CMS/EIP Fiscal Report              Center: 01 
Services beginning 04/01/2009 ending 06/30/2009                Date of Report:08/25/2009   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
  EIIF-EIIF_NM-EI INDIVIDUAL SESSION BY NONMED PROF       37             218.00        10900.00           50.00
Subtotal (Total Children Is Unduplicated)                 37             218.00        10900.00           50.00
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Total                                                                    218.00        10900.00           50.00
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Number of Children (Unduplicated) With at Least One Service         37
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Center 01
Flag      Claims      Units       Chgs       Paid
-------------------------------------------------
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 
              81     218.00   10900.00       0.00 
Other          0       0.00       0.00       0.00 
-------------------------------------------------
Total         81     218.00   10900.00       0.00