CMS/EIP Fiscal Report Center: 09
Services beginning 01/01/2016 ending 03/31/2016 Date of Report:05/12/2016 Page: 1
List order: No List
Agency Filter:EXT
Payclass Filters:MED
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
EI Services,Class #03
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 599 4308.000000 215101.2600 49.9307
OCCT-97530-OT SESSION BY LICENSED OT 31 186.000000 13287.8400 71.4400
PHY-97110-PT SESSION BY LICENSED PT 57 472.000000 33719.6800 71.4400
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 60 446.000000 31862.2400 71.4400
Subtotal (Total Children Is Unduplicated) 683 5412.000000 293971.0200 54.3184
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Total 5412.000000 293971.0200 54.3184
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Number of Children (Unduplicated) With at Least One Service 683
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Center 09
Flag Claims Units Chgs Paid
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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
1720 5412.000000 293971.0200 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 1720 5412.000000 293971.0200 0.0000