CMS/EIP Fiscal Report Statewide
Services beginning 10/01/2025 ending 12/31/2025 Date of Report:01/07/2026 Page: 1
List order: No List
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
EIGF-T1027TTSC-EI GROUP SESSION BY EI PROF 104 752.000000 20304.0000 27.0000
EIIF-T1027SC-EI INDIVIDUAL SESSION BY EI PROF 32 102.750000 5548.5000 54.0000
OCCT-97530-OT SESSION BY LICENSED OT 13 17.000000 1382.4400 81.3200
OCCT-97530HM-OT SESSION BY OT ASST 43 162.500000 10582.0000 65.1200
PHY-97110-PT SESSION BY LICENSED PT 44 88.000000 7156.1600 81.3200
PHY-97110HM-PT SESSION BY PT ASST 47 90.500000 5893.3600 65.1200
SPL-92507-SPL THERAPY SESSION BY LICENSED SLP 76 240.500000 19557.4600 81.3200
SPL-92507HM-SPL THERAPY SESSION BY SLP ASST 12 43.500000 2832.7200 65.1200
Subtotal (Total Children Is Unduplicated) 147 1496.750000 73256.6400 48.9438
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Total 1496.750000 73256.6400 48.9438
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Number of Children (Unduplicated) With at Least One Service 147
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Center 04
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 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
1662 1114.000000 55690.0600 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 1662 1114.000000 55690.0600 0.0000
Center 10
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 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
125 102.750000 5548.5000 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 125 102.750000 5548.5000 0.0000
Center 57
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 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
359 280.000000 12018.0800 0.0000
Other 0 0.000000 0.0000 0.0000
---------------------------------------------------------
Total 359 280.000000 12018.0800 0.0000