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:TPIN
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 20 118.000000 6353.2000 53.8407
EIIF-T1027SCGT-EI INDIVIDUAL SESSION BY EI PROF 2 14.000000 756.0000 54.0000
OCCT-97530HM-OT SESSION BY OT ASST 2 5.000000 325.6000 65.1200
OCCT-97530HMGT-OT SESSION BY OT ASST 1 0.750000 48.8400 65.1200
PHY-97110-PT SESSION BY LICENSED PT 5 54.000000 4391.2800 81.3200
PHY-97110GT-PT SESSION BY LICENSED PT 1 1.000000 81.3200 81.3200
PHY-97110HM-PT SESSION BY PT ASST 3 23.250000 1367.5200 58.8181
PHY-97110HMGT-PT SESSION BY PT ASST 3 11.000000 716.3200 65.1200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 11 60.500000 4448.9800 73.5369
SPL-92507GT-SPL THERAPY SESSION BY LICENSED SLP 6 31.750000 2581.9100 81.3200
Subtotal (Total Children Is Unduplicated) 45 319.250000 21070.9700 66.0015
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Total 319.250000 21070.9700 66.0015
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Number of Children (Unduplicated) With at Least One Service 45
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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 102 100.000000 6967.0200 6967.0200
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
225 219.250000 14103.9500 0.0000
Other 0 0.000000 0.0000 0.0000
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Total 327 319.250000 21070.9700 6967.0200