Summary Report for Family Support Plan Service Authorizations (FSPSAs) Overlapping the Report Period                                             Center: 09

This report estimates subtotals of units and fees for the number of days of overlap between each included
FSPSA record and the user-selected report period.  For example, if the FSPSA record authorizes services from
01/01/01 to 08/01/01, and the Report Period is selected as 01/01/01 to 03/01/01, this summary calculates
authorized units/fees for the 28 days of overlap (02/01/01 to 03/01/01).  Note that service authorization periods
may range from 1 to 12 months and may vary in intensity from child to child.
 
FSPSAs overlapping: 04-01-25 and 06-30-25                  Date of Report: 07-19-25                  Page: 1

Eligibility Filter: Program Patients
   
With the filters selected there were 1203 FSPSA's found 


Services  Cpt Code                                       Number of   Number of       Total Units      Total Fees          Avg Fee   
                                                         Children    Records         Overlapping      Overlapping       Per Unit Auth
                                                                                   Report Period     Report Period                



Service Coordination, Class # 01
 SCONLY-SCONLY      *SERVICE COORDINATION ONLY                  25         26           46.723808           $0.0000            $0.0000
                                                         ----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated)                       25         26           46.723808           $0.0000            $0.0000


Screening, Eval, and Assessment, Class # 02
 NUTR  -97802       NUTRITIONAL EVAL, INITIAL                   10         11           35.307937        $1765.4000           $50.0000
 NUTR  -97803       NUTRITIONAL EVAL, FOLLOW-UP                 10         13          126.000000        $6300.0000           $50.0000
 OCTH  -97165       OT EVAL LOW COMPLEXITY                       1          1            1.142857          $66.4100           $58.1100
 SPCH  -92521       EVAL OF SPEECH FLUENCY                       1          1            1.142857          $66.4100           $58.1100
 SPL   -92526       TREATMENT OF SWALLOWING DYSFUNCTION          8         11          120.890475        $7024.9500           $58.1100
                                                         ----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated)                       29         37          284.484126       $15223.1700           $53.5100


EI Services, Class # 03
 COIFF -COIFF       IFSP CONSULT, PROF, FACE TO FACE           130        201          274.683364       $13734.1800           $50.0000
 COIFP -COIFP       IFSP CONSULT, PROF, BY PHONE                47         59           87.515851        $2187.9000           $25.0000
 CONIF -CONIF       CONSULT, ITDS FACE TO FACE                 159        172          186.084094        $9304.2100           $50.0000
 CONOF -CONOF       CONSULT, OT, FACE TO FACE                   93         98           94.009525        $4700.4900           $50.0000
 CONOP -CONOP       CONSULT, OT, PHONE                           2          2            2.000000          $50.0000           $25.0000
 CONPF -CONPF       CONSULT, PT, FACE TO FACE                   51         54           62.427778        $3121.3900           $50.0000
 CONPP -CONPP       CONSULT, PT, PHONE                           1          1            1.000000          $25.0000           $25.0000
 CONSF -CONSF       CONSULT, SLP, FACE TO FACE                  87         92           90.176190        $4508.8100           $50.0000
 CONSP -CONSP       CONSULT, SLP, PHONE                          6          6            5.505556         $137.6400           $25.0000
 EIIF  -T1027SC     EI INDIVIDUAL SESSION BY EI PROF           252        323         2599.823811      $140390.5200           $54.0000
 EIIF  -T1027SCGT   EI INDIVIDUAL SESSION BY EI PROF             1          1           11.000000         $594.0000           $54.0000
 OCCT  -97530       OT SESSION BY LICENSED OT                   23         30          215.342065       $17511.6100           $81.3200
 OCCT  -97530HM     OT SESSION BY OT ASST                        3          6           37.285714        $2428.0400           $65.1200
 OCCT  -97530HMGT   OT SESSION BY OT ASST                        1          1            1.000000          $65.1200           $65.1200
 OCCT  -97530TLGTHM OT SESSION BY OT ASST                        1          1            6.142857         $400.0300           $65.1200
 PHY   -97110       PT SESSION BY LICENSED PT                   33         45          342.309524       $27836.6200           $81.3200
 SPL   -92507       SPL THERAPY SESSION BY LICENSED SLP         39         48          438.621428       $35668.7100           $81.3200
                                                         ----------------------------------------------------------------------------
Subtotal (Total Children Is Unduplicated)                      517       1140         4454.927757      $262664.2600           $58.9600


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Total                                                                    1203         4786.135691      $277887.4300           $58.0600
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Number of Children (Unduplicated) With at Least One Authorization      542