000 18150.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 23 13.500000 337.5000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 76 157.500000 7875.0000 50.0000
CONPF-CONPFGT-CONSULT,PT,FACE TO FACE 465 343.500000 17175.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 8 2.000000 50.0000 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 69 67.250000 3362.5000 50.0000
CONSF-CONSFGT-CONSULT,SLP,FACE TO FACE 487 376.000000 18800.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 16 12.500000 312.5000 25.0000
DSTT-DSTT-DIRECT SERVICE COORDINATOR TRAVEL 424 2332.750000 0.0000 0.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 1 1.000000 25.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 135 589.000000 29450.0000 50.0000
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 352 2518.250000 125912.5000 50.0000
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 425 2661.000000 26610.0000 10.0000
OCCT-97530-OT SESSION BY LICENSED OT 50 225.250000 16091.8600 71.4400
OCCT-97530GT-OT SESSION BY LICENSED OT 51 291.000000 21586.0800 74.1790
OCCT-97530TL-OT SESSION BY LICENSED OT 32 188.250000 13891.3800 73.7922
OCCT-97530TLGT-OT SESSION BY LICENSED OT 69 340.750000 24409.6000 71.6349
PHY-97110-PT SESSION BY LICENSED PT 34 287.500000 20539.0000 71.4400
PHY-97110GT-PT SESSION BY LICENSED PT 29 159.750000 11412.5400 71.4400
PHY-97110TL-PT SESSION BY LICENSED PT 56 361.250000 25807.7000 71.4400
PHY-97110TLGT-PT SESSION BY LICENSED PT 53 212.750000 15198.8600 71.4400
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 75 389.950000 27858.7000 71.4417
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 82 680.280000 48659.0200 71.5279
SPL-92507TL-SPL THERAPY SESSION BY LICENSED SLP 71 363.800000 25989.1600 71.4380
SPL-92507TLGT-SPL THERAPY SESSION BY LICENSED SLP 130 1043.000000 74454.3600 71.3848
TELEC-TELEC-TELECONFERENCE,PROVIDER TO FAMILY,PHONE 126 189.000000 6993.0000 37.0000
Subtotal (Total Children Is Unduplicated) 1043 14775.03000 611015.5800 41.3546
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Total 34660.530000 1418650.6500 40.9299
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Number of Children (Unduplicated) With at Least One Service 2880
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Center 53
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 162 167.500000 9227.3500 710.7500
P 11697 10753.280000 525554.5900 524385.8400
D 591 553.000000 33256.8200 0.0000
S 837 452.500000 17884.3400 92.5000
H 142 121.500000 6185.6900 9.2500
T 0 0.000000 0.0000 0.0000
32187 21714.750000 771909.9900 0.0000
Other 952 892.500000 54219.3700 286.7500
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Total 46568 34655.030000 1418238.1500 525485.0900