CMS/EIP Fiscal Report              Center: 57 
Services beginning 04/01/2010 ending 06/30/2010                Date of Report:08/18/2010   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                       58            8656.00        77904.00            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             151.00        10249.88           67.88
  PHY-97110-PT SESSION BY LICENSED PT                     17              87.50         5939.50           67.88
  SPL-92507-SPL THERAPY SESSION BY LICENSED SLP           43             183.50        12455.98           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            9426.50       115965.96           12.30
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Total                                                                   9426.50       115965.96           12.30
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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
-------------------------------------------------
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 
             409    9426.50  115965.96       0.00 
Other          0       0.00       0.00       0.00 
-------------------------------------------------
Total        409    9426.50  115965.96       0.00