CMS/EIP Fiscal Report              Center: 06 
Services beginning 10/01/2025 ending 12/31/2025                Date of Report:01/07/2026   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
  AUDE-92552-PURE TONE AUDIOMETRY -AIR ONLY                1               1.000000           21.4600           21.4600
  AUDE-92555-SPEECH AUD THRESHOLD (DETECTION)              1               1.000000           16.1500           16.1500
  AUDE-92567-TYPMANOMETRY (IMPEDANCE TESTING)              1               1.000000            7.9200            7.9200
  EXIT-EXIT-COS Exit                                      89              90.000000         4500.0000           50.0000
Subtotal (Total Children Is Unduplicated)                 90              93.000000         4545.5300           48.8767
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EI Services,Class #03
  COIFF-COIFF-IFSP CONSULT, PROF, FACE TO FACE            46              49.250000         2462.5000           50.0000
  COIFF-COIFFGT-IFSP CONSULT, PROF, TELEMEDICINE          74              78.250000         3787.5000           48.4026
  COIFP-COIFP-IFSP CONSULT, PROF, BY PHONE                15              16.250000          406.2500           25.0000
  CONIF-CONIF-CONSULT, ITDS FACE TO FACE                   4               5.000000          250.0000           50.0000
  CONIF-CONIFGT-CONSULT, ITDS, TELEMEDICINE               10              12.500000          625.0000           50.0000
  CONIP-CONIP-CONSULT, ITDS PHONE                          2               2.000000           50.0000           25.0000
  CONOF-CONOF-CONSULT, OT, FACE TO FACE                    1               1.000000           50.0000           50.0000
  CONOF-CONOFGT-CONSULT, OT, TELEMEDICINE                  8              13.000000          650.0000           50.0000
  CONOP-CONOP-CONSULT, OT, PHONE                           1               1.000000           50.0000           50.0000
  CONPF-CONPF-CONSULT, PT, FACE TO FACE                    1               1.000000           50.0000           50.0000
  CONPF-CONPFGT-CONSULT, PT, TELEMEDICINE                  2               2.500000          125.0000           50.0000
  CONPP-CONPP-CONSULT, PT, PHONE                           1               1.000000           25.0000           25.0000
  CONSP-CONSP-CONSULT, SLP, PHONE                          1               1.000000           25.0000           25.0000
  EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF          333            1992.250000       105610.5000           53.0107
  EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF         90             377.250000        19075.5000           50.5646
  EPIC-99601-Early Steps Professional Development Fee    663            4329.000000        64365.0000           14.8683
  INTR-T1013-INTERPRETER                                  31             151.000000         9357.0000           61.9669
  NESF-99600-NATURAL ENVIRONMENT SUPPORT FEE             218            1181.000000        14052.0000           11.8984
  OCCT-97530GT-OT SESSION BY LICENSED OT                   2               7.000000          406.6000           58.0857
  PHY-97110-PT SESSION BY LICENSED PT                      1               7.000000          569.2400           81.3200
  PHY-97110GPGT-PT SESSION BY LICENSED PT                  1               1.000000           81.3200           81.3200
  PHY-97110GT-PT SESSION BY LICENSED PT                    1               1.000000           81.3200           81.3200
  PHY-97110HMGT-PT SESSION BY PT ASST                      1               6.000000          390.7200           65.1200
  SPL-92507-SPL THERAPY SESSION BY LICENSED SLP            4              34.000000         2764.8800           81.3200
  SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP          4              17.750000         1199.4700           67.5758
Subtotal (Total Children Is Unduplicated)                933            8288.000000       226509.8000           27.3299
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Total                                                                   8381.000000       231055.3300           27.5689
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Number of Children (Unduplicated) With at Least One Service        949
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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           4664    4718.000000  127341.9400  127341.9400 
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 
            3568    3663.000000  103713.3900       0.0000 
Other          0       0.000000       0.0000       0.0000 
---------------------------------------------------------
Total       8232    8381.000000  231055.3300  127341.9400