CMS/EIP Fiscal Report              Center: 03 
Services beginning 10/01/2017 ending 12/31/2017                Date of Report:02/03/2018   Page:   1
            List order: No List
    Payclass Filters:TPIN    
    Eligibility Filter:Not Part C
 
 
Services                                              Number of            Number of    Fee Reported          Avg Fee
                                                      Children             Units                              Per/Unit
 
EI Services,Class #03
  INTR-T1013-INTERPRETER                                   2               7.000000          225.0000           32.1429
Subtotal (Total Children Is Unduplicated)                  2               7.000000          225.0000           32.1429
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Total                                                                      7.000000          225.0000           32.1429
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Number of Children (Unduplicated) With at Least One Service          2
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Center 03
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 
               3       7.000000     225.0000       0.0000 
Other          0       0.000000       0.0000       0.0000 
---------------------------------------------------------
Total          3       7.000000     225.0000       0.0000