This template helps EPT practices prepare the key performance indicator information required for biannual submission through the EPT Deliverable Portal. Practices use it to report the administrative measures associated with Milestones 18, 19, and 20: empanelment, patient-side continuity, and third next available appointment. The template also collects current Medi-Cal assigned lives and performance on quality-of-care measures specific to the practice’s selected population of focus. Practices can use this resource to organize results, confirm reporting periods, document required supporting information, and prepare a complete and consistent KPI submission. Milestone achievement or improvement benchmarks generally must be sustained across two consecutive submissions or met in the final submission for payment eligibility.