CMS/EIP Fiscal Report              Center: 57 
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
  ECE-ECE-EARLY CHILDHOOD EDUCATION                       64            7651.00        68859.00            9.00
  EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF            4              48.00         2400.00           50.00
  OCCT-97530-OT SESSION BY LICENSED OT                    28              88.50         6007.38           67.88
  PHY-97110-PT SESSION BY LICENSED PT                     17              55.00         3733.40           67.88
  SPL-92507-SPL THERAPY SESSION BY LICENSED SLP           40             138.50         9401.38           67.88
Subtotal (Total Children Is Unduplicated)                 72            7981.00        90401.16           11.33
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Total                                                                   7981.00        90401.16           11.33
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Number of Children (Unduplicated) With at Least One Service         72
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Center 57
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 
             288    7981.00   90401.16     350.00 
Other          0       0.00       0.00       0.00 
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Total        288    7981.00   90401.16     350.00