CMS/EIP Fiscal Report              Center: 06 
Services beginning 01/01/2025 ending 03/31/2025                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                                      64              64.000000         3200.0000           50.0000
Subtotal (Total Children Is Unduplicated)                 64              64.000000         3200.0000           50.0000
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EI Services,Class #03
  COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE            47              46.250000         2302.0000           49.7730
  COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE          58              60.250000         2975.0000           49.3776
  COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE                35              36.500000          875.0000           23.9726
  CONIF-CONIF-CONSULT, ITDS FACE TO FACE                   1               1.000000           50.0000           50.0000
  CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE                5               4.000000          200.0000           50.0000
  CONIP-CONIP-CONSULT, ITDS PHONE                          1               0.500000           12.5000           25.0000
  CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE                  5               5.000000          250.0000           50.0000
  CONOP-CONOP-CONSULT, OT, PHONE                           2               1.750000           62.5000           35.7143
  CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE                  2               3.000000          150.0000           50.0000
  EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF          347            2297.750000       123283.5000           53.6540
  EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF         76             305.000000        16456.5000           53.9557
  EPIC-99601-Early Steps Professional Development Fee    465            3126.000000        46557.0000           14.8935
  INTR-T1013-INTERPRETER                                  42             296.000000        20400.0000           68.9189
  NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE             408            2607.000000        31047.0000           11.9091
  OCCT-97530-OT SESSION BY LICENSED OT                     2               8.000000          325.2800           40.6600
  PHY-97110-PT SESSION BY LICENSED PT                      2               4.000000          325.2800           81.3200
  PHY-97110HM-PT SESSION BY PT ASST                        1               7.000000          439.5600           62.7943
  PHY-97110HMGT-PT SESSION BY PT ASST                      1               2.000000          130.2400           65.1200
  SPL-92507-SPL THERAPY SESSION BY LICENSED SLP            7              47.500000         3862.7000           81.3200
  SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP          2              12.000000          975.8400           81.3200
Subtotal (Total Children Is Unduplicated)                915            8870.500000       250679.9000           28.2600
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Total                                                                   8934.500000       253879.9000           28.4157
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Number of Children (Unduplicated) With at Least One Service        922
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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           3977    4060.750000  115806.8500  115806.8500 
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 
            4791    4873.750000  138073.0500       0.0000 
Other          0       0.000000       0.0000       0.0000 
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Total       8768    8934.500000  253879.9000  115806.8500