CMS/EIP Fiscal Report Center: 10
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: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
EIIF-EIIF_NM-EI INDIVIDUAL SESSION BY NONMED PROF 1 1.500000 75.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 29 95.750000 4800.0000 50.1305
Subtotal (Total Children Is Unduplicated) 30 97.250000 4875.0000 50.1285
-----------------------------------------------------------------------------------------------------------------------
Total 97.250000 4875.0000 50.1285
-----------------------------------------------------------------------------------------------------------------------
Number of Children (Unduplicated) With at Least One Service 30
-----------------------------------------------------------------------------------------------------------------------
Center 10
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
110 97.250000 4875.0000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 110 97.250000 4875.0000 0.0000