CMS/EIP Fiscal Report Center: 06
Services beginning 01/01/2023 ending 03/31/2023 Date of Report:04/20/2023 Page: 1
List order: No List
Agency Filter:EXT
Payclass Filters:GR
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
EXIT-EXIT-EXIT ASSESSMENT 2 4.000000 150.0000 37.5000
Subtotal (Total Children Is Unduplicated) 2 4.000000 150.0000 37.5000
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EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 98 82.750000 3950.0000 47.7341
COIFF-COIFFGT-IFSP CONSULT,PROF,FACE TO FACE 22 18.000000 900.0000 50.0000
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 100 78.000000 1937.5000 24.8397
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 12 14.500000 725.0000 50.0000
CONIF-CONIFGT-CONSULT,ITDS,FACE TO FACE 10 11.500000 550.0000 47.8261
CONIP-CONIP-CONSULT, ITDS PHONE 15 16.000000 387.5000 24.2188
CONOF-CONOF-CONSULT, OT, FACE TO FACE 6 6.000000 300.0000 50.0000
CONOF-CONOFGT-CONSULT,OT,FACE TO FACE 7 12.500000 600.0000 48.0000
CONOP-CONOP-CONSULT, OT, PHONE 8 8.500000 212.5000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 5 5.500000 231.2500 42.0455
CONPF-CONPFGT-CONSULT,PT,FACE TO FACE 3 3.500000 175.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 4 3.500000 87.5000 25.0000
CONSF-CONSF-CONSULT, SLP, FACE TO FACE 2 3.500000 125.0000 35.7143
CONSF-CONSFGT-CONSULT,SLP,FACE TO FACE 1 1.000000 50.0000 50.0000
CONSP-CONSP-CONSULT, SLP, PHONE 3 4.500000 112.5000 25.0000
EIIF-96154-HEALTH AND BEHAVIOR INTERVENTION 5 9.000000 450.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 355 2286.750000 114117.5000 49.9038
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 45 139.250000 6962.5000 50.0000
INTR-T1013-INTERPRETER 1 20.500000 1556.0100 75.9029
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 1094 7202.000000 71570.0000 9.9375
OCCT-97530-OT SESSION BY LICENSED OT 1 5.000000 359.8000 71.9600
OCCT-97530HM-OT SESSION BY OT ASST 1 0.500000 28.8000 57.6000
OCCT-97530HMGT-OT SESSION BY OT ASST 1 3.000000 172.8000 57.6000
PHY-97110-PT SESSION BY LICENSED PT 1 5.250000 377.7900 71.9600
PHY-97110GT-PT SESSION BY LICENSED PT 2 1.250000 89.9500 71.9600
PHY-97110HMGT-PT SESSION BY LICENSED PT ASST 1 2.000000 115.1200 57.5600
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 11 44.000000 3166.2400 71.9600
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 4 8.750000 567.1700 64.8194
Subtotal (Total Children Is Unduplicated) 1151 9996.500000 209877.4300 20.9951
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Total 10000.500000 210027.4300 21.0017
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Number of Children (Unduplicated) With at Least One Service 1151
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Center 06
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 0 0.000000 0.0000 0.0000
P 7675 7608.000000 158618.7000 158618.7000
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
2373 2392.500000 51408.7300 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 10048 10000.500000 210027.4300 158618.7000