CMS/EIP Fiscal Report Center: 57
Services beginning 04/01/2010 ending 06/30/2010 Date of Report:08/18/2010 Page: 1
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 58 8732.00 78588.00 9.00
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 9 237.00 5925.00 25.00
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 5 68.00 3400.00 50.00
OCCT-97530-OT SESSION BY LICENSED OT 29 155.00 10521.40 67.88
PHY-97110-PT SESSION BY LICENSED PT 17 89.50 6075.26 67.88
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 43 185.00 12557.80 67.88
SPL-92508-GROUP SPL SESSION PER CHILD 6 5.50 72.60 13.20
TRAV-TRAV-PROVIDER TRAVEL TO NATURAL ENVIRONMENT 1 38.00 19.00 0.50
Subtotal (Total Children Is Unduplicated) 75 9510.00 117159.06 12.32
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Total 9510.00 117159.06 12.32
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Number of Children (Unduplicated) With at Least One Service 75
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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
413 9510.00 117159.06 0.00
Other 0 0.00 0.00 0.00
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Total 413 9510.00 117159.06 0.00