CMS/EIP Fiscal Report Center: 57
Services beginning 10/01/2011 ending 12/31/2011 Date of Report:02/16/2012 Page: 1
List order: No List
Agency Filter:EXT
Payclass Filters:LEA
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
EI Services,Class #03
ECE-ECE-EARLY CHILDHOOD EDUCATION 118 18484.00000 18484.0000 1.0000
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 6 269.000000 6725.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 4 51.000000 2550.0000 50.0000
OCCT-97530-OT SESSION BY LICENSED OT 47 273.000000 18531.2400 67.8800
PHY-97110-PT SESSION BY LICENSED PT 27 170.500000 11573.5400 67.8800
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 51 317.500000 21551.9000 67.8800
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 1 2.000000 108.6400 54.3200
SPL-92508-GROUP SPL SESSION PER CHILD 2 5.500000 72.6000 13.2000
TRAV-TRAV-PROVIDER TRAVEL TO NATURAL ENVIRONMENT 1 38.000000 19.0000 0.5000
Subtotal (Total Children Is Unduplicated) 130 19610.50000 79615.9200 4.0599
-----------------------------------------------------------------------------------------------------------------------
Total 19610.500000 79615.9200 4.0599
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 130
-----------------------------------------------------------------------------------------------------------------------
Center 57
Flag Claims Units Chgs Paid
---------------------------------------------------------
R 0 0.000000 0.0000 0.0000
U 0 0.000000 0.0000 0.0000
B 0 0.000000 0.0000 0.0000
P 0 0.000000 0.0000 0.0000
D 0 0.000000 0.0000 0.0000
S 0 0.000000 0.0000 0.0000
H 0 0.000000 0.0000 0.0000
T 0 0.000000 0.0000 0.0000
637 19610.500000 79615.9200 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 637 19610.500000 79615.9200 0.0000