CMS/EIP Fiscal Report Center: 10
Services beginning 07/01/2024 ending 06/30/2025 Date of Report:07/19/2025 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 2 4.500000 225.0000 50.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 43 563.750000 30085.5000 53.3667
Subtotal (Total Children Is Unduplicated) 43 568.250000 30310.5000 53.3401
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Total 568.250000 30310.5000 53.3401
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Number of Children (Unduplicated) With at Least One Service 43
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Center 10
Flag Claims Units Chgs Paid
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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
640 568.250000 30310.5000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 640 568.250000 30310.5000 0.0000