CMS/EIP Fiscal Report              Center: 06 
Services beginning 04/01/2025 ending 06/30/2025                Date of Report:07/19/2025   Page:   1
            List order: No List
    Agency Filter:EXT       
    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                                      88              88.000000         4400.0000           50.0000
Subtotal (Total Children Is Unduplicated)                 88              88.000000         4400.0000           50.0000
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EI Services,Class #03
  AUD-92630-AUD REHAB PRELING HEARING LOSS                 2               2.000000          138.7000           69.3500
  COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE            53              50.250000         2500.0000           49.7512
  COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE          68              71.500000         3437.5000           48.0769
  COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE                23              22.000000          531.2500           24.1477
  CONIF-CONIF-CONSULT, ITDS FACE TO FACE                   5               6.500000          325.0000           50.0000
  CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE                7               6.250000          312.5000           50.0000
  CONOF-CONOF-CONSULT, OT, FACE TO FACE                    1               2.000000          100.0000           50.0000
  CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE                  5               8.000000          400.0000           50.0000
  CONOP-CONOP-CONSULT, OT, PHONE                           1               1.000000           25.0000           25.0000
  CONPF-CONPF-CONSULT, PT, FACE TO FACE                    2               4.000000          175.0000           43.7500
  CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE                  1               0.500000           25.0000           50.0000
  CONSF-CONSF-CONSULT, SLP, FACE TO FACE                   2               3.500000          175.0000           50.0000
  CONSP-CONSP-CONSULT, SLP, PHONE                          1               3.000000           75.0000           25.0000
  EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF          886            6738.250000       362829.0000           53.8462
  EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF        209            1111.750000        59494.5000           53.5143
  EPIC-99601-Early Steps Professional Development Fee    652            4311.000000        64497.0000           14.9610
  INTR-T1013-INTERPRETER                                  64             540.000000        34885.0000           64.6019
  NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE             428            2865.000000        33936.0000           11.8450
  OCCT-97530-OT SESSION BY LICENSED OT                     1               7.000000          569.2400           81.3200
  OCCT-97530GT-OT SESSION BY LICENSED OT                   5              20.000000         1618.3000           80.9150
  OCCT-97530HM-OT SESSION BY OT ASST                       3               5.000000          325.6000           65.1200
  OCCT-97530HMGT-OT SESSION BY OT ASST                     1               1.500000           65.1200           43.4133
  PHY-97110-PT SESSION BY LICENSED PT                     14             128.000000         9430.6400           73.6769
  PHY-97110GT-PT SESSION BY LICENSED PT                    4               9.500000          772.5400           81.3200
  PHY-97110HM-PT SESSION BY PT ASST                        9              68.000000         4165.0500           61.2507
  PHY-97110HMGT-PT SESSION BY PT ASST                      6              24.000000         1410.7100           58.7796
  SPL-92507-SPL THERAPY SESSION BY LICENSED SLP           28             185.500000        15084.8600           81.3200
  SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP         16              88.000000         7156.1600           81.3200
Subtotal (Total Children Is Unduplicated)               1108            16283.00000       604459.6700           37.1221
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Total                                                                  16371.000000       608859.6700           37.1914
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Number of Children (Unduplicated) With at Least One Service       1115
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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           8495    8604.500000  252249.9000  252249.9000 
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 
            7599    7766.500000  356609.7700       0.0000 
Other          0       0.000000       0.0000       0.0000 
---------------------------------------------------------
Total      16094   16371.000000  608859.6700  252249.9000