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:MED
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-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 501 3175.000000 170583.0000 53.7269
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 135 637.500000 34263.0000 53.7459
OCCT-97530-OT SESSION BY LICENSED OT 4 20.000000 1545.0800 77.2540
OCCT-97530GT-OT SESSION BY LICENSED OT 1 4.000000 162.6400 40.6600
PHY-97110-PT SESSION BY LICENSED PT 2 13.000000 1057.1600 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 1 1.000000 81.3200 81.3200
PHY-97110HM-PT SESSION BY PT ASST 2 10.000000 651.2000 65.1200
PHY-97110HMGT-PT SESSION BY PT ASST 1 6.000000 390.7200 65.1200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 1 9.000000 731.8800 81.3200
Subtotal (Total Children Is Unduplicated) 596 3875.500000 209466.0000 54.0488
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Total 3875.500000 209466.0000 54.0488
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Number of Children (Unduplicated) With at Least One Service 596
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Center 06
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
3855 3875.500000 209466.0000 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 3855 3875.500000 209466.0000 0.0000