CMS/EIP Fiscal Report              Center: 53 
Services beginning 10/01/2016 ending 12/31/2016                Date of Report:02/04/2017   Page:   1
            List order: No List
    Payclass Filters:OTHER    
    Eligibility Filter:Program Patients
 
 
Services                                              Number of            Number of    Fee Reported          Avg Fee
                                                      Children             Units                              Per/Unit
 
  
There was no data found using the above listed filters!