CMS/EIP Fiscal Report Center: 06
Services beginning 07/01/2024 ending 09/30/2024 Date of Report:04/06/2025 Page: 1
List order: No List
Agency Filter:EXT
Payclass Filters:GR
Eligibility Filter:Part C (excluding not eligible)
Services Number of Number of Fee Reported Avg Fee
Children Units Per/Unit
Screening, Eval, and Assessment,Class #02
EXIT-EXIT-COS Exit 120 93.500000 4631.2500 49.5321
Subtotal (Total Children Is Unduplicated) 120 93.500000 4631.2500 49.5321
-----------------------------------------------------------------------------------------------------------------------
EI Services,Class #03
COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE 78 87.750000 4125.0000 47.0085
COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE 65 70.750000 3312.5000 46.8198
COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE 56 53.500000 1306.2500 24.4159
CONIF-CONIF-CONSULT, ITDS FACE TO FACE 7 11.000000 550.0000 50.0000
CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE 6 7.500000 375.0000 50.0000
CONIP-CONIP-CONSULT, ITDS PHONE 3 3.500000 87.5000 25.0000
CONOF-CONOF-CONSULT, OT, FACE TO FACE 5 6.500000 325.0000 50.0000
CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE 6 7.500000 375.0000 50.0000
CONOP-CONOP-CONSULT, OT, PHONE 2 2.500000 62.5000 25.0000
CONPF-CONPF-CONSULT, PT, FACE TO FACE 3 6.000000 300.0000 50.0000
CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE 1 0.500000 25.0000 50.0000
CONPP-CONPP-CONSULT, PT, PHONE 1 3.000000 75.0000 25.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 405 3223.500000 159129.0000 49.3653
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 92 396.500000 19212.5000 48.4552
EPIC-99601-Early Steps Professional Development Fee 509 4062.000000 60375.0000 14.8634
INTR-T1013-INTERPRETER 37 330.250000 20595.0000 62.3618
NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE 496 3755.000000 44907.0000 11.9593
OCCT-97530-OT SESSION BY LICENSED OT 3 18.500000 899.5000 48.6216
OCCT-97530HM-OT SESSION BY OT ASST 1 7.000000 172.8000 24.6857
OCCT-97530HMGT-OT SESSION BY OT ASST 2 9.000000 518.4000 57.6000
PHY-97110HM-PT SESSION BY PT ASST 1 2.000000 100.7300 50.3650
PHY-97110HMGT-PT SESSION BY PT ASST 1 6.500000 374.1400 57.5600
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 7 53.250000 3831.8700 71.9600
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 2 9.000000 647.6400 71.9600
Subtotal (Total Children Is Unduplicated) 1042 12132.50000 321682.3300 26.5141
-----------------------------------------------------------------------------------------------------------------------
Total 12226.000000 326313.5800 26.6901
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 1063
-----------------------------------------------------------------------------------------------------------------------
Center 06
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 12069 12226.000000 326313.5800 326313.5800
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
0 0.000000 0.0000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 12069 12226.000000 326313.5800 326313.5800