CMS/EIP Fiscal Report Center: 57
Services beginning 10/01/2009 ending 12/31/2009 Date of Report:02/16/2010 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 78 12000.0 108000.00 9.00
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 9 353.00 8825.00 25.00
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 5 90.00 4500.00 50.00
OCCT-97530-OT SESSION BY LICENSED OT 41 228.50 15510.58 67.88
PHY-97110-PT SESSION BY LICENSED PT 28 107.50 7297.10 67.88
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 58 268.75 18242.75 67.88
SPL-92508-GROUP SPL SESSION PER CHILD 7 20.50 270.60 13.20
TRAV-TRAV-PROVIDER TRAVEL TO NATURAL ENVIRONMENT 2 102.00 51.00 0.50
Subtotal (Total Children Is Unduplicated) 98 13170.3 162697.03 12.35
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Total 13170.25 162697.03 12.35
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Number of Children (Unduplicated) With at Least One Service 98
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Center 57
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
567 13170.25 162697.03 0.00
Other 0 0.00 0.00 0.00
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Total 567 13170.25 162697.03 0.00