CMS/EIP Fiscal Report Center: 05
Services beginning 10/01/2008 ending 12/31/2008 Date of Report:02/17/2009 Page: 1
Agency Filter:EXT
Payclass Filters:LEA
Eligibility Filter:Part C (excluding not eligible)
List order: No List
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
EI Services,Class #03
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 7 17.25 431.25 25.00
EIIF-EIIF_NM-EI INDIVIDUAL SESSION BY NONMED PROF 40 276.50 13825.00 50.00
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 17 63.00 3150.00 50.00
Subtotal (Total Children Is Unduplicated) 57 356.75 17406.25 48.79
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Total 356.75 17406.25 48.79
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Number of Children (Unduplicated) With at Least One Service 57
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Center 05
Flag Claims Units Chgs Paid
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R 0 0.00 0.00 0.00
U 0 0.00 0.00 0.00
B 0 0.00 0.00 0.00
P 0 0.00 0.00 0.00
D 0 0.00 0.00 0.00
S 0 0.00 0.00 0.00
H 0 0.00 0.00 0.00
T 0 0.00 0.00 0.00
157 356.75 17406.25 0.00
Other 0 0.00 0.00 0.00
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Total 157 356.75 17406.25 0.00